The Ontario Government and Sexual Reassignment Surgery

This is a little different from what I normally write about on this blog, but Sexual Reassignment Surgery (SRS) has been on my mind alot this week. What I am mostly bugged about is the complete ignorance Ontarians seem to have about this topic…

So, this week, George Smitherman, the Minister of Health for Ontario made a statement about relisting SRS in our Ontario Health Insurance Plan (OHIP). Ten years ago, the Conservative government made the cruel and stupid decision to de-list the important surgery. For the past 10 years, trans activists and their allies have been fighting to get this surgery relisted and countless transgender and transsexual people who want and need this surgery have been suffering needlessly from the government’s neglect and penny pinching (it’s estimated that this re-listing will cost the province about $200,000 per year, a mere fraction of the total health budget).

George Smitherman originally made this promise back in 2003, and then backed down on it, and many of us lost faith in him. Now, he has announced that the surgery is back. A little late, but I am relieved and thankful.

According to a Toronto Star poll done yesterday, 74% of Ontarians are against the move. I’m not that surprised. Transphobia and genderism is still very much a problem in Ontario (and elsewhere) and transpeople are still regarded as people with psychiatric problems.

And this brings me to my next concern. Smitherman has said that all surgeries must first be approved through the Centre for Addiction and Mental Health’s (CAMH) Gender Identity Clinic (GIC), a clinic that has come under a great deal of fire by the LGBT communities in recent years. Trans health care is a developing field, and the Standards of Care have changed and updated with the times in order to be more respectful of transpeople. CAMH’s GIC is criticized for not updating their assessment criteria and not using these internationally approved new standards.

And there is an alternative. Over the last 10 years, transpeople able to pay for the surgery themselves (and most people can’t afford it) have been accessing SRS on their own in Canada and in other countries. To be approved, they usually have to produce a couple of letters (from a psychiatrist and a psychotherapist) corroborating their readiness for the surgery. There are capable, transpositive health care providers in Ontario who have been providing these assessments and letters for years (and who follow the new Standards of Care). Transpeople should have the option to continue seeking assessments from these folks. Don’t we all deserve a choice in our health care providers (imagine if you needed a triple by-pass and you were told you could only go to one clinic in all of Ontario, a clinic that many people with coronary problems had criticized?)?

On Thursday, just before Smitherman’s big announcement, a dozen excited e-mails crackled through my inbox, predicting the relisting (the news had been leaked the night before). I saw a few clients that day who had heard the news, people who have been waiting for years for this decision, people for whom this really matters. SRS for these folks is not a superficial sort of plastic surgery. It is a life defining, life preserving, medical requirement.

So hurray for Ontario. And let’s hope that Ontarians catch up with this decision in time. And let’s hope that Smitherman expands the options for assessment so that they are more in line with international trans health standards.