Alberta Trans* Healthcare Under Fire
Trans* healthcare in Alberta has taken a heavy hit this year, causing concerns across the province’s Trans* community. The first strike was to gender-affirming top-surgeries in January, wherein Alberta Health modified their approval process for the surgeries.(1) Although mastectomy and breast augmentations are now covered under Alberta Health Insurance, many individuals are now being rejected or bumped from the waiting list for improperly filed paperwork.
Prior to January 21, gender-affirming surgeries required a recommendation from either an individual’s doctor or psychologist in order to be placed on the waiting list for surgery. Now, Alberta Health requires a diagnosis of gender dysphoria by a licenced Alberta Psychiatrist, along with the completion of the new “Request for Breast Surgery form.” However, the form cannot be processed by the individual seeking surgical treatment; the process needs to be requested and validated by the individual’s surgeon or primary care provider.(2) This setback has completely reshuffled the list of people waiting for these surgeries, causing agonizingly long wait times to grow even longer.
Then in early September, Trans* Albertans were sent reeling in the wake of Dr Michael Marshall’s resignation as the head of the Gender Program at the University of Alberta. In an interview with Global News, Dr. Marshall cited lack of funding as the cause of his abrupt departure. However, no amount of funding can explain his lack of notice to his patients, many of whom found out about his resignation from the news or social media.
Understandably, many within the trans* community are frustrated with this news, as it means that their transition will be delayed much longer. If no other head is found for the Gender Program, 3000 - 4000 individuals will be stranded and left to find other routes for care; a dangerous ultimatum for those who rely on the program for their hormones.
Alexander Anne, a now-former patient of Dr. Marshall, is feeling a little stranded. “When he was originally stationed in Red Deer, my roommate was seeing him, and I was waiting for my first appointment when we found out he had moved up to Edmonton without giving his patients any notice…. I had an appointment with him in May,” Alexander explained during our conversation. “He was still actively in charge of my referrals for top surgery and so on when I found out via a Facebook post that he had resigned.”
Dr. Joe Raiche, who is a psychiatrist in Calgary specialising in Trans* care voiced his worries to Global News about just where those displaced patients will go.
“The other psychiatrist is maxed out and doesn’t have a lot of capacity to absorb [the displaced patients], so do they come to Calgary? We are looking at trickle-down that will impact the entire province and unless there’s a different system for transgender Albertans, it will add to that dismal wait time.”(3)
In an article posted to her Patreon, Kara Dejong-Roberts, a resident of Edmonton, AB, voiced her concerns:
“Alberta Health has to step up its game when it comes to the health care of LGBT individuals. We're fighting to survive amongst a society so unwelcoming and despite constant pushback, we continue to [prevaile]. I know several transgender people who have successfully committed suicide because they weren't accepted by their family and had nowhere to go for help because well, there is [none]”(4) [sic]. Kara pointed out in her article that there would be a drastic increase in suicide by Trans* individuals in response to these changes.
According to the Centre for Suicide Prevention, Trans* people are twice as likely as other individuals in the LGBTQIA+ community to attempt suicide and states that approximately 22% - 43% already have. They cite some of the risk factors for suicidality among Trans* individuals include the stress of the risks and wait-times involved in transitioning, as well as: “Institutional prejudice manifesting as laws and policies which create inequalities and/or fail to provide protection from discrimination”(5). Fully transitioning has been shown to lower the rate of suicide amongst Trans* individuals significantly, which sounds like an absolute no-brainer.
Skipping Stones, a non-profit in Calgary has dubbed the situation the “Trans Health Crisis,” and has responded by creating a letter-writing campaign.(6) The intent of this campaign is to inundate health and political officials with concerns about Trans* Healthcare. Skipping Stones’ call to action has caused several members of the LGBTQIA+ community and its allies to urge the Alberta government to adopt more Trans*-positive healthcare practices, suggesting, among other things, that we should adopt programs similar to those in British Columbia(7) and Ontario.(8)