Manitoba rejects funding for trans surgeries
TRANS / NDP government makes decision behind closed doors
Kaj Hasselriis / National / Friday, May 08, 2009
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PROPOSAL REJECTED. Kerri Irvin-Ross, Manitoba's Minister of Healthy Living, refused to say why funding for SRS was rejected earlier this year. A confidential government document warned the minister that Manitoba is lagging behind other provinces.
(photo by Brynn Hughes)
Manitoba's NDP government refused a proposal to fully fund sex reassignment surgeries for trans people, Xtra.ca has learned. The policy would have brought the province in line with British Columbia, Ontario and Quebec by covering the costs of hormone therapy as well as procedures like chest reconstruction and clitoral release.
 
The proposal, brought forward by the province's Ministry of Healthy Living, was created after consultation with queer community members. It was approved by top bureaucrats but rejected by NDP cabinet ministers at a Treasury Board meeting earlier this year.
 
Kerri Irvin-Ross, Manitoba's Minister of Healthy Living, refused to tell Xtra.ca why her department's plan isn't going ahead. "What happens in Treasury Board is confidential," she said. But she added, "There's an economic downturn happening and that's slowing things down."
 
Manitoba posted one of the only balanced budgets in Canada this year, increasing core spending by 4.4 percent. The government predicts a $48 million surplus this time next year.
 
Irvin-Ross declined to say if her proposal will be resurrected. "It doesn't mean the strategy is gone forever," she said. "My challenge right now is building an incremental plan. We are looking at moving things forward but not at the pace people are wanting."
 
Last fall, an internal government document warned Irvin-Ross about the inadequacies of Manitoba's current position regarding sex reassignment surgeries. Marked 'Confidential,' it said:
 
  • Manitoba has no standards of care for gender identity disorder in spite of the fact that internationally accepted standards exist;
  • Treatment is largely the financial responsibility of the individual and any provided services are coincidental and generally do not result in the desired outcomes associated with gender reassignment;
  • Coverage is denied on the basis that treatments are cosmetic, experimental, or not medically necessary, contrary to all available evidence; and,
  • The long-term social and economic costs of not treating gender identity disorder exceed the short-term costs of providing comprehensive treatment.
 
Currently, trans people in Manitoba who want to undergo a sex change have to be assessed by doctors at the Centre for Mental Health and Addictions (CAMH) in Toronto. If doctors at CAMH give the go-ahead, patients then have to take hormone treatments for up to two years. The full cost of hormone blockers and replacements — up to $400 per month — isn't covered by government.
 
Most surgeries leading to a sex change aren't covered, either. Manitoba pays for penis removal (penectomies) and breast removal (mastectomies) but after that, trans people are pretty much expected to pay for the rest themselves. Cosmetic procedures like chest reconstruction and clitoral release aren't insured.
 
The proposal for funding that was rejected by the NDP estimated that 15 to 20 trans people a year would take advantage of the policy, at a cost to taxpayers of $15,000 to $60,000 per case.
 
Last fall's confidential document also contained this warning for Irvin-Ross:

"Reforms in other provinces are well known within the local transgender community; Manitoba is quickly becoming one of the least responsive jurisdictions in terms of meeting the needs of the transgender community."
 
When asked if she agreed with that statement, Irvin-Ross said no. "We've made progress and we have more to do," she said.
 
'TO REJECT IT IS TO SAY WE DON'T ACCEPT YOU.' Trans youth aren't happy about Manitoba's decision to reject funding for sex reassignment surgery. "It's a big letdown," says Mark Harwood-Jones.
(photo by Brynn Hughes)
An hour after Irvin-Ross was interviewed by Xtra.ca, she presided over a press conference at the Manitoba Legislature to unveil a new booklet aimed at eliminating homophobia, biphobia, transphobia and heterosexism in Manitoba.
 
In the audience were trans high school students Sebashtien Reece and Mark Harwood-Jones. When told of the Manitoba government's decision to reject funding for sex reassignment surgery, they expressed anger.
 
"It's a stupid move," said Reece. "It shouldn't have happened. To reject it is to say we don't accept you."
 
"It's a big letdown," said Harwood-Jones. "I feel like we were making strides but apparently the government refuses to acknowledge this." Harwood-Jones said he would postpone his post-secondary studies so he can earn enough money to pay for sex reassignment surgery himself. "We don't have support from our parents so we can't get financial help from them," he said.
 
