Transgender surgery assessments now available in N.L.

Out-of-province travel for transition assessments no longer required

Transgender people in Newfoundland and Labrador no longer have to travel to Ontario to determine whether or not they’re able to undergo gender confirmation surgery — they can be assessed here at home.

Previously, the province required that a transgender person be assessed at the Centre for Addiction and Mental Health (CAMH) in Toronto to determine whether they would be able to undergo gender reassignment surgery. Newfoundland and Labrador was the only province in the country requiring out-ofprovince travel for the assessments, prior to Monday.

After years of advocacy and a human rights complaint against the province earlier this year, the provincial government has announced the assessments will be allowed in Newfoundland and

Labrador. Health Minister John Haggie, joined by activist Gemma Hickey, was at the Paul Reynolds Centre in St. John’s on Monday for the announcement.

“It has taken some time to get here. We wanted, though, to get it right. We wanted to hear what people with lived experience had to say. We wanted to ensure we were being fair and inclusive,” said Haggie.

“We wanted to be sure, (and) in the end, we designed a process that helps those who may need it by removing unnecessary barriers that they may face.”

Gender confirmation surgery is a procedure opted for by some transgender people to have their body match their gender identity. While not all transgender people opt to undergo the procedure, those that do will have their bodies changed through surgery, so their physicality will match the reality of their gender identity.

A person whose assigned gender at birth was female, for example, can undergo an assessment and be diagnosed with gender dysphoria, which would allow them to undergo surgery, so their bodies match their true gender. Gender dysphoria is a medical condition where one’s emotional and psychological gender identity does not line up with one’s biological sex. Research points to the effects of gender dysphoria on the transgender community as a contributor to the suicide rate among the transgender population.

In 2017, a review of academic literature on mental health among the transgender community was conducted by researchers from Mcgill, Dalhousie and the University of Saskatchewan. The researchers found that 29 per cent of transgender individuals had attempted suicide in their lifetime, while 55 per cent had suicidal thoughts, compared with 0.5 per cent and 3.7 per cent among the general population, respectively. Those numbers were found to have dropped considerably once gender-confirmation surgery was completed.

Hickey said Monday’s announcement is a major step in the right direction for the transgender community.

“It’s an amazing day. It’s an historic day. We’ve all worked hard to get to this day. I feel that it’s one less barrier for transgender individuals,” Hickey said.

“We build up a trust with our health-care professionals, our doctors, our nurses, our therapists. These are the people that know us and can assess us properly. We shouldn’t have to go away.”

The majority of procedures required by those who choose to undergo gender confirmation surgery are still not offered in this province. While those requiring a mastectomy may be able to get it in this province, more complicated procedures like genital reconstructive surgery have to be done out-ofprovince.

Most of those surgeries are covered under the provincial Medical Care Plan (MCP) and those who must travel can apply for assistance through the province’s medical transportation assistance program to help absorb some of the travel costs.

Haggie said the transgender community in this province is small, so it’s unlikely there will be a full range of transition surgeries available here.

“These are the kind of surgeries that are not outside the scope of plastic surgeons, for example, that we have in the province. The other more complicated bottom surgeries are those that, like anything else, to be good at it you need to keep familiarity — you need volume,” said Haggie.

“Simply because of the fact we’re only a province of 500-odd-thousand people, we in-house are never going to be able to get those numbers.”

Blair Curtis, a transgender activist from Mcivers, says he is delighted by the policy change.

“It’s definitely huge. I’m so thankful that the government realized that CAMH was unnecessary. I’m so happy, honestly, I don’t even have words,” he said.

Curtis filed a human rights complaint against the province in January calling out the lack of access to transition surgery assessments in this province. Curtis paid out of pocket for his assessment, but says he is happy others now won’t have to.

“I couldn’t wait for CAMH anymore,” he said.

“With CAMH gone now, I’m sure trans folks will have easier access and access in general to have these surgeries and not have to pay out of pocket. I know a lot of trans folks couldn’t pay out of pocket. It’s just too expensive.”