In 1977, 15-year-old Mardi Pieronek ran away from home. She never felt like she belonged in rural Alberta, but ever since coming to terms with her identity at age ten, she realized it was unsafe to express herself in the conservative environment of her hometown.
Mardi travelled to Vancouver to freely live as her authentic self: a woman.
Coming out as transgender is no easy task; transitioning requires more change than altering your physical appearance. For Mardi, this meant leaving behind life as she knew it in her conservative prairie community to start over in the big city.
Mardi and a group of friends with the same aspirations jumped on a train, and after hours of travel, their destination became visible over the horizon. They took their first glimpses of the Vancouver skyline, taking in the sight of where they would call home for this new chapter of their lives. 
Somewhere between those buildings lay Davie Street, where they would learn and grow in amongst women with the same experiences as them.
Davie Street was home to trans women ranging from teens beginning of their transition to elder “trans-mothers” who taught them how to survive with a world that thought they were better off dead and hardships that all too often cut their lives short.
Now aged 62, Mardi has found online stardom, earning over a quarter-million followers on her TikTok account @MardiPantz where she illustrates the legacy and history of trans survival in BC as one of the few women who transitioned in the 1970s still alive today.
According to the 2021 census, approximately 13,800 Canadians in Mardi’s generation, those born between 1946 and 1965, don’t identify with their gender assigned at birth. However, this mostly includes individuals who transitioned in recent decades because of reduced stigma and increased accessibility to support and community.
A better visual of the amount of surviving transgender people from the 1970s can be understood with the disproportionate and often fatal struggles they faced.
A 2018 study by Statistics Canada in Canadians over 15 found transgender people reported 22% more experiences of physical assault, sexual assault, and violent victimization than cisgender people, and 25% more reported drug or alcohol usage to cope with lifetime experiences of abuse, violence, and victimization.
Transgender people also were found to have worse mental health, with 54% more rating their mental health as negative than cisgender people. Trans respondents also reported about four times more diagnoses of both anxiety and mood disorders, and 29% more reported having ever seriously contemplating suicide. 
These statistics would have been even more disproportionate in previous decades without any current legislation protecting transgender rights or preventing discrimination. As a result of these hardships, most people who Mardi knew from her time on Davie Street passed from struggles with AIDs, violence, suicide, and addiction without access to support, community, or healthcare.
Mardi’s mission with her online advocacy is to educate the public and the new generation of trans youth about the legacy of the trans community in securing current legal protections, an important history to protect against recent political campaigns seeking to erase this progress.
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Matt Gagarin didn’t run away from home, but he too fled to BC to escape obstacles of prejudice and seek new opportunities. After graduating high school in 2021, he left his hometown north of Dallas, Texas and settled in Victoria to study at UVic.
For most people applying to university, the decision on where to spend the first chapter of their adult life is a daunting choice. For Matt, this was amplified with considerations around his safety as a transgender man.
“There were a lot of push-away factors from the states and a lot of pull-in factors from Canada,” Matt recalls, “During that time, around the end of 2020 and the beginning of 2021, there was a lot of stuff going on in the United States… that was very much the beginnings of an anti-trans movement.”
After getting accepted to UVic, Matt had a lengthy to-do list in preparation for his international move. He already had a passport, but it might as well have been for a different person; everything from the name, sex, and picture no longer reflected his external identity.
It was a buzzer-beater to get his documentation in order. His new passport arrived in the mail days before his flight due to pandemic backlogs and he got his study permit approved at the airport, but he made it to Victoria. Matt settled down and enjoyed the quiet peace of acceptance, but things down south continued to decay.
In November 2021, the Children’s Medical Center Dallas quietly disbanded its Gender Education and Care Interdisciplinary Support (GENECIS) program which provided Matt his Hormone Replacement Therapy (HRT). This followed weeks of outcry from right-wing protestors accusing the hospital and staff of child abuse for providing youth with gender-affirming care.
