This clinic for gender-affirming health care went private. The founder wishes it didn't have to

Kit Sparrow was faced with two options when he sought out gender-affirming care: wait months for a specialist appointment, or pay out of pocket for a privately run, virtual service.

The Ontario-based accessibility-technology engineer had spent years trying to understand his gender identity. Last March, he decided to visit his family doctor and begin transitioning. 

While his physician responded positively, they didn't have the training or experience to prescribe hormone treatment and instead referred him to an endocrinologist. That referral, Sparrow says, came with a seven-month wait.

"Hearing that I had to wait even longer was just a punch in the gut," he told White Coat, Black Art host Dr. Brian Goldman.

Depending on where a patient is located in Canada, wait times for gender-affirming care can be months to years — a precarious position for people who are already struggling with their mental health, experts say.

Meanwhile, advocates worry that heightened political rhetoric surrounding gender-affirming care for youth could further strain availability within a health-care system that is already under-resourced.

Foria Clinic — a privately run, virtual-only service — wants to help reduce those wait times.

It was born out of the Ontario-based Connect Clinic, a similar online service founded in 2019 by Dr. Kate Greenaway that aimed to make gender-affirming care more accessible for patients in rural parts of the province. Changes to the provincial funding formula in 2022 meant the clinic had to close shop, leaving 1,500 patients — and 2,000 more on the waitlist — without a gender-affirming care physician. 

In order to continue offering care to an underserved population, Greenaway decided to go private. It wasn't her preferred choice, she said, but the province offered no alternative funding options that would cover her costs. 

"This is the last population we want to charge for care," she told Goldman.

The changes to Connect Clinic stemmed from the Ontario government's move to a hybrid model for funding. The shift meant family physicians like Greenaway would have to pair virtual care with in-person visits. 

But Greenaway's practice was based in Toronto, far from her patients in rural Ontario, which ruled out in-person visits. If she had to switch to the hybrid model, her goal of reaching rural Ontarians would be impossible, she said.

After her clinic's closure, Greenaway joined Calgary-based health-care startup PurposeMed, which bills itself as "improving access to complex care for underserved communities," to start Foria.

"It was a tough sell to me," she said. "I am a very strong supporter of our public health system."