‘Come as you are’: New Vancouver clinic focuses on affirming, trauma-informed care

Click to play video: 'New Vancouver health-care clinic focuses on racialized, trans and non-binary people'
New Vancouver health-care clinic focuses on racialized, trans and non-binary people
A new Vancouver clinic has opened to provide wrap-around health-care services to racialized, transgender and non-binary people. Catherine Urquhart reports. – Jun 7, 2023

A new health-care clinic has opened in Vancouver offering trauma-informed, sex-positive and gender-affirming care to women, racialized people, non-binary and trans folks in the Lower Mainland.

The CAYA Health Centre takes its name from the phrase “come as you are,” and opened in April to fill what its founders perceived as a gap in comprehensive services for patients who don’t always fit into the norms.

“We are here to validate your symptoms, not minimize your symptoms. We’re really here to listen,” said Stephanie Dang, a registered dietician who founded CAYA with registered clinical counsellor Dr. Veronica Li.

“In health care, men and women are different. They present differently. Women respond to medication differently. A lot of the medical research is done on men.”

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Dang said the duo’s desire to improve health care interactions and outcomes came from their own experiences as racialized women. Their care centre aims to treat people who “fall through the cracks” trying to find multidisciplinary services that meet their complex needs.

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All of CAYA’s staff — including medical doctors, counsellors, dietitians, physiotherapists, massage therapists, and administrators — identify as women or non-binary, Dang added. She said CAYA faced a few regulatory hurdles to get the centre up and running, but since it opened its doors virtually and in-person on April 11, the reception has been positive.

“I think the number one kind of best thing that we’ve experienced so far is having patients come in and, you know, get emotional on how grateful they are to have access to a place like this,” she explained.

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“You know, feeling heard, feeling validated, listened to — their symptoms are no longer minimized and they have everything. It’s a one-stop shop in one place. That’s been wonderful. It makes all of the challenges completely worth it.”

CAYA’s website says all its services are covered by B.C.’s Medical Services Plan unless otherwise specified by a patient’s doctor. A list of fees is available online.

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While there are many physicians and health-care facilities that offer sex-positive, trauma-informed care and specialize in women’s and non-binary health in B.C., Dang said patients often have to take on the “exhausting” process of travelling to multiple locations and retelling their stories to access a rage of services at safe spaces, such as massage therapy and STI testing.

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At an unrelated press conference Wednesday, Health Minister Adrian Dix said the “health outcomes” speak for themselves when it comes to the groups that CAYA serves, who face “very significant, in some cases unique, challenges.”

“So it’s not surprising that we want specialized care in those area,” he said.

The minister, however, said he’s “very proud of the work” the B.C. government has done to accommodate the health-care needs of all people, from all walks of life and backgrounds.

“I think that the steps that have been taken have been exceptional in B.C. They’ve been country-leading. We’ve caught up, in some cases, with other jurisdictions providing care. But obviously people in those circumstances, their overall health outcomes are challenged so it is a group of people that need supports in the community.”

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The University of British Columbia’s Marina Adshade lauded the expansion of health-care options for female, racialized, trans and non-binary patients in the Lower Mainland. The assistant professor of teaching at the Vancouver School of Economics specializes in the intersection of economics, sex, gender, families and health.

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“I think this space is valuable and I think it’s wonderful that they’ve put in the time and energy to create those safe spaces,” she said.

“Of course, I would like to see those everywhere, right? Because one clinic can only meet the needs of so many people and, you know, here you’re meeting the needs specifically of people in Vancouver where there are other services,” she added.

“What would be amazing is to see that type of attitude spread to other clinics and then outside of the Lower Mainland into other parts of the provinces where people are greatly underserved.”

Adshade said there are broader societal impacts when this group of patients — which represents more than half the population — doesn’t have their health-care needs met. Women going through menopause, for example, tend to drop out of the workforce or experience underemployment due to their symptoms, she explained.

“If we pay more attention to menopause symptoms, women would be able to to work longer. They would retire with more income, they would be better equipped to support their families and so on,” Adshade said.

“So there are real economic costs to not supporting everybody’s health-care needs. That’s where my research comes in, is looking at the economic and societal costs of not meeting the health care needs of the whole population.”

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Intergenerational problems can also stem from poor experiences in health care, Adshade added. Poor outcomes can mean less time volunteering in the community, caring for an elderly parent as well, or spending time with children — particularly for women, who tend to be caregivers.

— with files from Catherine Urquhart

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