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Changes to Trans Health Program spark concern

Results of program review expected in March

The need for trans support services in Vancouver is growing, says Kelly Worrall (above), but the Trans Health Program seems to be limiting the support available. "It's impossible to provide care for trans people in BC on $160,000," she says. Credit: Nathaniel Christopher photo

Members of Vancouver’s trans community are alarmed by what one person describes as “the ongoing failure of Vancouver Coastal Health to provide adequate care to the gender-diverse community of BC.”

“I wanted to bring attention as quickly as possible to how dire the situation was,” says Kelly Worrall, who facilitated a public meeting on Jan 19.

The meeting, which attracted 17 attendees, was held partly in response to a Facebook note written by Catherine Mateo, a member of the Transgender Health Program’s (THP) advisory group. Mateo’s note outlines some of the potential changes coming to the THP’s Thursday night drop-in group.

Vancouver Coastal Health (VCH) runs and funds the THP and is currently reviewing its programming. The review, which costs $30,000 of the program’s $160,000 operating budget, will help determine what services are available and the best way to deliver them, says VCH director of mental health and addiction, Lorna Howes.

The review was initially scheduled to conclude in December but was extended by two months to include more voices.

“Once the plan started to come together, we found out that we actually needed to expand the group of people we were talking to to include more people than the original scope of the project,” Howes explains. “It was initially just the advisory group, but we’ve since talked to other stakeholders, including community members, as well as some people from the medical community.”

The proposed changes to the Thursday drop-ins were presented by a review contractor at the Jan 10 advisory group meeting.

The need for trans support services is growing, says Worrall, yet the THP is looking at limiting the support available to meet budget, “when the answer clearly, in my view, is that we desperately need to increase the resources. But we cannot possibly meet the needs of the community on $160,000. It’s ridiculous!”

Some of the changes proposed include limiting attendance to 20 people per Thursday drop-in meeting (or 10 if only one facilitator is available) and requiring attendees to be registered and approved before they can attend.

“It’s great that we’re going to get 10 people getting a better support experience,” says Worrall. “But if that means we’re getting five people who aren’t getting support or new people who are looking for a friendly face to talk to about their problems and God forbid we lose one of those people as a result — and we’ve lost three people in the last month — if we lose another one because they don’t have a place to turn to, this is terrible.”

Mateo believes the THP plans to eliminate spontaneous drop-in participants from its Thursday meetings in order to preserve the meetings themselves. “Virtually everyone in a position of authority at the THP believes that if changes are not made, the group will be eliminated completely,” she claims.

Corey Keith, who attended the Jan 19 meeting, says the Thursday drop-ins are a vital component of transgender wellness in Vancouver.

“We need to claim and find our own space. But in the meantime, we need to get the support we need for our medical needs, like getting hormones, looking at SRS, those sort of things, depending on individual situations,” she says. “That’s primary. But not only that, we need emotional support. Other than the support groups it’s something that’s been totally forgotten. That’s a huge part of mental health, especially if you remain in a family or society that is not supportive of you.”

The THP was established in 2003 to replace Vancouver Hospital’s Gender Dysphoria Program after it closed in May 2002. Established in the early 1980s, the old program’s mainly clinical approach offered psychiatric and medical care for transgender people and was the sole gatekeeper for publicly covered transition surgeries.

The THP now has four casual staff members who collectively cover the 30 hours that were vacated when long-time director Lukas Walther resigned in October. Howes says a new program coordinator will be hired following the completion of the review.

“There is no right decision to be made with $160,000,” Worrall maintains. “You’re not going to solve a problem. It’s an impossible mission to provide care for trans people in BC on $160,000.”

Howes says no decisions about the program will be made until the results of the review are finalized in early March. That report may include recommendations for more funding from VCH.

“What happens is that, like in any other program, if the report says we need more funding, we create a business case and put it forward,” Howes says. “Quite frankly, some of the other programs are very successful at getting increased funding. But there’s a lot of questions to be asked, including if it’s temporary funding or permanent funding.”

Howes has reviewed a “very early draft of the review” and says she feels optimistic about the future of the program.

“They are kind of attacking it from a whole bunch of different levels,” she says. “They are looking at things from the structure, the actual functioning of the program, clinicians in the program right through to on-the-ground stuff from the client’s perspective.”