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Toronto: Difference between revisions
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[[File:Toronto.jpg| | {| class="wikitable" style="width:200px; border:1px solid black;float:right" | ||
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|colspan="8" style="text-align:center"|[[File:Toronto.jpg|300px | thumb|right|]] | |||
|- | |||
| '''Contraception: Over-the-Counter''' | |||
| condoms | |||
|- | |||
| '''Contraception: Prescription/Clinic Required''' | |||
| pills, IUD, shots | |||
|- | |||
| '''Emergency Contraception''' | |||
| no prescription required; widely available in pharmacies | |||
|- | |||
| '''STIs''' | |||
| no travel restrictions; HIV-positive foreigners not deported | |||
|- | |||
| '''Menstrual Products''' | |||
| pads, tampons, cups | |||
|- | |||
| '''Abortion Law''' | |||
| legally available on request | |||
|- | |||
| '''LGBTQ Laws''' | |||
| homosexuality legal; gender change legal | |||
|- | |||
| '''Related Pages''' | |||
| [[Montreal]], [[Vancouver]], [[Canada]] | |||
|- | |||
|} | |||
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''' | '''OVERVIEW''' | ||
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As the largest city in Canada, you will find an incredible range of health care options. You will find all major contraceptive methods, including condoms, pills, patches, shots, etc. in Toronto. While contraceptives are not subsidized by the Canadian health care system for all people, you can find lower-cost pills and IUDs (including insertion) at public sexual health clinics. You can purchase emergency contraception ("the morning after pill") at pharmacies or obtain it at sexual health clinics. There are no formal age restrictions but pharmacists can refuse to dispense EC to people who do not seem "mature." There are many public sexual health clinics that offer STI tests. While some only cover HIV, other clinics can test for a range of STIs, especially if you make an appointment rather than dropping in. There is an HPV vaccination program in place. You can access Pre-Exposure Prophylaxis (PrEP) and Post-Exposure Prophylaxis (PEP). Maternity and paternity leave is covered under Employment Insurance (EI). Regarding abortions, you can receive them at hospitals, free-standing clinics or at Birth Control Sexual Health Centre. If you're a Canadian citizen or permanent resident, the costs are covered. If you're not a Canadian citizen or permanent resident, you can expect to pay $300-$900 for the procedure, but there are some financial assistance resources available. | |||
==Contraception== <!--T:4--> | ==Contraception (Birth Control)== <!--T:4--> | ||
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'''Note | '''General Note:''' There are many types of contraceptives, also known as "birth control," including IUDs, oral contraceptives, patches, shots, and condoms, etc. If you would like to view a full list, click [https://www.plannedparenthood.org/learn/birth-control here]. | ||
=== | ===Laws & Social Stigmas=== <!--T:6--> | ||
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In Canada, you can find condoms sold in many stores. For other birth control options, like the pill, IUD, shot or implant, you will need a prescription from a physician or nurse. | |||
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Generally, Canada has a high rate of contraceptive use. It's estimated that over 70% of Canadian women (of reproductive age) use modern contraceptive methods, and about 22% of Canadian men have underwent male sterilization.<ref>[http://www.un.org/en/development/desa/population/publications/pdf/family/trendsContraceptiveUse2015Report.pdf Trends in | |||
Contraceptive Use Worldwide 2015]</ref> Yet some women still face difficulty when trying to access birth control. The Society of Society of Obstetricians and Gynaecologists of Canada found that Canadian women have less birth-control options than women in other developed countries.<ref>[http://www.theglobeandmail.com/life/health-and-fitness/health/canadians-feel-the-cost-of-health-policies-limiting-access-to-birth-control/article23883108/ It's time to give Canadian women more options when it comes to birth control, experts say]</ref> Furthermore, the Canadian Contraception Consensus report found that 15% of sexually-active Canadian women aren't using any form of birth control, and 20% are using birth control inconsistently. The largest barrier is probably cost. Contraceptives aren't free under Canada's universal health care plan, and affordable birth control options are typically found through the public sexual health clinics (which can have limited drug choices, limited opening hours and long wait times). It should be stressed, however, that these clinics do provide affordable options and are an invaluable resource in Canada.<ref>[http://www.metronews.ca/life/health/2016/01/11/canada-birth-control-policy-needs-overhaul.html Canada lags behind other nations in birth control access, and it's costing us]</ref> | |||
