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Introduction: The early years (ages 0-8) is a critical stage of childhood development, supporting families during this time requires collective efforts across sectors. Siloed streams limit our ability to meet families' needs thereby missing opportunities to positively influence childhood outcomes. In northern British Columbia a small group of professionals completed training in Compassionate Systems Leadership (CSL). The CSL approach focuses on developing shared knowledge and cultural awareness to strengthen capacity to effectively progress systems change initiatives. Applying CSL with a wider community across northern BC allowed the team to examine how all partners could address silos in early years services. Aims Objectives Theory or Methods: A first step in applying CSL is to be culturally sensitive and actively relational with professionals working within early years services. In February 2021 we hosted a summit in northern BC, bringing together professionals across child and family serving sectors. The objectives were to find common ground, celebrate local work supporting children, and build on understanding priorities in the early years. Our five day event wove together Indigenous and western pedagogies, highlighting northern First Nation voices and cultural practices. The event used a hybrid model of pre-recorded asynchronous sessions with a concluding full day virtual workshop. Highlights or Results or Key Findings: Early years services were described as patchy and inconsistent. Critically, the burden of weaving together supports falls to primary caregivers, and across sectors it was acknowledged this created gaps in comprehensive early years services. Many communities worked hard to lessen fragmentation and participants described how relational ways of being helped co-create partnered supports. Participants acknowledged that working compassionately facilitated local initiatives which positively impacted the early years, yet gaps remained including the absence of health's engagement in work across the region. There was consensus that a holistic, culturally respectful, multidisciplinary team, which includes primary health care was needed to support the health and development needs of young children. Discussion focused on expanding hub models of care which exist in select northern communities. A clear message from the summit was a willingness for crosssector collaboration, and the development of an integrated approach to support families in the early years is required. Conclusions: In facilitating a safe space that allowed for vulnerability and relational ways of engaging across sectors we discovered commitment, interest, and a willingness for those present to consider new ideas and partnerships that would allow for greater integration of early years services in northern BC's rural contexts. Implications for applicability/transferability sustainability and limitations: Shifting from siloed work to integration across services is complex. Relational ways of being helped providers with this complexity, creating space to learn from each other, begin co-creation, and enhance partnerships. This was evident in early years services but is likely to apply in other service areas seeking integration. [ABSTRACT FROM AUTHOR]

Introduction: Sex variations comprise a heterogeneous group of medical conditions. These include congenital adrenal hyperplasia (CAH), androgen insensitivity syndrome, Turner syndrome, and more, reportedly affecting approximately two percent of the population. These conditions can involve lifelong management. However, no research has examined the experiences nor the healthcare practices used with these individuals in their transitions through healthcare in Canada. Further, the majority of research on healthcare transitions from other countries focuses on the pediatric to adult care transfer, despite transitions taking place across the lifespan. Aims Objectives Theory or Methods: Firstly, we aimed to investigate the current context of care for individuals with sex variations through an environmental scan of the current care pathways and guidelines for transition used by health providers. This included a search of 13 Canadian Children's Hospital websites, a survey sent to providers, and freedom of information requests submitted to these hospitals. Secondly, we sought to learn from the experiences of individuals with sex variations and their families in transitioning through care, along with their providers' understandings of transition for this group. Thus, we conducted engagement sessions in BC and Ontario applying a community-participatory learning approach Highlights or Results or Key Findings Through the environmental scan, we found no hospital-specific resources used by healthcare providers for guiding care transitions for individuals with sex variations. Our engagement sessions consisted of in-person focus groups and virtual interviews with individuals from Ontario and British Columbia. We also included secondary data from a small BC study with women with CAH. Altogether, data from 17 individuals (15 with sex variations and two caregivers) was included. Interviews highlighted three important themes: (1) transition is a lifespan activity - individuals faced different healthcare challenges that required transition as they aged, (2) the building of personal agency, and (3) wellness promotion and healing in this population. An additional output from the study included the co-development of a small advisory group of adults identifying with sex variations, involved in work around health education and consultation. Conclusions: Canadian care guidelines for managing transition with sex variations are lacking. For individuals with sex variations there is little information to support individual health literacy and selfmanagement. There exists an opportunity for these individuals and their providers to begin building a visible network that can inform care delivery and policy. Implications for applicability/transferability sustainability and limitations: A limitation of this study was failure to adopt inclusive terminology at study conception (e.g., our website domain, dsdtransition.ca). We learnt that intersex or sex variation is preferred by the community. We encourage use of inclusive terminology in healthcare and the co-development of transition guidelines with Canadians with sex variations [ABSTRACT FROM AUTHOR]

Objectives: To: (1) complete an integrative literature review of transition studies that focus on individuals with intersex traits; (2) conduct an environmental scan of the current resources (practice guidelines, policies and procedures) used by healthcare providers working with Canadians with intersex traits; (3) investigate the experiences of Canadians with intersex traits in their healthcare transitions across the lifespan and (4) assess the understanding of healthcare providers about these transitions., Design: A qualitative prospective community participation study was conducted. It used mixed methods including an environmental scan and semistructured engagement sessions., Setting: The environmental scan examined resources available throughout Canada. The engagement sessions took place in British Columbia and Ontario, Canada., Participants: Sixteen participants were recruited. These included 13 individuals with intersex traits (a heterogeneous group of congenital conditions affecting the development of sex characteristics) and three caregivers., Methods: Mixed methods included an integrated literature review, environmental scan and qualitative approaches developed in collaboration with community partners., Results: The literature review identified gaps in transition care for individuals with intersex traits. The environmental scan uncovered no specific resources used by healthcare providers working with patients with intersex traits, though several general guidelines were used. Engaging providers in the study was problematic. Thematic analysis generated three main themes that emerged from the engagement sessions: (1) transition is a lifespan activity; (2) building personal agency is valuable and (3) well-being promotion is an application of health literacy., Conclusions: Transition resources for individuals living in Canada with intersex are scarce. Transitions happen across the lifespan with ownership of thought and actions seen as acts of personal agency. Health literacy skills and knowledge change with increased age, yet the primary source of knowledge often remained important in the individual's autobiographical self., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)