Eighteen months after the passing of a law that removes surgical requirements for gender-marker changes, Quebec may finally adopt new regulations to accommodate trans realities.
Until recently, trans people could not change their gender until they underwent sex-reassignment surgery. That requirement was outlawed in December 2013, but Quebec is still working out new rules to replace it.
When new requirements were finally presented under a new provincial government last December, trans activists were unimpressed.
“So far everybody has been quite clear on how the regulation that was proposed is not good,” says Gabrielle Bouchard, activist and coordinator at the Centre for Gender Advocacy.
“The minister of justice clearly showed that she didn’t expect people to react so strongly [to the proposed regulations], which in turn leads me to believe she was very badly informed and misled to think that this was okay.”
But Bouchard says there is good will to change it. The justice minister kept her promise to hold committee hearings for community groups. Those hearings ended May 14.
The proposed regulations included three criteria. Firstly, someone wishing to change their gender would have to live two years at all times under the appearance of that gender, and promise to live with that appearance until they die.
Second, they would need a letter from a doctor, psychiatrist, sexologist or psychologist stating that a gender change is beneficial. And a third person would need to testify under oath that they have known the person for at least two years, and that they have been living under that appearance.
A two-year, full-time-appearance period is a contentious issue — trans people are sometimes forced to change their appearance, depending on where they are.
“They may have to go see grandma dressed as they were dressed before, just because grandma won’t get it,” Bouchard explains.
Full-time appearance is also difficult to prove.
“Do you have to show the [registrar of civil status] your picture in pajamas? What type of bikini you wear?” Bouchard asks. “You might not want to wear something that is very gendered, just because it’s not safe for you.”
BC, Alberta, Manitoba and Ontario have no waiting period or surgery requirement.
According to Bouchard, there is a double standard when it comes to changing different aspects of civil status. Couples wanting to be married don’t have to prove they’ve been together for a certain period of time, for example.
“There is more marriage and divorce in Quebec than there is gender-marker change,” she says.
The second requirement, a letter from a medical professional, is being criticized as unnecessary.
“Health and mental health specialists should not be required to provide a letter in order to confirm somebody’s gender identity,” says psychologist Françoise Susset. “If what you’re wanting to do is confirm someone’s gender identity, no one can do that.”
The third corroboration of living under the appearance of a sex for two years is also dangerous for trans people, because it makes them dependent on another person’s testimony.
“It puts people in potentially toxic power dynamics,” Bouchard says, as trans people can be isolated after coming out.
“You’ll allow someone to decide what your gender will be or [what] your appearance will be — just to have this person in your life long enough for them to say you’re worthy of this gender marker change,” she says.
Most trans groups want to remove any requirement for corroboration, because they say a trans person is the only one capable of defining their own gender.
Reno Bernier, the registrar for civil status, directs the agency that approves claims for gender and name changes. He told the commission on May 13 that he supports corroboration to ensure the “stability and coherence” of Quebec’s official documents.
Bernier said the system needs to be “stable” to prevent people from changing their gender on a whim or for fraudulent reasons.
Having a declaration under oath to ensure a level of formality is not an issue, according to Bouchard. Having trans people take an oath that they will appear as one gender until they die, when definitions of gender are constantly fluctuating, is the problem.
A week after the end of the hearings, the commission — made up of Members of the National Assembly — released recommendations to remove the two-year waiting period and a medical assessment. The commission suggests the corroboration of an adult, who has known the person for six months and can vouch for their gender identity. The government is expected to implement these recommendations soon.
Some LGBT groups have advocated for removing gender markers altogether from documents like driver’s licenses and health insurance cards, and allowing people to determine their own gender identity instead of being assigned one at birth.
Until the regulations are finalized, trans people still need to follow the old law. This means they are unable to change their gender marker without genital reassignment surgery, which is difficult to obtain in the public system.
Transphobia and discrimination can also be amplified when gender markers don’t match a person’s appearance.
“Because my gender marker isn’t changed, I have to ‘come out’ every time I use my health card, for example,” James Hughes, a trans person from Montreal, told the commission.
Hughes added that he was refused a blood test at a public clinic because his appearance didn’t match the photo on his health card. Similarly, in order to receive study loans, he has to explain why his gender is marked as female on official documents. He is also forced to use gender-neutral bathrooms for disabled people.
The Centre for Gender Advocacy put together a map of public places where trans people have been refused services in the last 18 months. These places include Quebec’s driver’s permit agency, clinics and health services and the office of the registrar of civil status.
“There’s no strong process to be able to counter this.” Bouchard says, describing a bureaucratic system of filing complaints and the burden it puts on people that are already struggling with everything else in their lives.
These issues are faced by a growing minority across the province. According to Bouchard’s research, at least 1,000 people changed their gender identity since 1978, in 135 cities across Quebec.
Bouchard says hospitals are especially unwelcoming for trans people, although Bernier told the commission that there are 47 specialists in trans issues.
Pediatrician Shuvo Ghosh and Susset, meanwhile, testified that they could count the number of doctors who specialize in trans issues on one hand and that the most well-known mental health specialists working with trans people run private practices.
“There are many more of us than there are doctors, but people have to pay out of pocket,” Susset said. “It’s one thing to have people pay for assessments leading to irreversible medical changes and another to mobilize the few health and mental health professionals to provide assessments for the State for admin purposes.”