=== | ===What to Get & Where to Get It=== <!--T:9--> | ||
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* | * You can buy condoms online at [http://www.topcondomscanada.com/ Top Condoms Canada], [http://idealcondoms.ca/ IdealCondoms.ca] and [https://www.undercovercondoms.com/ Undercover Condoms]. | ||
* | * For low-cost birth control (e.g. condoms, pills, IUD, etc), you can visit a public sexual health clinic. There are about 14 of these public clinics in Toronto, including Black Creek Community Health Centre, Hassle Free Clinic, Immigrant Women's Health Centre, Jane Street Clinic, Scarborough Sexual Health Clinic, etc. Some are drop-in and some require scheduling an appointment. Here is a [http://www1.toronto.ca/wps/portal/contentonly?vgnextoid=30865e67bbee0410VgnVCM10000071d60f89RCRD complete list] of all these clinics in Toronto. | ||
* | * Birth control rings, like Nuvaring, are available in Toronto. You can get them at [http://www.womenscollegehospital.ca/programs-and-services/bcbc/ Women's College Hospital - Bay Centre for Birth Control] and many other places. | ||
* | * If you want to get an IUD at public clinics, you'll generally have a choice between Liberté UT 380 and Flexi-T, which cost around $60-65 for the procedure. Some clinics also let you purchase Mirena at a pharmacy and they will then perform the insertion for you at the clinic. | ||
* | * If you want to get an IUD at a private clinic, one recommendation is [http://www.womenscollegehospital.ca/programs-and-services/bcbc/ Women's College Hospital - Bay Centre for Birth Control]. You buy the IUD at their pharmacy and then they do the insertion. They charge around the following prices: Mirena: $363.40. Jaydess: $290.06. Mona Lisa: $57.70. They're known to be sex-positive and a good experience overall. As someone wrote, "You can go during walk-in hours or make an appointment. You'll see a nurse and they talk to you about all your options, side effects, pregnancy rates, etc. It's run by Planned Parenthood, so there's no selling happening and no pressure that some doctors may have, or any pressures about not having sex etc etc (they're a "sex-positive atmosphere.") The nurses make you feel so comfortable and are honest and compassionate."<ref>[https://www.reddit.com/r/toronto/comments/362rqd/best_place_to_get_an_iud_in_toronto/?st=ix49re6c&sh=15fa2b7f Best place to get an IUD in Toronto?]</ref> You can also go Planned Parenthood Toronto. You buy the IUD at the pharmacy and then Planned Parenthood does the insertion. Here are their rates: Mirena: $380. Jaydess: $306. Mona Lisa: $54-63 | ||
=== | ===Costs=== <!--T:11--> | ||
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While Canada has a universal health care system, it does not offer free contraceptives. You can get lower-cost birth control at the public sexual health clinics (for example: birth control pills ranging from free to $10/per month supply, and IUDs for $60). If you get IUDs at a private clinic, you can expect to pay around $55 (for Mona Lisa), $290-$300 (for Jaydess) or $360-380 (for Mirena). | |||
==Contraception | ==Emergency Contraception (Morning After Pill)== <!--T:13--> | ||
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''' | '''Important Notes:''' Emergency contraception may prevent pregnancy for three days (72 hours) and sometimes five days (120 hours) after unprotected sex. Take EC '''as soon as possible''' after unprotected sex. If you don't have access to dedicated EC, oral contraceptives can be used as replacement EC, but remember the following: 1) Only some contraceptives work as EC 2) Different contraceptives require different dosages and time schedules to work as EC 3) You must only use the first 21 pills in 28-day packs and 4) They may be less effective than dedicated EC. | ||
