Manitoba rejects funding for trans surgeries

Manitoba’s NDP government refused a proposal to fully fund sex reassignment surgeries for trans people, Xtra.ca has learned. The policy would have brought the province in line with British Columbia, Ontario and Quebec by covering the costs of hormone therapy as well as procedures like chest reconstruction and clitoral release.

The proposal, brought forward by the province’s Ministry of Healthy Living, was created after consultation with queer community members. It was approved by top bureaucrats but rejected by NDP cabinet ministers at a Treasury Board meeting earlier this year.

Kerri Irvin-Ross, Manitoba’s Minister of Healthy Living, refused to tell Xtra.ca why her department’s plan isn’t going ahead. “What happens in Treasury Board is confidential,” she said. But she added, “There’s an economic downturn happening and that’s slowing things down.”

Manitoba posted one of the only balanced budgets in Canada this year, increasing core spending by 4.4 percent. The government predicts a $48 million surplus this time next year.

Irvin-Ross declined to say if her proposal will be resurrected. “It doesn’t mean the strategy is gone forever,” she said. “My challenge right now is building an incremental plan. We are looking at moving things forward but not at the pace people are wanting.”

Last fall, an internal government document warned Irvin-Ross about the inadequacies of Manitoba’s current position regarding sex reassignment surgeries. Marked ‘Confidential,’ it said:

• Manitoba has no standards of care for gender identity disorder in spite of the fact that internationally accepted standards exist;
• Treatment is largely the financial responsibility of the individual and any provided services are coincidental and generally do not result in the desired outcomes associated with gender reassignment;
• Coverage is denied on the basis that treatments are cosmetic, experimental, or not medically necessary, contrary to all available evidence; and,
• The long-term social and economic costs of not treating gender identity disorder exceed the short-term costs of providing comprehensive treatment.

Currently, trans people in Manitoba who want to undergo a sex change have to be assessed by doctors at the Centre for Mental Health and Addictions (CAMH) in Toronto. If doctors at CAMH give the go-ahead, patients then have to take hormone treatments for up to two years. The full cost of hormone blockers and replacements — up to $400 per month — isn’t covered by government.

Most surgeries leading to a sex change aren’t covered, either. Manitoba pays for penis removal (penectomies) and breast removal (mastectomies) but after that, trans people are pretty much expected to pay for the rest themselves. Cosmetic procedures like chest reconstruction and clitoral release aren’t insured.

The proposal for funding that was rejected by the NDP estimated that 15 to 20 trans people a year would take advantage of the policy, at a cost to taxpayers of $15,000 to $60,000 per case.

Last fall’s confidential document also contained this warning for Irvin-Ross:

“Reforms in other provinces are well known within the local transgender community; Manitoba is quickly becoming one of the least responsive jurisdictions in terms of meeting the needs of the transgender community.”

When asked if she agreed with that statement, Irvin-Ross said no. “We’ve made progress and we have more to do,” she said.

An hour after Irvin-Ross was interviewed by Xtra.ca, she presided over a press conference at the Manitoba Legislature to unveil a new booklet aimed at eliminating homophobia, biphobia, transphobia and heterosexism in Manitoba.

In the audience were trans high school students Sebashtien Reece and Mark Harwood-Jones. When told of the Manitoba government’s decision to reject funding for sex reassignment surgery, they expressed anger.

“It’s a stupid move,” said Reece. “It shouldn’t have happened. To reject it is to say we don’t accept you.”

“It’s a big letdown,” said Harwood-Jones. “I feel like we were making strides but apparently the government refuses to acknowledge this.” Harwood-Jones said he would postpone his post-secondary studies so he can earn enough money to pay for sex reassignment surgery himself. “We don’t have support from our parents so we can’t get financial help from them,” he said.

Irvin-Ross has met with trans teens and their parents. She also travelled to a clinic in Montreal that performs sex-change operations, where she met a patient who underwent female-to-male surgery. “I thought they provided a great quality of service,” she said.

Manitoba’s NDP government has been in power for almost 10 years. “I don’t want people to think we’re not moving forward,” Irvin-Ross said. “But in the community it may not feel that way.”