The controversy over the Stelmach government’s delisting of Gender Reassignment Surgery (GRS) is fraught with what certainly appears to be “political” motivations and most certainly with, to be charitable, numerous misunderstandings of exactly what the procedure means and what transsexuality is.
That we, as a province, need to trim some fat off various budgets is a given. Once again, we are in a recession following an overly-inflated boom and, like the last time, we suddenly find the bottom has dropped out from under us.
But the fact that those we elected to manage our provincial affairs and tax monies did not learn anything from the last go-round, and got suckered punch by this recession with little or no contingency in place is, quite bluntly, incredible.
Booms are followed by busts and while the previous boom didn’t last long, it was inevitable a recession was going to hit. The provincial government should have understood that. That they appeared to not have understood that, let alone neglected to take steps to shore up such safety nets as social assistance, medical care, housing, etc., suggests rather strongly what their level of competence is; and it doesn’t look good.
Be that as it may, to delist GRS in order to save a paltry $700,000 (and it is paltry when we are looking at a deficit of $4.7 billion) is unconscionable. To even put the discussion in terms of dollar and cents is unconscionable.
Yes, I realize when one is dealing with budgetary concerns it comes down to dollars. Having sat on numerous boards over the years, I understand the headaches of dealing with budgets, trying to be responsible and cutting unnecessary expenditures, or at least expendable ones. That transsexuals are seen as “expendable” is disturbing.
There also seems to be an ignorance on the part of “average Albertans” when it comes to this issue. The letters to the editor in both of Calgary’s major newspapers, and no doubt in other newspapers throughout the province, are full of misdirected calls for those seeking GRS to save up some money and fund the procedure(s) themselves. Tell me, who in this current economic climate can realistically save the tens of thousands of dollars the surgery costs? It’s not like your average transperson is a CEO of a major company, or pulling down a fat paycheque (though they could be if such ignorance wasn’t so prevalent to begin with).
Plus, many of the subsidiary procedures are not covered by Alberta Health, such as surgery to “feminize” the face, larnyx shaving to increase the pitch of the voice, electrolysis, and breast implants for Male-to-Female (MtF) transsexuals or masectomies for Female-to-Male (FtM), and hormone treatments. Only the actual reassignment surgery, commonly referred to as “bottom surgery”, is covered, so the individual already must pay for these procedures.
The actual genital surgery is done in Montreal, necessitating travel and related expenses while one recovers from the complex and highly invasive surgery. Alberta Health only covered the costs of the actual surgery and recovery.
Such surgery, be it “only” the genital aspect or the whole spectrum, is hardly what any reasonable individual upon reflection would consider “elective” or “merely cosmetic.”
Certainly, to suggest transfolk “choose” to become the opposite gender and therefore should pick up the costs themselves is naive at best and cruel and willfully ignorant at worst.
Transsexuality is a recognized medical condition and the treatment is surgery to bring the physical body in line with the actual gender identity of the individual. If one were to make an analogy - and I hesitate to do so for fear of further trivializing the issue - for many MtF transfolk the presence of a male appendage is like having some sort of major tumor on their body that impacts all aspects of their lives.
They may look, act, dress and, for all intents and purposes, be female but as long as they possess the genitalia which, in our culture, defines them as male, there is a profound and ongoing disconnect occurring in their lives and psyches. Ditto for FtM transsexuals.
There are also some legal issues involved. If one presents as one gender yet all one’s documentation is issued under another, it creates a myriad of roadblocks to successful daily living. You get pulled over for a simple traffic violation and the officer asks to see your driver’s license. Your license indicates you are the opposite sex. Your average cop is not that well-versed in gender politics so, as far as the officer is concerned, you’re “in drag” and immediately suspect. And say you want to travel to the States. It doesn’t take much to get an inkling of the hoops one would have to go through, to get the appropriate documentation (passport, travel visas, etc.) when your birth certificate lists you as the opposite gender.
Many transfolk are forced to constantly carry documentation indicating their transsexual status or their transitioning status, such as a doctor’s or psychologist’s letter. So much for just blending in and getting on with one’s life.
In some jurisdictions, you cannot get your birth certificate altered to reflect who you are now. As far as the powers that be are concerned, it doesn’t matter what gender you are supposed to be, because in their view the birth certificate reflects how you were born, and cannot/should not be changed.
As for personal relationships, which are so important to us as human beings, imagine meeting someone and reaching a point where intimacy is likely. Then you must have ”The Conversation” with the person you hope feels as strongly about you as you feel about them - only to be met with an adverse, and too often a violent, reaction. For many MtF transwomen the reaction on the part of their (male) partners is not just violent, it alarmingly often becomes homicidal. The list of murdered transwomen, commemorated each year during Trans Awareness Week, is long...too long.
I am not as aware of the statistics for transmen in such a situation. While many transmen have come out of a strong dyke culture, and of these many elect to not undergo so-called ‘bottom surgery’ since phalloplasty or similar procedures are nowhere near as successful-looking as created vaginas and labia, clearly transmen are not exempt from violence or negative reactions regardless of whether their partner of choice is genetically female or male. I am aware of some transmen who identify as gay men and I am certainly aware of the attitude many gay bio-males (not a great term) have towards their trans brothers, so I am assuming gay-identified transmen experience similar reactions to that which heterosexual transwomen experience.
When I was the Prairies/NWT/Nunavut Regional co-director for Egale Canada, one of the committees I sat on was the Trans Issues Committee. The key issue at that time was Ontario’s delisting of GRS and having the procedure re-listed under the Ontario Health Insurance Plan (OHIP). It was a long and stressful process for all involved, but especially for those directly affected by the delisting.
Just as we are seeing here in Alberta, many transfolk found themselves suddenly left in limbo. The long-awaited and long-hoped for surgery designed to assist them in being who they were was suddenly and inexplicably off the table.
Disappointment doesn’t even begin to describe what some of these individuals experienced.
They were panic-stricken, by and large, and what hopefulness they had finally been able to garner after years of heartache, struggle, dysfunction, and in some cases suicidal tendencies was suddenly ripped away from them. One day, the future at last appeared within their grasp. The next day, it was gone.
Luckily, through the efforts of some very brave and persistent individuals within the trans community and the support of openly gay then-Minister of Health George Smitherman - the decade-long delisting of GRS in Ontario was reversed.
Of course there are still some issues to work out, such as having candidates for GRS vetted at least in part through Toronto’s Centre for Addiction and Mental Health (CAMH) - which has come under extensive fire from trans activists for its treatment of trans people in the past - and having only one doctor, based in Montreal, responsible for all surgeries. But overall it would seem the relisting of GRS in Ontario has been successful despite OHIP currently covering only genital reconstruction for both MtF and FtM surgeries, as well as mastectomies. OHIP will not cover breast augmentation or hormone treatment, although a spokesperson for OHIP has stated some people may be eligible to have hormones covered by the Ontario Drug Plan.
It would seem a reasonable, and reasonably easy thing to do for Alberta to learn from Ontario’s experience and follow suit. If history is any indication, however, the Alberta government will dig in its heels to force a time-consuming and expensive human rights battle, and it will be years before GRS is relisted here. Meanwhile, real tragedies and real trauma will continue to unfold. And that is unconscionable.