“They still existed in the hospital, it just wasn’t advertised anywhere, wasn’t in the public sphere at all, wasn’t called GENECIS… it was just an endocrinology unit,” Matt explained. He and other current patients were told they would be able to continue treatment until the program shut down, though without warning of when this would occur. 
A visit to his endocrinologist at the Children’s Hospital years later in August 2023 put the last nail in the coffin. Here, Matt was informed the hospital could no longer provide HRT after Texas passed Senate Bill 14 and banned gender-affirming care for transgender youth.
Matt had originally planned to use his American insurance to cover HRT as long as Texan law allows children on their parent’s plan until they turn 26. “They told me I have until the middle of this year to find another doctor,” he said. Those in Texas will need to seek costly out-of-state care, but Matt can luckily access continued coverage in BC.
This bill was far from being the first gender-affirming care ban in the US, with dozens of other states banning HRT, puberty blockers, and gender-affirming surgery since 2021. These bans have also spread beyond the states, with Alberta becoming the first Canadian province to ban gender-affirming care for youth this past February.
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Soon after arriving in Vancouver, Mardi scheduled visits with endocrinologists and other doctors to assess her health and hormone levels. She discovered she had low levels of testosterone and decided to take minimal amounts of hormones.
Unfortunately for Mardi, she couldn’t get prescribed hormones from her endocrinologist and had to find other means. Before HRT was readily accessible from provincial healthcare services, most trans women got their hormones from others on the street.
In the September 1978 issue of the Gender Review published by the Foundation for the Advancement of Canadian Transsexuals (FACT), Dr. Charles Ihlenfeld describes that many patients he encountered at this time were unable to get care from qualified medical professionals.
“In some instances, these patients have been unable to find doctors willing to treat them in their localities. At other times, the patients themselves may have preferred not to seek medical help,” Dr. Ihlenfeld writes, “these latter patients may have feared a negative reaction from the physician, or … found treatment ‘on the street’ easier and less expensive.”
Without medical guidance on hormone administration, many girls around Mardi took dangerously high dosages and suffered severe health consequences later in life. “A lot of [trans women] that were really fair and effeminate like me went overkill with some hormones right away, and a lot of them died from cancer,” she recalls.
Once Mardi turned 18, she could consider options for surgery, and had breast augmentation at the top of her list. “Everybody was getting their boobs done. ‘Get your nails done and your [boobs],’ that’s what everybody would say, all the girls on the street,” Mardi says, “so that’s what I did.” 
It was essential for living as “stealth,” a past term trans women used to describe passing in public as a cisgender woman. Becoming “stealth” was seen as a survival method to avoid harassment from potentially hostile strangers on the street by flying under the radar of prejudice.
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Today, provincial governments in Canada provide and regulate gender-affirming care. Trans Care BC, a program run by the Provincial Health Services Authority (PHSA) since 2015, works to provide gender-affirming care, resources, and services in BC through partnerships with the Ministry of Health, regional health authorities and service providers, and trans representatives.
Accessing gender-affirming care in Canada begins with a primary care provider. If an individual desires HRT or gender-affirming surgery, most provinces, including BC, requires diagnosed gender dysphoria, defined by the DSM-5 as a “marked incongruence between one’s experienced/expressed gender and their assigned gender.”
According to Trans Care BC, the Medical Services Plan (MSP) fully covers the following services: chest construction surgery, or “top” surgery, genital reconstruction surgeries known as “bottom” surgeries and gonadectomy procedures to remove testes or ovaries. HRT can be funded by BC PharmaCare but may require special authorization to approve coverage as a necessary medical treatment for diagnosed gender dysphoria. 
After receiving a diagnosis of gender dysphoria, gender-affirming care varies with the patient’s preferred path of treatment. This could involve consultation processes, readiness assessments, or referrals to other healthcare providers depending on the treatment plan. However, these extra steps can be barriers to accessible treatment.“The system seems to be built around a sentiment like ‘make sure you’re sure,’ but to a degree that limits who can be called trans and who can’t,” says Olivia Dawson, a 21-year-old trans woman in Victoria. “They have the ability and authority to ice you out of the system by saying ‘I do not feel comfortable providing you with the care that would treat your symptoms.’”