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In Canada, emergency | In Canada, the emergency contraceptive pill (the morning after pill) is available at a variety of places, including women's clinics, sexual health centres, hospitals, and pharmacies. However, the laws around its availability vary by province. In Ontario and most provinces, emergency contraceptive pills are available over-the-counter, except for Ulipristal-based pills, such as ellaOne, which requires a prescription.<ref>[https://www.healthlinkbc.ca/healthlinkbc-files/emergency-contraception Emergency Contraception (EC)]</ref> In Quebec, emergency contraceptive requires a prescription, and in in Saskatchewan, it is available behind the counter at pharmacies.<ref>[http://planb.ca/where-to-get-it.html Plan B - Where to Get It (Canada)]</ref> | ||
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Generally speaking, age restrictions on emergency contraception vary by province. In Ontario and many other provinces, there are no age restrictions, so young people and teenagers are legally allowed to purchased emergency contraceptive pills without a prescription or parental consent. However, there are some age restrictions when purchasing EC. As reported by the International Consortium for Emergency Contraception, "In May 2008, the National Association of Pharmacy Regulatory Authorities (NAPRA) recommended full OTC access for the LNG regimen with no age restriction. This recommendation is being applied Under Common Law; however, pharmacists have the discretion to restrict sale of EC if a woman does not appear mature. All provinces follow Common Law with the exception of Quebec, which follows Civil Code, and Saskatchewan."<ref>[http://www.cecinfo.org/country-by-country-information/status-availability-database/countries/canada/ EC Status and Availability: Canada]</ref> | |||
===What to Get & Where to Get It=== <!--T:18--> | ===What to Get & Where to Get It=== <!--T:18--> | ||
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* You can obtain most emergency contraceptive pills (morning after pills) without a prescription from a pharmacy, doctor, women's clinic, sexual assault centres, sexual health clinics, or hospital emergency rooms. | |||
In Canada, if you want dedicated progestin only EC, you can take NorLevo 0.75 mg (available over the counter) or Plan B (available over the counter). You should take 2 pills within 120 hours after unprotected sex. If you can't access dedicated EC, you can use some oral contraceptives as replacement EC -- but, remember: in 28-day packs, only the first 21 pills can be used. Some of the contraceptives you can use are Ovral (take 2 pills within 120 hours after unprotected sex and take 2 more pills 12 hours later), Minovral (take 4 pills within 120 hours after unprotected sex and take 4 more pills 12 hours later) and Alesse (take 5 pills within 120 hours after unprotected sex and take 5 more pills 12 hours later).<ref>[http://ec.princeton.edu/worldwide/ Princeton EC website]</ref> | In Canada, if you want dedicated progestin only EC, you can take NorLevo 0.75 mg (available over the counter) or Plan B (available over the counter). You should take 2 pills within 120 hours after unprotected sex. If you can't access dedicated EC, you can use some oral contraceptives as replacement EC -- but, remember: in 28-day packs, only the first 21 pills can be used. Some of the contraceptives you can use are Ovral (take 2 pills within 120 hours after unprotected sex and take 2 more pills 12 hours later), Minovral (take 4 pills within 120 hours after unprotected sex and take 4 more pills 12 hours later) and Alesse (take 5 pills within 120 hours after unprotected sex and take 5 more pills 12 hours later).<ref>[http://ec.princeton.edu/worldwide/ Princeton EC website]</ref> | ||
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* | * There are two '''HPV vaccines''' available in Canada: Cervarix® (HPV2) and Gardasil®9 (HPV9). Ontario has an 'HPV vaccination program for children: "Ontario now offers vaccination against cancer-causing Human Papillomavirus (HPV) free of charge to all boys and girls in Grade 7. The program is run through school-based clinics by local public health units."<ref>[http://www.health.gov.on.ca/en/ms/hpv/ Ontario's HPV Immunization Program]</ref> | ||
* You can get the '''Hepatitis B vaccine''' at many sexual health clinics. | |||
