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British Columbia Transgender man files complaint against B.C. health ministry over surgical delay

A transgender man has filed a human-rights complaint against B.C.'s Ministry of Health over delays in his gender reassignment surgery, and advocates say such backlogs are a continuing and unacceptable problem.

The complaint, filed at the B.C. Human Rights Tribunal, accuses the ministry of discrimination.

The complainant, who is not identified, says he has applied for female-to-male gender reassignment surgery, specifically a bilateral mastectomy with chest contouring. He says he was authorized for Medical Services Plan funding in July, 2013, but still has not had the procedure.

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He says the ministry authorizes only one doctor in the province to perform the surgery and that doctor has missed time on medical leave, pushing already scheduled surgeries even further back. The complainant says the delay has had an extremely negative impact on him and caused stress.

The complaint was originally filed last July; a tribunal adjudicator last week ruled it could move forward.

Dara Parker, executive director of Qmunity, a Vancouver-based resource centre for the lesbian, gay, trans, bi and queer communities, said the lengthy wait for gender reassignment surgery is a recurring problem. "People stay on waiting lists for years," she said in an interview Wednesday.

Ms. Parker said the waiting list just to be assessed for gender reassignment surgery generally has between 100 and 200 people on it. The waiting list for an actual procedure – once funding approval has been granted – can have 100 to 200 more, she said.

Ms. Parker said there's still a general lack of awareness among the public when it comes to the need for gender reassignment surgery.

"They're essential, life-saving surgeries. But I think the average person still sees them as elective," she said.

Andrea Szewchuk, of the Catherine White Holman Wellness Centre, a holistic facility that serves the trans community, said it can take up to two years, if not longer, for chest surgeries to be performed once funding has been approved.

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Dr. Szewchuk said chest surgeries can be carried out in B.C., but other procedures, such as a vaginoplasty or phalloplasty, require individuals to travel to Montreal because the proper medical infrastructure is not in place here.

"Historically, transgender health has not really been as well-supported as it should be. I think that is shifting – it just needs to shift more quickly," Dr. Szewchuk said in an interview.

The Ministry of Health, in a written statement, said it is working to improve access to gender reassignment services. In 2010, it said, it expanded the province's gender reassignment surgery program to include coverage for chest contouring and to provide dedicated operating-room time for mastectomies and contouring. The statement said B.C. recently removed the requirement that individuals must live as their chosen gender for a year before being eligible for referral to surgery.

Last month, the ministry announced the Provincial Health Services Authority will assume responsibility for the co-ordination of transgender services in B.C. in April. Health Minister Terry Lake said at the time the province recognized there was room for improvement in the access and delivery of health services to transgender people.

Anna Marie D'Angelo, a spokeswoman for Vancouver Coastal Health, said the doctor who was previously on medical leave has returned to work, after missing more than three months.

The complainant in the human-rights case says the ministry insists on overseeing the entire process for transgender patients, which causes unnecessary delay and uncertainty. The complainant says such oversight is not required for cisgender patients.

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The complainant requested anonymity because he said transgender people are at higher risk of violence, and susceptible to discrimination in areas such as employment and housing. The ministry opposed the request, but the adjudicator granted it.

The ministry told the tribunal it cannot be blamed for the fact the surgeon has a waiting list. It said the tribunal is already hearing a similar case about the process individuals must go through before they can be approved for gender reassignment surgery.

Adjudicator Marlene Tyshynski ruled that allowing the new complaint to move forward would be in the public interest. She recommended the two cases be joined.

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