Irvin-Ross has met with trans teens and their parents. She also travelled to a clinic in Montreal that performs sex-change operations, where she met a patient who underwent female-to-male surgery. "I thought they provided a great quality of service," she said.
 
Manitoba's NDP government has been in power for almost 10 years. "I don't want people to think we're not moving forward," Irvin-Ross said. "But in the community it may not feel that way."


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Reader Comments


 
Hormones
"patients then have to take hormone treatments for up to two years. The cost of those treatments — about $400 per month — isn't covered by government." What hormones cost $400 per month? Mine cost about 45$ befor pharmacare.
Brodey, Brandon Mantioba
05/08/09 12:47 PM EST
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Inaccuracy in Reporting?
I agree with Brodey that the reporting on HRT is questionable. As someone who is on the MTF-spectrum, and as such, hormone costs are always higher, I am supposed to be paying $75 a month before quebec subsidies. After the quebec subsidies it's a mere $35. So where is the $400/month coming from? Aside from that, good article!
Kate, Montreal QC
05/10/09 10:20 AM EST
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Treatment costs
Thanks for your comments, Brodey and Kate. I've been told that the full cost of hormone blockers and replacements can be up to $400 per month. On Monday, I'll ask Xtra's online editor to change that sentence in the story to this: "The full cost of hormone blockers and replacements — up to $400 per month — isn't covered by government."
Kaj Hasselriis, Winnipeg Manitoba
05/10/09 1:19 PM EST
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Disappointing to say the least
I got a call from my psychologist recently telling me that Manitoba had decided not to cover her services for trans patients. I had no idea that surgery funding was on the line too. This is extremely frustrating, what are those of us who can't afford it supposed to do? It's a catch 22 for me, I can't pay for it with out a job but I need it so that I'm comfortable enough to get a job. The sad thing is this is the first solid, and recent, information on coverage in Manitoba that I've found. If only it wasn't bad news.
Vic, Winnipeg Manitoba
05/14/09 4:41 PM EST
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what is this? the 1940's?
good gods, penectomies? That they would cover such a horribly outdated surgery is flabbergasting! Why not just give us bloodletting or leaches?
Kaitlyn, Ottawa Ontario
05/14/09 5:43 PM EST
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What penectomies?
To Kaitlyn in Ottawa: They don't lop the damn thing off! They slit it open, scoop out the insides like a banana, flip it inside out, then stuff it back in with some packing to form the new shape. It's hardly cosmetic or outdated surgery...more reconstructive, and it WORKS!
Natalie Murray, Trenton Ontario
05/14/09 6:56 PM EST
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Funding in bc??
There's full funding in british columbia? I've been trying to tap into those resources and to no avail. It doesn't help I'm on disability and cant afford to pay for chest surgery myself. I really wish they'd start seeing that people like me/us NEED these to survive, I'm severely depressed because of the stop of my transition due to lack of funds, and haven't left my house in an entire year.
nio, nanaimo bc
05/14/09 6:57 PM EST
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That's not a penectomy, Natalie
What you are describing is a vaginoplasty. Penectomy is exactly as you said, a removal of the penis and nothing more. Now, it could be that the quote is in error and the author meant to say a vaginopasty, however they are two VASTLY different procedures, and penectomies are nearly a half century out of date.
Kaitlyn, Ottawa Ontario
05/14/09 7:22 PM EST
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Coverage in BC
There is very limited covered for trans health in BC. As an FTM, I can tell you that HRT is NOT covered (and my T only costs about $12/month), there's definitely no coverage for any FTM bottom surgery such as clitoral release, and as for chest surgery, removal is covered up to $1500, but male chest contouring is not. It would have been nice to see a quote in here from the President of CPATH. And, they've published PDFs on the state of trans health in each Canadian province. It would have been a good idea to consult those before publishing inaccurate information.
Joshua, Rainforest BC
05/14/09 8:00 PM EST
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Update on this story
You can read the latest on this story here: Activists speak out against Manitoba's SRS decision
Web Editor, Toronto ON
05/14/09 8:43 PM EST
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What penectomies?
To Kaitlyn: Zigackly. But you'd be surprised how many cisgens think a penectomy is involved...including a number of MDs I've dealt with.
Natalie Murray, Trenton Ontario
05/14/09 9:06 PM EST
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