Advocate calls for more coverage for gender affirming surgeries
Advocates and doctors in Saskatchewan are calling on the provincial government to broaden the health coverage for surgeries required by trans people suffering from gender dysphoria.
Last week, Saskatoon celebrated Transgender Visibility Week, which coincided with a recent change by the provincial government making it easier for trans individuals to receive local authorizations for the funding of sexual reassignment surgery outside of the province.
This change was just one of many suggested by the Saskatchewan Medical Association (SMA) in 2006 when it passed a number of resolutions to improve health care for Saskatchewan’s trans population.
“In the past, it used to be that there was only one psychiatrist in Alberta and one organization in Ontario where people had to go just to get the initial assessment done to get funding,” said family physician Dr. Leane Bettin, who works with a number of trans patients. “It’s a bit of a hoop people have to jump through, really, in order to get funding and the wait time for that was a minimum of two years.”
Now, Saskatoon-based psychiatrist Dr. Sara Dungavell has been allowed by the provincial government to approve funding for trans patients in Saskatchewan. Although it’s a step forward, Bettin says she would like to see more people authorized to make these approvals, including family physicians like herself or psychologists who have the training and experience to help get these approvals through more quickly.
Trans activist Reann Legge, who uses the pronouns she and her, agrees with Bettin’s view that there should be more people able to provide these approvals, but also says there is a lot more to be done within the health-care system to help trans people suffering from gender dysphoria.
“I guess the people who made the decisions thought, ‘This whole trans thing is for sex,’ which it totally is not,” she said. “So, having some of those more feminizing surgeries that the politicians seem to think of as cosmetic, would help me pass to everyone more completely.”
Legge adds that giving trans people the opportunity to make these changes affecting how people initially see them would take a lot of the worry out of who people perceive them to be — they have taken the step to remove their former mask and now want to be able to live a life in which they feel comfortable in their skin.
Though health-care coverage will pay for 100 per cent of the out-of-province sexual reassignment surgery — once approval has been received — it does not cover the additional costs such as travel and sometimes recovery. Other surgeries, which Legge referred to, are not covered by the province, such as larynx surgery, to alter the pitch of someone’s voice, facial feminisation surgeries and breast augmentation, which is only covered in certain circumstances.
For those transitioning from female to male, Bettin notes there are similar issues. While mastectomies to remove breast tissue are funded by the government, the additional reconstructive surgery to give the chest a more masculine appearance is not — even though it is available in Saskatchewan.
It’s less about the genitals and more about how people see you on the outside, Legge explains, and to someone with gender dysphoria, having the option to make these changes could be the difference between life and death.
“When it comes to treatments that are medically necessary in the treatment of gender dysphoria, that does include things like the voice surgeries and facial feminisation surgeries,” Bettin said, “especially for people who are transitioning from male to female at a later age, because that can be a real barrier to how they are seen by the world.”
Bettin notes many of these surgeries are mentioned within the SMA resolutions and though it might take some time, she is hopeful they will also be implemented, in order to remove at least a few of the hoops trans individuals are forced to jump through or pay out of pocket to deal with.
“I’m fighting for trans people in the future, so they don’t have to face the same hurdles I have,” Legge said.