B.C. improves and expands trans access to gender-affirmative surgery within province

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      British Columbia continues to move forward with trans-inclusive developments and a B.C. trans healthcare announcement that was made today will mark a first for Western Canada.

      At a news conference held today (November 16) at Vancouver General Hospital, B.C. Health Minister Adrian Dix announced that province will now be able to provide publicly funded gender-affirming lower surgeries within the province.

      Dix stated that details about the lower surgery program are still being finalized but will be running within Vancouver Coastal Health in 2019.

      In the past, those who sought gender-affirming lower surgery were publicly funded but they had to travel outside the province, which created additional financial, medical, and mental or emotional challenges, including increased stress and depriving patients of their social support systems at home.

      “The trans community has advocated over a number of years for improved access to care, including access to complex lower surgeries within B.C.,” said Adrian Dix, Minister of Health. “For those seeking lower surgery, people were required to travel to Montreal or to the U.S., resulting in additional medical risks associated with travelling long distance after surgery and in receiving followup care if there were complications.”

      In addition, access to publicly funded gender-affirming chest and breast surgeries will expand beyond Vancouver and Victoria with an additional nine surgeons in Burnaby, Kamloops, Kelowna, Port Moody, and Prince George, for a total of 14 surgeons in the province.

      Expanded access to gender-affirming surgeries is part of the new B.C. Surgical and Diagnostic Imaging Strategy, which the B.C. Ministry of Health is funding with $75 million in 2018-19 and will increase to $100 million in 2019-20.

      In response to a question about how much these surgical procedures can cost, Dix said the contracts paid for by the medical services plan are not public.

      "But clearly the cost of those surgeries in the United States, and even in Montreal, is dramatically above what would cost the public healthcare system to do those surgeries here so in the longterm, this absolutely makes sense," he stated.

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      Trans Care B.C. medical director Dr. Marria Townsend said that as gender-affirming surgeries are incredibly specialized and require "meticulous pre-operative planning and post-operative followup", she went on to explain how care provided closer to home can improve surgical outcomes.

      "When surgical complications do arise, people will now have access to an in-province skilled team of surgeons who can appropriately address complications in a timely way before things worsen," she explained. "My hope is that this will reduce the number of times that people have to make that stressful decision about whether or not to go to an emergency room when they are experiencing a complication, an emergency room where the team may potentially have no experience working with transgender people or know anything about the surgical procedures that person has had."

      Trans educator Gwen Haworth, who documented her transition in the 2007 documentary She's a Boy I Knew, talked about the challenges she faced after coming out as trans in 2000 and traveling to Montreal in 2004 for surgery unavailable in B.C.

      "At the time, access to care was more limited and required jumping through additional hoops. Navigating what did exist was challenging, costly, and time-consuming," she said. "This impacted my ability to focus on other areas of my life and it put a strain on my relationship with my family, my friends, and loved ones."

      Vancouver-West End MLA Spencer Chandra Herbert, who said he knows many trans people who have suffered in the past and how trans people have and continue to face stigma, shame, hatred, and discrimination, called the announcement "a real step forward".

      According to a B.C. government news release, the number of people who travel outside B.C. to receive lower surgeries each year, which is currently around 100 individuals, has been increasing annually. The number of gender-affirming chest and breast surgeries rose from 56 in 2014 to 178 in 2018, with over 200 anticipated in 2019. An estimated 46,000 British Columbians identify as trans or gender diverse, and only a small number of these people will seek gender-affirming medical or surgical services.

      Today's health announcement follows the B.C. government's decision, effective November 1, to include a third gender option, "X", on government-issued identification, in addition to "M" and "F".

      Additionally, in the face of a conservative Christian–based petition and rallies to remove the LGBT–inclusive sexual orientation and gender identity (SOGI) intitiave in B.C. schools, the B.C. government affirmed on September 29 that SOGI resources for schools would remain in place.

      You can follow Craig Takeuchi on Twitter at @cinecraig or on Facebook. You can also follow the Straight's LGBT coverage on Twitter at @StraightLGBT or on Facebook.

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