Fully covered, in-province chest surgery might be finally within grasp for some of British Columbia’s female-to-male transsexuals, thanks to a recent policy change at BC’s Ministry of Health.
By directive of the ministry, Vancouver Public Health will now make operating room time available for chest surgeries in public hospitals in the Lower Mainland.
The ministry also decided to extend medical service plan (MSP) coverage to chest contouring, a surgical procedure to realign chest tissue after a mastectomy that previously cost trans guys up to $2,000.
For 31-year-old Ryan Jarman and about 30 other trans men, the long fight for access to the tools to transition might be nearing its end.
“I am really happy, but I am also still a little bit doubtful that it is really going to happen in the end. There have been so many delays and waiting,” says Jarman.
When Jarman was approved by MSP for a mastectomy in 2007, he was hoping it would be only a matter of weeks until he could get the surgery done. His hopes were quickly shattered when he found out the only way to get his sex reassignment surgery (SRS) in Vancouver was through private clinics, which are not funded by the medical service plan.
Jarman says he is now waiting for Dr Cameron Bowman, Vancouver’s SRS specialist, to give him “the green light” for surgery.
Bowman, who underwent a year of ministry-funded training to become an expert in sex reassignment surgeries only to find he couldn’t get operating-room time, says he is “tremendously relieved” to finally see some progress.
“This is what I am trained to do and this is what I believe in, so I am very, very happy with the decision and mostly happy for the patients who have been forced to wait for so long.”
Bowman thinks that within the next six months he will be granted enough operating-room time at public hospitals to perform chest surgery on about 30 trans guys that have been on his waiting list for years.
“It is good that the ministry has finally acknowledged that this is good, that it is important work, necessary work.”
Bowman hopes the ministry’s decision will open the door for more discussion about bottom surgeries too, which at this point are performed in Ontario and Quebec but not in British Columbia.
Equality in health coverage for female-to-male and male-to-female sex reassignment surgeries is another issue that still requires attention, he says.
“The government funds MtF bottom surgery, but not the other way round. That is an obvious inequity. It’s a human rights inequity issue among other things,” he says.
Like Bowman, Dr Trevor Corneil, medical director at Vancouver Coastal Health for transgender primary care, believes making operating room time available is an important step in the process of integrating trans men into society and BC’s healthcare system.
“Binding and covering up breasts can be uncomfortable and often painful,” Corneil says. “Having that [chest surgery] done sooner rather than later facilitates trans men’s ability to integrate into society as their gender defines.”
Michael Holmes, one of the trans men on Dr Bowman’s waiting list, knows all too well what it means to be unable to live fully in one’s self-defined gender. Like Jarman, Holmes was approved years ago by MSP to have his breasts removed, but couldn’t get the surgery done.
“It really puts a damper on things. You can’t go out swimming or doing anything like that,” he says. “If I could get the top surgery, that would mean a lot to me. I could move on and fit into the community a lot better.”
Jarman says he is convinced the surgery will make “a huge difference” in terms of his self-perception and level of comfort in his own body. He hopes the ministry’s recent decision will result in a long-term commitment to trans men’s health needs.
“For the people who haven’t been approved by MSP yet, it might be more difficult. I have no idea if they will be able to get their top surgery done in the future. These things change so fast. One month it is approved and the next it isn’t.”