Question Period Note: Access to Sexual and Reproductive Health Care Information and Services

• There are key barriers and challenges related to access to sexual and reproductive health (SRH) information and services, including abortion, in Canada. Accurate SRH information and culturally safe and relevant SRH services, particularly for marginalized populations, is lacking across Canada.

• All Canadians should have access to sexual and reproductive health resources and services, no matter where they live.
• Health Canada’s Sexual and Reproductive Health Fund was created in 2021 to advance mandate commitments. Through Budget 2021 and 2023, $81 million has been committed to the fund over six years.
• The fund supports community-based organizations that help make access to abortion, gender affirming, and other sexual and reproductive health care information and services more accessible for underserved populations.
IF PRESSED FOR AN UPDATE ON MANDATE COMMITMENTS
• Since 2021, the Sexual and Reproductive Health Fund (SRHF) has committed $36.1M to community organizations to help make access to abortion, gender affirming care, and other sexual and reproductive health care information and services more accessible for underserved populations. An additional $16.7M has been provided to Quebec.
• Budget 2023 renewed the SRHF until 2026-27.
• The SRHF has funded 21 community organizations..
• The Medical Expense Tax Credit has been expanded to include more costs related to use of reproductive technologies, making conception more affordable.
IF PRESSED ON ACCESS TO CARE FOR TRANS AND NON-BINARY ADOLESCENTS
• Health Canada is aware of the government of Alberta’s proposed policies that would reduce access to gender affirming care for youth.
• Our government believes decisions regarding gender-affirming care should be made using evidence-based information.
• Our government believes that transgender youth and their families should be supported to make informed decisions about the different social and/or medical interventions they may wish to explore.
• The Sexual and Reproductive Health Fund has supported three community organizations that address trans communities access to care with an investment of approximately $7,4 million.
IF PRESSED ON WHETHER ALBERTA’S DECISION ON TRANS CARE IS AGAINST THE CANADA HEALTH ACT
• The aim of the Canda Health Act is to ensure all residents of provinces and territories have reasonable access to medically necessary health care services on uniform terms and conditions and without charges related to the provision of those services.
• The Act does not stipulate specific procedures to be covered by provincial and territorial plans. Rather, provincial and territorial health ministries determine medical necessity, in conjunction with the medical profession.
• Any procedures that are deemed medically necessary by a province or territory must be delivered in a manner that meets that requirements of the Act.
IF PRESSED ON MISINFORMATION AND DISINFORMATION REGARDING THE CARE OF TRANS AND NON-BINARY CHILDREN AND YOUTH
• This government believes that trans and non-binary young people, and their families, should have access to gender affirming, evidence based, and high-quality health care.
• Gender identity is an inherent characteristic that cannot be changed.
• This government is protecting trans and non-binary young people through strategic funding, as well as through outlawing conversion therapy. The government is monitoring with concern the rise of both misinformation and disinformation regarding trans and non-binary young people, and impacts on support and public policy regarding trans and non-binary children, adolescents and adults.
IF PRESSED ON CONCERNS ABOUT DESISTANCE OR TRANSITION REGRET
• While stories of “desistance” or “transition regret” can receive significant media attention and are used as part of misinformation and disinformation campaigns, in fact it is rare that youth stop their gender transition and return to living as their gender assigned at birth. Evidence shows that a number of young people who do stop their transition report it was because they did not have enough support or were experiencing discrimination due to being trans; some of these youth go on to transition later in life.
IF PRESSED ON ABORTION SERVICES – GENERAL

• This Government is committed to upholding the fundamental right to choose and believes that no one should be forced to carry an unwanted or unsafe pregnancy.
• Of the $81 million committed in Budget 2021 and Budget 2023, approximately $11.4 million to date has been invested in three projects focused on access to abortion. Through these projects, new resources and supports are being developed for health care professionals, access to accurate information about abortion is being improved, and financial and logistical support for travel for abortion care is being provided.
IF PRESSED ON ABORTION SERVICES – COMPLIANCE UNDER THE CANADA HEALTH ACT
• While abortion services are insured in all provinces and territories there is still work to be done to improve access in many areas of the country.
• Health Canada continues to engage with Ontario as they work to implement their action plan, including the introduction of new regulations, which is expected to eliminate patient charges for access to abortion services.
• The abortion clinic in New Brunswick closed in February 2024, but New Brunswick remains subject to Canada Health Transfer deductions for patient charges levied through fiscal 2023-24, for refusing to provide coverage for these services.
IF PRESSED ON WHETHER THE GOVERNMENT WILL PROVIDE FUNDING TO ORGANIZATIONS OFFERING ALTERNATIVES TO ABORTION (I.E. CONTINUING THE PREGNANCY)
• This fund is specifically designed to help women access abortion and it will not support initiatives that discourage or are opposed to freedom of choice or attempt to override the individual’s right to make decisions about their own body.
IF PRESSED ON THE LEGAL STATUS OF MEDICATION ABORTION IN THE UNITED STATES AND THE AVAILABILITY OF MIFEGYMISO IN CANADA
• Health Canada is aware that the U.S. Supreme Court heard oral arguments on how patients can access Mifepristone on March 26, 2024, with the judgment expected in June.
• Mifegymiso, which is not available in the U.S., is the only abortion pill authorized in Canada and publicly covered by all provinces and territories. It combines Mifespristone and Misoprostol.
• Health Canada is closely monitoring the supply of Mifegymiso in Canada. There are currently no supply issues.
IF PRESSED ON DATA
• The Government is also investing $7.6 million over five years for Statistics Canada to collect data that will fill existing information gaps and help us target appropriate sexual and reproductive health supports for Canadians.
IF PRESSED ON SEX EDUCATION CURRICULA
• Health Canada is aware of the government of Saskatchewan’s recent policy change and Alberta’s proposed policy change regarding sexual education.
• Our Government is committed to working towards a country where everyone is free to be themselves and participate fully in society. This is especially important when homes and communities are not welcoming spaces for diversity.
• The federal government believes that young people should have access to accurate sex education and that schools should be an inclusive environment where all children can learn about keeping themselves healthy and safe.

The Government of Canada has made strong commitments to gender equality, using a feminist lens, and realizing and protecting sexual and reproductive health rights.

Key barriers and challenges related to inequitable and variable access to sexual and reproductive health services remain. Indigenous, racialized and 2SLGBTQI+ populations, as well as women and youth from underserved populations face the highest sexual and reproductive health risks and the greatest barriers to accessing support, information, and services.

Since the establishment of the Sexual and Reproductive Health Fund, Health Canada has successfully issued two calls for proposals, and is now administering 24 projects. $29M has been committed to 23 SRH projects across Canada, and a further $9.7M has been committed to Québec for projects within that province.

Of these projects, seven address 2SLGBTQI+ communities, four address access to abortion, four focus on Indigenous communities, four address multiple priorities, two focus on racialized people or newcomers, and two specifically address youth.

Canada’s current national-level data on sexual and reproductive health is limited to a narrow range of indicators. There is insufficient data available to support understanding and evidence-based decision-making to address a full range of key indicators of sexual and reproductive health, including prevalence of sexually transmitted infections, contraception use, pregnancy intention, and sexual knowledge and behaviours.

• People who are 2SLGBTQI+, Indigenous, racialized, living with disabilities (including chronic conditions), newcomers, or women and youth from underserved communities face the highest sexual and reproductive health risks and the greatest barriers to accessing support, information, and services. Often, they do not receive quality care.