Nova Scotia, Canada: Transgender man wants N.S. to pay for sex change

Friday, August 12, 2005
The Halifax Herald Limited
Transgender man wants N.S. to pay for sex change
By MATT HUNT GARDNER

Eric MacDonald isn't comfortable inside the body he was born with.

"For a transsexual, just to take a shower is a traumatic experience where you have to totally disembody yourself because you are showering the body of a stranger," the 34-year-old told CBC Radio Thursday.

Mr. MacDonald was born a woman. He's been taking hormones for the last few years and is living as a man.

His next step is sex reassignment surgery, but here in Nova Scotia the provincial government won't pay for it.

So he is speaking out about the difficulties of being a transgender person in Nova Scotia and working with the Nova Scotia Rainbow Action Project.

The group wants to educate Nova Scotians about sex reassignment issues and hopes to talk to the Health Department about getting the surgeries covered by provincial health insurance. The group has met the Nova Scotia Human Rights Commission as part of their education effort.

"We're in the middle of a lobbying awareness effort right now," Kevin Kindred, the vice-chairman of the group's "trans action" committee, said Thursday.

"We're focusing our efforts more on education."

Mr. Kindred said the group isn't prepared yet to lobby the provincial Health Department. He couldn't say exactly when the group would be ready.

"If it comes forward as a request, it will certainly be looked at and considered," Health Department spokeswoman Michelle Lucas said Tuesday.

"There are a number of priorities on the health-care agenda, and it would certainly have to be considered, not in isolation, but in amongst all the other priorities we're looking at."

The Clinique de Chirurgie esthetique St-Joseph, the Montreal clinic that specializes in sex reassignment surgery, performs 240 male-to-female surgeries and 10 to 15 female-to-male surgeries each year. Many patients are from out-of-province.

A basic male-to-female transition surgery at the clinic costs $7,010. It includes genital surgery and breast implants, plus anesthetics, a four-day hospital stay and 10 days of residence care. A basic female-to-male surgery costs $65,940. It includes mastectomy (breast removal) and genital surgery performed in three stages: phalloplasty (construction of external male genitalia), testicular implant surgery and penile implant surgery. The process requires various anesthetics, a total of 13 days in hospital and 23 days in residential care.

For a more full transition, patients may need a number of other surgeries too, which could include rhinoplastly (nose surgery), forehead shaving (reshaping the bone), Adam's apple shaving, chin implants, pectoral or calf implants, collagen injection, electrolysis or other procedures.

Hormone therapy, which precedes and continues after surgery, also can run up a large bill unless a transgender person has a health insurance plan that covers prescription drugs. Laurie Arron, director of advocacy for Egale Canada, a national advocacy group, said the surgeries and drugs are just too expensive for most transgender people.

"Trans people tend to have difficulty with employment because there are still many barriers," he said from Toronto in a phone interview Thursday. "A lot of trans people do wind up working in jobs that are low paying and a lot of trans people wind up on the street."

There are five steps people who wish to change their sex must take. The first is seeing a family physician who must determine if a persona has gender identity disorder. If the person does, he or she may continue along the steps that ultimately lead to surgery, which is seen as a necessary medical treatment.

"Trans people are living in pain, and they deserve to have the medical procedures to alleviate that pain," Mr. Arron said.

Egale is working now to get sex reassignment surgery covered again in Ontario, where it was removed from the funding list in 1998. British Columbia, Alberta, Saskatchewan, Quebec and Newfoundland and Labrador all have some kind of provincial funding for sex reassignment surgery; however, access to the procedures isn't always easy, Mr. Arron said.



Canada: Nova Scotia Province urged to pay for transsexuals' surgery - CBC