Research suggests that Canada's newly arrived immigrant and refugee communities tend to be healthier than the domestic population, and that their health declines over time. Studies examining immigrant and refugee health primarily focus on how barriers associated with language, the settlement experience, culture, and systemic processes impede the utilization of health services among refugee men and women respectively. However, without the benefit of a gender comparison, such studies fail to identify the variation in health needs and differences in health-seeking between refugee men and women, and are thus limited in their capacity to improve service utilization. Drawing from exiting literature on refugee health status pre-migration and during resettlement, this paper implicates the role of health care reform processes in exploring the gender differences in access and health-seeking. A postcolonial feminist epistemology is advanced as a means to include the voices of refugees and other marginalized groups in future research and practice in order to encourage substantive change.