Trans message boards lit up May 15. The hot topic? Ontario health minister George Smitherman’s comments during a Queen’s Park scrum which suggested he’s working to re-list sex reassignment surgery (SRS). Short on detail, the trans community was left wondering what re-listing the surgery would look like.
Susan Gapka is the chair of the Trans Health Lobby Group and has been working with Rainbow Health Ontario to get SRS covered by the province.
“This is the strongest signal from this government that they are prepared to move forward on sex reassignment surgery,” says Gapka.
A spokesperson for Smitherman calls it “an intention, a direction we’re moving in,” but admitted that “there are still some details that are being worked out.” Smitherman’s office pledges that the start date will be announced “in a few short weeks.”
But the devil is in the details — Ontario can re-list trans surgery in a way that still keeps it out of reach for most people.
Trans surgery was covered under OHIP (the Ontario Health Insurance Plan) until Oct 1, 1998. But tight controls meant only eight to 12 surgeries were performed a year — and only trans women had access to it. Stringent rules meant that many who wanted the surgery were barred from access through OHIP.
SRS is currently covered in British Columbia. In Alberta, the province approves 16 operations a year.
Helma Seidl is a counseller who helps people prepare for their transitions.
“There are lots of people who are very happy once they transition, who don’t want this surgery,” says Seidl. “But there are lots of people who waited because they don’t have the money — $16,000 per surgery or more. If we have it paid by they government, that will open up the opportunity to a lot of people.”
But with details scant, Seidl wonders which parts of the complex SRS equation will be covered.
“I hope it will include one-on-one counseling, laser hair removal, chest surgery and bottom surgery, but I don’t think they will include all of it. We’ll see.”
Smitherman made the comments after a reception on Queen’s Park about International Day Against Homophobia, but wouldn’t offer the details of the Liberals’ plan.
In the ’90s, the clinical-psychological model for approving operations left many feeling cold. In addition to those who were turned down, those who did go through all the steps “did not find it to be a good experience,” says Gapka.
At the time, all SRS in Ontario was approved by a single clinic — the Clarke Institute, now the Centre for Addiction and Mental Health (CAMH). Smitherman’s announcement caught CAMH off guard.
“We are pleased that the province is taking an interests in this; it’s an important issue,” says Michael Torres, a representative of CAMH. “We look forward to moving on this in the coming weeks.”
Torres couldn’t provide more detail as of press time.
Gapka, who works with the staff at the Sherbourne clinic, says that the next fight will be to keep trans surgery from returning to the old model.
“We will be monitoring the implementation. There’s an indication that it might go back to the 1998 process, and we really have to push to make sure that doesn’t happen,” says Gapka. “We need to meet with the minister and his staff to discuss how this is going to be rolled out.”
Still, the announcement represents an opportunity for the trans community to help shape the policy that will be adopted, says Gapka.
“It was a very courageous announcement,” she says. “The good news is that the way it was delivered in 1998 — that doesn’t exist today. It’s been dismantled. So if we have an opportunity to comment, and a seat at the table, we have to operate with the belief that what we say is going to be taken into account.”
Even Gapka was surprised by Smitherman’s announcement. In 2003, Dalton McGuinty announced that SRS was “not a priority” and would not be re-listed.
Gapka and trans activists across the province have been working on the Trans Human Rights Campaign. Their two goals were the inclusion of trans surgery in OHIP and getting trans people added to provincial human rights legislation.
Activists planned to use their inclusion in the Ontario Human Rights Code as a wedge to challenge the province’s stance on SRS.
“We had anticipated movement on the human rights amendment — we were expecting to get a statement on the amendment before the legislature rose for the summer. So this is good, it’s just not how we were expecting it to happen,” says Gapka.
But there will be plenty of time to work out the nuts and bolts in the coming months, she says. For now, she’s just happy that there is movement on a file that’s been stagnant for a decade.
“It’s a good day to be a trans person,” she says.
The next meeting of the Rainbow Health Network is Wed, May 21, 6pm. Room 222 of the Eric Palin Hall of Ryerson University at 99 Gerrard St E.