* If you want Post-exposure prophylaxis (PEP), you should contact a hospital emergency department or their doctor for treatment. Generally, no appointment is required since patients should be counseled and treated ASAP. | * If you want '''Post-exposure prophylaxis (PEP)''', you should contact a hospital emergency department or their doctor for treatment. Generally, no appointment is required since patients should be counseled and treated ASAP. | ||
* Pre-Exposure Prophylaxis (PrEP) is available in Canada. In February 2016, Health Canada approved Truvada as prevention.<ref>[http://www.prepwatch.org/canada/ PrEPWatch: Canada]</ref> According to ACT Toronto, "Any doctor can prescribe PrEP. If you have a family doctor that you feel comfortable with, that is a good place to start. There is ongoing testing and medical care required with PrEP, so accessing PrEP through a doctor that you already have a connection with is ideal."<ref>[http://www.actoronto.org/PrEP/how PrEP - How do I get it?]</ref> CATIE has | * If you want '''Pre-Exposure Prophylaxis (PrEP)''', it is available in Canada. In February 2016, Health Canada approved Truvada as prevention, and generic versions of TDF/FTC are approved for prevention. There are an estimated 900-1,100 people on PrEP in Canada, as of 2018.<ref>[http://www.prepwatch.org/canada/ PrEPWatch: Canada]</ref> According to ACT Toronto, "Any doctor can prescribe PrEP. If you have a family doctor that you feel comfortable with, that is a good place to start. There is ongoing testing and medical care required with PrEP, so accessing PrEP through a doctor that you already have a connection with is ideal."<ref>[http://www.actoronto.org/PrEP/how PrEP - How do I get it?]</ref> CATIE has compiled extensive resources on PrEP for Canadians, which you can check out [http://www.catie.ca/en/prep here]. For updates on PrEP access in Canada, [https://www.prepwatch.org/canada/ PrEPWatch] is also a great resource. | ||
===Costs=== <!--T:42--> | ===Costs=== <!--T:42--> | ||
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* [https://www.actioncanadashr.org/ Action Canada]: "Action Canada works within Canada and globally to promote health, wellbeing, and rights related to sexuality and reproduction. Building on the strong histories of our three predecessor organizations, we cover a broad spectrum that includes directly providing support, referrals, and information; working with other groups and organizations on a range of campaigns using a collaborative, movement-building approach; and policy advocacy related to sexual and reproductive rights (including abortion), gender, LGBTQ rights, comprehensive sexuality education, and more." | |||
* Telehealth Ontario — a free 24/7 service which uses nurse practitioners to answer your health concerns: 1-866-797-0000. 1-866-797-0007 (TTY). | * Telehealth Ontario — a free 24/7 service which uses nurse practitioners to answer your health concerns: 1-866-797-0000. 1-866-797-0007 (TTY). | ||
* Sexual Health Information Line - Toll free: 1 (800) 668-2437; Local: (416) 392-2437. Hours of operation: Monday to Friday 10 am – 10:30 pm; Saturday and Sunday 11 am – 3pm | * Sexual Health Information Line - Toll free: 1 (800) 668-2437; Local: (416) 392-2437. Hours of operation: Monday to Friday 10 am – 10:30 pm; Saturday and Sunday 11 am – 3pm | ||
* [https://www.toronto.ca/community-people/health-wellness-care/health-clinics/sexual-health-clinics/ List of Sexual Health Clinics in Toronto]: This list is provided by the city of Toronto. | |||
* [http://birthcontrolsexualhealth.ca/ Birth Control and Sexual Health Centre]: "The Birth Control and Sexual Health Centre has been serving the community since 1972 and provides sexual health services to women, men and transgendered clients... We provide free services in a caring and non-judgmental manner to a diverse community, recognizing the differences in gender, race, ethnicity, sexuality and ability of our clients. We do not require a health card. There is no age limit or geographic boundaries. We are pro-choice supporting all decisions regarding an unplanned pregnancy." Email: info@birthcontrolsexualhealth.ca | |||
* [http://www.ppt.on.ca/ Planned Parenthood Toronto]: They provide sexual and reproductive health care, including contraception, HIV and STI testing, pregnancy care, counseling and support, and programming for LGBTQ youth and young parents. Address: 36B Prince Arthur Avenue, Toronto, ON M5R 1A9; Phone: (416) 961-0113; Fax: (416) 961-2512; Email: ppt@ppt.on.ca | |||
