Pink Triangle Press: 2SLGBTQIA+ Health Disparities in Canada

Pink Triangle Press Commissioned Environics Research on a national research study examining health disparities experienced by 2SLGBTQIA+ people across Canada. The study provides evidence to support more equitable and inclusive healthcare policy and practice.

About The Project

With funding from Women and Gender Equality Canada (WAGE), Pink Triangle Press (PTP) set out to answer a fundamental question: does Canada’s healthcare system truly deliver on its promise of “universal” care for 2SLGBTQIA+ people?

To support evidence-based advocacy and reform, PTP partnered with Environics Research to produce the 2025 Pink Paper on Health; a national, bilingual, comparative study examining health outcomes and healthcare experiences among 2SLGBTQIA+ and non-2SLGBTQIA+ adults across Canada.

Designed to be both rigorous and practical, the study combined a large-scale survey with stakeholder interviews to capture the realities behind the numbers. The result was a first-of-its-kind evidence base documenting disparities across outcomes, access, quality of care, and lived experiences of stigma and discrimination – providing a credible foundation for identity-affirming healthcare reform.

Background

Pink Triangle Press recognized a persistent gap in Canada: standardized, inclusive health data that reflects 2SLGBTQIA+ people’s distinct experiences and needs.  Without that evidence base, inequities can remain invisible – especially when data is aggregated in ways that mask differences under the 2SLGBTQIA+ umbrella.  This project was intended to elevate lived experience, quantify disparities, and equip healthcare leaders, policymakers, and advocates with insights that can drive measurable change. 

Objectives of the Community Consultation

Health outcomes
and wellbeing

Understand how physical and mental health outcomes differ between 2SLGBTQIA+ and non-2SLGBTQIA+ Canadians. 

Healthcare access
and system navigation

Identify where access breaks down, what barriers exist, and how experiences differ once people enter the system. 

Stigma, discrimination,
and priorities for reform

Measure experiences of stigma/discrimination in care settings and clarify what changes would meaningfully improve care and trust.  

The Ask

PTP asked Environics to deliver a national benchmark that could withstand scrutiny and support advocacy. The study needed to be bilingual, pan-Canadian, and comparative (2SLGBTQIA+ and non-2SLGBTQIA+), while balancing statistical rigour with meaningful human context.

The approach also needed to document disparities across key domains: health outcomes, service accessibility, quality of care, and lived experiences of stigma and discrimination; and support intersectional analysis to ensure differences under the 2SLGBTQIA+ umbrella remained visible and could be acted on.

Our Approach

Grounded the work in a mixed-method design

We structured the project in two complementary phases: a national survey to quantify patterns at scale, along with stakeholder interviews to deepen interpretation and connect findings to system-level realities. 

This approach ensured the findings were both credible and actionable by quantifying disparities at a national level while also capturing the lived experiences that shape how people access and experience care.

Fielded a national bilingual survey with a robust sampling strategy

The survey was fielded in spring 2025 and offered in both English and French. The sample was designed to enable robust comparisons and subgroup analysis, including targeted oversamples of 2SLGBTQIA+ subgroups (e.g., trans participants). It also included an open link distributed by PTP that was open only to 2SLGBTQIA+ people, helping to reach communities that are often underrepresented in general population research. 

In total, 2,110 adults completed the survey, including 1,062 2SLGBTQIA+ and 1,048 non-2SLGBTQIA+ respondents. Rigorous data quality checks and cleaning procedures were applied to protect the integrity of the dataset and ensure the conclusions were reliable and defensible.

Ensuring representation in participant profiles to uncover intersectional realities

Identities and lived experiences of individuals are shaped by the intersection of multiple social, cultural, and systemic factors, such as sexual orientation, gender identity, race, socio-economic status, ability, and geography. The report reveals other important differences between intersectionalities. Quality of life is poorer for rural, Black, and Two-Spirit respondents, and poorest for lower income and less educated queers.

This is why it was crucial to ensure various groups were represented in the research sample. Looking at all 2SLGBTQIA+ people as one group, risks losing the nuances that intersectional factors have on lived experiences, and masks underlying disparities.

Added stakeholder interviews to translate findings into action

To support interpretation and action, we conducted 16 virtual one-on-one stakeholder interviews with healthcare leaders, professionals, researchers, medical students, and Indigenous stakeholders across multiple provinces. These interviews added depth to the survey findings – helping to contextualize key patterns, identify underlying drivers, and clarify implications for policy, service delivery, and provider education.

Involvement of subject-matter expert and academics

Throughout the course of the research academic professionals were involved in survey design up to writing up the final Pink Paper. Their expertise was key to placing research findings within broader scientific literature, helping to interpret results appropriately, identifying limitations, avoiding overstating conclusions and linking results to existing theory or evidence – strengthening the narrative and implications of the research.

Application of Insights

The Pink Paper on Health established a first national, bilingual, comparative evidence base on 2SLGBTQIA+ health outcomes and healthcare experiences in Canada. By documenting disparities across outcomes, access, quality of care, and lived experiences of stigma and discrimination, the study created a clear benchmark to support accountability and track progress over time. 

The report was designed to support healthcare reform by pairing population-level measurement with stakeholder-informed context. This help in clarifying both the scale of inequities and the implications for policy, service delivery, and provider education.  Beyond the report itself, the findings also informed PTP’s ongoing public-facing health communications, including the development of Script, which provides health resources and free newsletters tailored to PTP readers’ needs.

Performance

PTP positioned the final report as a “wake-up call,” using it to communicate urgency and reinforce that the healthcare system is failing a foundational principle for 2SLGBTQIA+ people.

Environics has been an incredible partner in this initiative. They were wonderful collaborators who brought both the rigour and weight of Environics to the research, but also, importantly, the team’s personal commitment and engagement in the outcomes of this work. We observed this at every step, enabling us to fully explore and find nuances in the data, which led to the insightful work we all see in this Pink Paper on 2SLGBTQIA+ Health Disparities.

David Walberg – CEO, Pink Triangle Press

About The Client

Pink Triangle Press (PTP) is one of the longest publishing 2SLGBTQIA+ media groups in the world, with a mission rooted in storytelling, community, and liberation.  PTP’s work amplifies activists, creators, thinkers, and change makers, and is grounded in the belief that media created by, for, and about 2SLGBTQIA+ communities plays a vital role in helping communities thrive.  Building on a long history of advancing freedom and equality, PTP partners with diverse communities to foster change and bring people together toward a better future for 2SLGBTQIA+ people. 

The Pink Paper on Health initiative was funded by Women and Gender Equality Canada, supporting the development of a credible national evidence base to inform equity-focused healthcare reform. 