Getting diagnosed with gender dysphoria diagnosis can also be a challenge. “They require you to have a long-described history of gender dysphoria. When I started transitioning, I wouldn’t have described what I was going through as gender dysphoria,” says Olivia, “if I have been given the option to think about my gender identity when I was a boy, I would’ve had so much history of gender dysphoria, but I had to make up for my gender-questioning shortcomings later on.”
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Back in the 1980s, most girls on Davie Street turned to the sex industry out of necessity. Mardi and other trans women struggled to find any opportunities for conventional work because of anti-trans discrimination. Mardi’s best friend was named Tiggy, a Metis trans woman who she ran away with to Vancouver. In the 1984 documentary Hookers on Davie, 19-year-old Tiggy is featured throughout the film describing her experiences in the sex industry
“Right now, I’m just so frustrated with it …it’s been six years now. Like I’d take anything just to get off the street,” Tiggy says in a scene discussing her struggle to find a job outside of the sex industry, “even being involved with all this [work], there’s just no time left for myself.”
Mardi uses “survival sex work” to describe industry as the only reliable income available to trans women. The stroll on Davie Street was the also only place to meet other trans women, as legal establishments weren’t safe to congregate.
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The AIDs crisis dramatically influenced public perceptions of LGBTQ people globally throughout the late 80s and early 90s. Misinformation about HIV and AIDs was foundational in representations of the crisis by both the public health officials and the media.
In the first chapter of British writer and AIDs activist Simon Watney’s 1987 book Policing Desire, he identifies the origin of AIDs misinformation in its early classification as an STD, fueling non-medical understandings of the condition and its conflation with HIV.
Misinformed public knowledges resulted in increased stigma, transforming the assumed threat of AIDs from the HIV virus itself to fears of gay promiscuity infecting heterosexual society.
Watney outlines consequences of this stigma in his third chapter with the example of hospital policy prioritizing concerns of the spread of AIDs to other patients over the health of AIDs patients. He writes:
“Five years into the epidemic, the ‘commonsense’ of AIDs commentary continues to register endless concern at the (non-existent) threat of infection by casual contact, to the complete disavowal of the real and constant threat which other sick people in hospitals present to people with AIDs, whose damaged immune system render them so vulnerable to other people’s disease. Thus, commentary produces expectations, and expectations fan out into lived experience.”
Discriminatory experiences like these were visible everywhere for targets of AIDs stigma, including the women on Davie Street with public concerns of the sex industry contributing to the spread of AIDs. HIV-positive women on Davie Street also struggled to get treatment or diagnoses for AIDs symptoms as a result of the ignorance towards AIDs in women.
AIDs discrimination also resulted in harmful policy for the women on Davie. The City of Vancouver installed traffic barriers with intent to deter sex industry clientele in 1981, and a provincial injunction prohibited sex work in the West End in 1984, temporarily vacating Davie Street. After years of advocacy, protection against AIDs discrimination was passed in Canadian law.
A 2005 report by the Canadian HIV/AIDs Policy and Law Review outlines existing legal protections against HIV/AIDs-based discrimination. In BC, this includes a 1988 court decision classifying AIDs as a disability federally defined in the Canadian Human Rights Act prohibiting discrimination for goods, services, facilities, accommodation, and employment. The BC Human Rights Code additionally protects against general discrimination within public facilities, tenancy, property purchase, and employment.
Legal remedies for experiences discrimination from employers, landlords, and businesses are established in the report through filing a complaint with the provincial Human Rights Commission (HRC). The HRC investigates complaints, attempts mediation, and proceeds the case to an independent tribunal if needed, but few cases make it to a tribunal hearing.
Canadian law prohibits the ability to sue for discrimination in a 1981 decision by the Supreme Court, which found there were enough existing legal protections for discrimination without defining it as a tort, or a civil wrong conditional for lawsuits. This makes it difficult to pursue justice against indirect discrimination or discriminatory experiences outside of businesses, places of employment, or housing.
