Sexual reassignment surgery is covered in seven Canadian provinces — for 94 per cent of Canadians — but those seeking the surgery in the Maritimes are forced to make tough choices about whether to pay for the surgery out of their own pockets.
After studying the issue, Health Minister David Wilson said in a letter last week that the province has decided not to fund the surgery.
“When we must decide which areas to fund, there are a number of items to consider. For example, what does the best available research tells us, and are we able to fund a service within our limited healthcare budget,” said Wilson.
“The department has given the matter of gender reassignment surgery considerable consideration and we went through a careful policy review, including extensive research and consultation with other jurisdictions.”
The surgery is either partially or fully funded in all provinces except Nova Scotia, New Brunswick and Prince Edward Island.
Proponents for covering the cost of surgery, such as the Nova Scotia Rainbow Action Project (NSRAP), argue that the surgery is “necessary for the well-being of many transgender Nova Scotians.”
“Nova Scotia is lagging behind other provinces and doing a disservice to trans Nova Scotians who are not getting the care they need,” NSRAP argues on its website.
“Instead, some people travel to other provinces and countries and pay out of pocket for treatment. Many others go without the medical care they need even when such services are deemed medically necessary by a care team of doctors, social workers, and psychiatrists.”
Parker Jackson, 21, was born a girl. But at 7 years old, he said looking into the mirror made him feel wrong.
“Imagine waking up everyday and you’re just like. ‘Ugh, this is not right. This is gross. I don’t even understand myself. This is not how I belong. I need to change this’ — that’s how it feels,” said Jackson.
Jackson is in the process of transitioning to life as a man.
The process involves therapy and hormone treatment, but he also needs a double mastectomy and reconstructive surgery to shape his body to fit who he is.
In Nova Scotia, that is considered an elective surgery that comes with a $10,000 price tag.
“My friends are saving up to buy cars and saving up to get houses and move out. I’m saving up to get [chest reconstruction]surgery,” he said.
Group calls decision 'discriminatory'
Kevin Kindred, chair of NSRAP, estimates that between six and eight Nova Scotians require the surgery each year at a cost ranging between $30,000 and $60,000 each.
“You and I have the right to any medically necessary surgery to be covered by [Medical Services Insurance]. There's a discriminatory decision that somehow trans people don't have that same right — and that's what we're trying to tackle,” he said.
Jackson has a choice facing all transgendered Nova Scotians — whether to put his transition on hold while he saves thousands of dollars, or move to a province that covers the surgery.
“I don't want to move, so I've never looked into it because this is my home. I probably could move, but do I want to? No. I do not want to move. I want Nova Scotia to change and I want help and I want it in my home,” he said.
Wilson said there's a lack of high-quality research about the effectiveness and long-term outcomes of sex reassignment surgery.
He said the decision to deny coverage came after a careful policy review and is declining interviews until after he meets with NSRAP on Wednesday.