* [http://immigranthealth.info/ IWHC Toronto]: "IWHC Toronto (formerly Immigrant Women’s Health Centre) is an independent sexual health clinic funded by the City of Toronto, through Toronto Public Health. For over 40 years, IWHC Toronto has been providing free, confidential, culturally sensitive and language-accessible sexual health-related clinical services, counselling and support services to women across the City of Toronto. As of 2016, IWHC Toronto also opened its doors to men. We serve our clients in 9 languages with all-female Centre and medical staff." phone: 416.323.9986; email: info@iwhctoronto.com | |||
* [http://www.bcchc.com/ Black Creek Community Health Centre]: They have a sexual health clinic offered weekly at 2 locations (Sheridan Mall Location on Tuesdays and Thursdays, from 3:00 pm - 6:00 pm; Yorkgate Mall on Mondays from 2:00 pm - 5:00 or 5:30 pm, depending on the day). Call us: 416-249-8000 /416-246-2388; Email us: info@bcchc.com | |||
* [http://hasslefreeclinic.org/ Hassle Free Clinic]: Sexual Health Clinic & Anonymous HIV Testing site in downtown Toronto. They primarily provide services for women and trans individuals. Address: 66 Gerrard St E Suite 200, Toronto, Ontario; Call +1 416-922-0566 | |||
* [https://hiv411.ca/organization/crossways-clinic/ Crossways Sexual Health Clinic]: They provide contraception, STI tests, etc. Address: 2340 Dundas Street West - Toronto, ON - M6P 4A9; Phone: +1 416-392-0999; Email: publichealth@toronto.ca | |||
* [https://www.torontocentralhealthline.ca/displayservice.aspx?id=151128 Jane Street Health Clinic]: Services include: birth control counseling, low-cost or free birth control, emergency birth control, pregnancy testing and counseling, rapid HIV testing, sexuality and relationship counseling, Pap smears, STI testing, etc. Address: 662 Jane St, Toronto, ON; Phone Numbers: 416-338-7272; Email: cjohnst4@toronto.ca | |||
* [https://www.centraleasthealthline.ca/displayservice.aspx?id=51535 Scarborough Sexual Health Clinic]: They provide free testing and treatment of sexual transmitted infections, along with birth control counseling, low or free cost birth control, emergency contraception, and other services. | |||
* [https://www.mountsinai.on.ca/care/womens-unit/family-planning-clinic Mount Sinai Hospital - Family Planning Clinic]: "This clinic focuses on contraceptive choices which your family doctor may not be able to address. In particular, we provide counseling for patients with complex medical and contraceptive needs, IUD insertion and offer tubal ligation surgery. Your first appointment will be a one-to-one consultation with a gynecologist and/or nurse to decide on a form of contraception that is right for you." Email: patientrelationsunit@mtsinai.on.ca | |||
* [http://sieccan.org/wp/ The Sex Information and Education Council of Canada (SIECCAN)]: "The Sex Information and Education Council of Canada (SIECCAN) is a national registered charitable organization founded in 1964 to foster professional education and public knowledge about sexuality and sexual health. SIECCAN works with health professionals, educators, and community organizations to ensure that all Canadians have access to high quality sexual health information, education and related health and social services." | * [http://sieccan.org/wp/ The Sex Information and Education Council of Canada (SIECCAN)]: "The Sex Information and Education Council of Canada (SIECCAN) is a national registered charitable organization founded in 1964 to foster professional education and public knowledge about sexuality and sexual health. SIECCAN works with health professionals, educators, and community organizations to ensure that all Canadians have access to high quality sexual health information, education and related health and social services." | ||
* [http://www.the519.org/ The 519]: "The 519 is committed to the health, happiness and full participation of the LGBTQ community. A City of Toronto agency with an innovative model of Service, Space and Leadership, we strive to make a real difference in people’s lives, while working to promote inclusion, understanding and respect." | * [http://www.the519.org/ The 519]: "The 519 is committed to the health, happiness and full participation of the LGBTQ community. A City of Toronto agency with an innovative model of Service, Space and Leadership, we strive to make a real difference in people’s lives, while working to promote inclusion, understanding and respect." | ||