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Mardi moved to Victoria at 19 to pursue modelling but struggled to find work. After landing a waitressing job, Mardi was let go before her first day for overstaffing. Later discovering the truth, that she had been outed, Mardi returned to Davie Street. 
Mardi started working as an escort, and as the cash started flowing, she found her new financial freedom intoxicating. “It was really intense, I just kept feeding my addiction,” said Mardi in a video on her YouTube channel, “my drugs [addiction], my money addiction, my ‘more’ addiction… to the point that I hit the wall, and almost died.”
In 1991, Mardi went to rehab. Going into recovery was the beginning of many changes in Mardi’s life. It was here she learned of Tiggy’s passing, a suicide which she later learned was the result of intense stigma after Tiggy tested positive for HIV.
It was also during her recovery that Mardi became the first woman to undergo bottom surgery with full funding from BC’s medical coverage, after being sent to Dr. Toby Meltzer in Portland.
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As of now, 23 U.S. states have passed bans on gender-affirming care, but this is only the tip of the iceberg for anti-trans legislation. Trans Legislation Tracker categorizes anti-trans bills in four areas: “education,” “sports,” “healthcare,” and “birth certificates, employment, and more,” with subcategories for civil rights, bathrooms, incarceration, child abuse, marriage, military, and more. Trans people are facing restrictions in almost every area of their lives.
The prevalence of these bills is growing exponentially. According to the Trans Legislation Tracker, 2023 had 600 anti-trans bills for consideration, more than triple the previous year. Since the start of 2024, there have already been 527 anti-trans bills introduced in state legislatures. 
The increased prevalence is also visible in Canada, with New Brunswick and Saskatchewan passing bills in 2023 requiring parental consent in schools for pronoun and name changes for students under 16 which could forcibly “out” the identities of transgender students to their families. On Jan. 31 of this year, Alberta Premier Danielle Smith announced legislation in multiple areas regulating trans youth.
The Alberta bills will require parental consent for changing pronouns in schools for students under 16, bans on puberty blockers and HRT for those under 16, and bans on surgery for those under 18. 
The surgery bill follows the existing international standards of gender-affirming care Canada has followed for decades from the World Professional Association for Transgender Health. However, the hormone ban is unprecedented across Canada.
“I am confident that Albertans do not want children to make irreversible decisions that impact their reproductive health,” Smith said in a press conference, “Í am also confident that parents love their kids, and they want to know what’s going on with their kids, it doesn’t matter what perspective they come from.”
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After leaving recovery, Mardi became involved with activism, working with groups like the Prostitution Alternatives, Counselling, and Education (PACE) Society through the 90s to spread awareness on the realities of trans women of sex work and industry discrimination.
“I really believe that if [advocacy] services were out there at that time, I wouldn’t have had a career in prostitution, I would have just went to college and did my thing,” Mardi said in a 1997 radio interview on her arrival to Vancouver in 1977, “There was so much shame about being [transgender] back then, you would just try to blend in as much as you can.”
Even though she no longer aspired to be “stealth” for survival, Mardi soon stepped down from advocacy to focusing on her recovery and reconcile her own internalized stigma towards her trans identity. Before she could help others, she had to prioritize helping herself.
She returned back to the public sphere of trans advocacy in 2017, uploading videos of her testimony on YouTube. In 2021, she began posting her story on TikTok, gaining traction this year amongst younger generations for educating youth on the legacy of trans resilience in the context of recent campaigns seeking to undo protections of gender-affirming care.
With the uncertainty in the outcomes of these bans, Mardi emphasizes the advantages of the trans community in the current political climate compared to past generations with increased support and visibility.
“The internet would’ve saved so many of us back then. Be grateful that you have such knowledge so easily [accessible],” Mardi writes in an Instagram caption, “Use this tool to continue the enlightenment of yourself and then the world around you.”