Is BC’s Transgender Health Program in jeopardy?

Members of the Transgender Health Program (THP) are concerned about the future of British Columbia’s transgender health service after the recent resignation of long-time director Lukas Walther.

Walther, who worked for the THP for more than seven years, finished his tenure on Oct 6. He is reportedly out of town and could not be reached for comment.

The program’s advisory group chair says it will be very difficult to find someone with Walther’s skills set but hopes he’ll be replaced as quickly as possible.

“A lot of people like myself are trans and we have a lot of knowledge about what being trans is and lived that experience. But what most of don’t have is the kind of connections he had in his head, and he’s just walked out the door with those,” Gayle Roberts says.

The THP was established in 2003 to replace Vancouver Hospital’s Gender Dysphoria Program — also known as the Gender Clinic — after it closed in May 2002. Established in the early 1980s, the Gender Clinic’s mainly clinical approach offered psychiatric and medical care for transgender people and was the sole gatekeeper for publicly covered transition surgeries.

Roberts doesn’t know how the program will continue without a director. She says administrators haven’t got anybody lined up to take Walther’s place. “When we asked at the meeting when this was likely to occur, we were not given any kind of date. It appears nobody is in the works. If his absence continues for a month or two months or six months and so on, then the program can be really harmed.”

Vancouver Coastal Health, which administers the THP, is seeking to replace Walther, who worked 30 hours a week, with a staff person who will work 20 hours a week for the duration of an external program review expected to conclude this December.

Vancouver Coastal Health’s director of mental health and addiction, Lorna Howes, says an additional staff person will be contracted to fill in for the remaining 10 hours.

“We conduct reviews of our programs from time to time to ensure they are meeting clients’ needs and following clinical best practice,” Howes says. “The budget from the Transgender Health Program is not changing.”

She says the review, which costs $30,000 of the program’s $160,000 overall operating budget, will help determine what services are available, as well as the best way to deliver them.

“What I would really want people to do is to engage with the review process so we can get the right skill sets to match the services,” she says. “So if people can get their thoughts and support into the review process we can all come away with a better understanding of the vision of the program.”

“VCH is completely committed to keeping this program running,” she promises. “And money will not be leaving the program.”

Advisory group member Michelle Bourbonniere is not convinced.

Bourbonniere is concerned about the fiscal transparency of the program. Despite repeated requests, she says VCH has failed to furnish the advisory group with a financial statement. Instead, the group was given a pie-chart breakdown of expenses, which lists percentages but no figures.

“This severe lack of transparency is leading members to believe that there may be something sinister going on with the budget,” she says. “At every meeting since January we’ve been asking where the money’s gone and have received no answer.”

Bourbonniere is particularly concerned about staffing costs, which constitute 58 percent of the budget, according to the pie chart. She claims that a staff member took several months of paid and unpaid leave from their position, which was not filled during their absence.

“It would have been a fair chunk from the budget that would have been allotted for that staff person,” says Bourbonniere. “We have asked management before and she told us that all money to the THP has stayed within the program, but she has not offered any proof to back this up. We’re supposed to take her word for it.”

Howes says that a person was, in fact, contracted with the leftover money. “In this case there was a gap between a person being paid for sick leave and returning to work,” she says. “That money was used to contract out for other people to provide the services that the other person would have been providing.”

Howes says privacy concerns prevent her from disclosing a detailed financial summary that would include things like an individual staff person’s salary benefit package, but she agrees the information could be broken down a bit more.

“We could provide financial information for direct services and indirect services but not to the penny,” she says. “It’s not a secret. But the level of detail they may be requiring might be considered confidential. We can provide general information. There’s no reason it can’t be shared.”