Before coming out as transgendered, 14-year-old Mackenzie Sawatzky walked six hours from her town of Stonewall. She spent three nights writing and sleeping on the streets of Winnipeg to find reprieve from a community that did not understand who she was or what she was going through. Two years later, Sawatzky goes by the name Reid Spence and confidently speaks about transitioning from female to male in a town, where until recently, such a thing was unheard of.
“Being transgendered is a big burden to bear, especially in a community that is so set in its ways about how society should be,” explains Spence. There are no resources in his hometown for transgenders and finding support from the people around him has been difficult. He has had a bible thrown at him while walking down the street and has received verbal and physical abuse from some of his classmates and teachers.
Although he deals with discrimination and resistance from the people of his community, Spence feels “blessed” for having a supportive family and a physician who is encouraging of his transitioning process, two factors which he realizes are uncommon among other trans youth.
Spence is one of an increasing number of young people who are coming out to their friends, families and teachers as transgendered and encountering the effects of a system that is not fully prepared for them. In Manitoba, where there is little public awareness about gender-identity issues, physicians and school systems are scrambling to provide the resources and the support that these young people are looking for.
“When kids discover that the term ‘transgender’ might apply to them, they don’t necessarily know where to go,” says Katie Owen who counsels many transgender youth at the Rainbow Resource Centre in Winnipeg. In Winnipeg, as with many cities and small rural towns across Canada, resources for transgender people are scarce or difficult to access.
“In most cases, family doctors don’t know a whole lot about transgender issues. Medical students only receive a short one- or two-hour workshop on this during their entire training as doctors.”
It is the physician, says Owen, who has the ultimate authority to refer a patient who is interested in transitioning. If denied by their family physician, as many are, a patient will have to wait to find another doctor who can refer them to an endocrinologist for hormone therapy, a psychologist for counselling, or a surgeon for sex reassignment surgery. But even if a family doctor is sympathetic to a young patient’s wishes, as Spence’s doctor is, if they do not have the requisite funds or the financial support of their parents, they cannot always access the services they need.
All patients seeking sexual reassignment surgery must travel to Toronto for a medical assessment, after which they cannot be guaranteed that their surgery can be performed in Winnipeg; some have to travel to Montreal for this. Manitoba Health covers the cost of the surgery but it will not cover related travel and accommodation costs or the costs associated with post-surgery care. And youth needing psychological support may not find the help they need, says Owen.
“If you don’t have health coverage for a psychologist, then you are sent to a psychiatrist and there are none in Manitoba that are specialists in trans-related issues.”
Although the medical system offers its share of challenges for transgender youth, so too does the school system.
“There are people in the school system who don’t know what to do with these kids,” says Jennifer Davis, project coordinator of Transgender Needs Assessment at the Nine Circles Community Health Centre in Winnipeg. Davis works with school divisions on transgender issues and can see how schools are lacking adequate supports to ease the transitioning process of transgendered students. Issues of bathroom safety, discrimination from teachers and students, and lack of opportunities to play on school sports teams are some of the issues being faced.
Young people are showing up to school in their gym clothes and wearing them all day, or holding in their bodily functions just so that they can avoid using the bathrooms or change-rooms at their school, says Davis. This puts these youth at risk for bladder and kidney infections and creates unneeded stress for students who are already struggling with a difficult existence.
Davis and other educators are working to improve this situation. Workshops are being held with school divisions to educate teachers and administrators on gender identity issues, and some schools are beginning to accommodate students within the existing infrastructure by letting them use the staff washroom to change and go to the bathroom.
A transgender networking committee has recently formed in Winnipeg to lobby the government for better primary care for transgendered people and the government is beginning to take notice, says Shelly Smith, executive director of the Rainbow Resource Centre.
“There is awareness now by the government because they have been challenged in the last couple of years,” says Smith. “The issue of gender identity is not going away, in fact it is the biggest issue [The Rainbow Resource Center] is now dealing with.”