The question of who will control sex reassignment surgery in Ontario remains un-answered, but trans activists say the system must change.
The provincial government announced in May that it would relist sex reassignment surgery (SRS) under the Ontario Health Insurance Plan (OHIP) 10 years after it was delisted. In June then-health minister George Smitherman told Xtra that he planned to return to the model in place in 1998, which had the Gender Identity Clinic (GIC) at the Centre for Addiction and Mental Health (CAMH) in charge of deciding who could access SRS.
That decision was condemned by many trans activists who accuse CAMH of being out of date and transphobic in its approach. CAMH held a community meeting on Aug 11 at the Sherbourne Health Centre (SHC) — which works extensively with the trans community — to discuss the issue.
Susan Pigott, CAMH’s vice president of communications and community engagement, says she told the meeting CAMH was not consulted by the ministry of health and has no idea whether it will end up in charge again.
“I don’t know what the ministry will do,” she says. “We have heard very little from the provincial government, not for lack of trying. We’re trying to encourage them not to just pick up where they left off.”
Pigott says CAMH will be meeting with SHC to discuss possible models for SRS that could be adopted by the province.
But some activists who attended the meeting say they were told things would probably return to the status quo.
“They said they were in consultation with the Sherbourne but that most likely they would go back to business as usual,” says Syrus Marcus Ware. “They said they were open to suggestions but most likely there wouldn’t be much change.”
That would be disastrous for trans people in Ontario, says Ware.
“They encourage you to be straight, they’re very rigid in terms of the gender roles and if you have a mental illness or other disability, you’re not considered,” he says.
Ware says a number of trans activists showed up to discuss SRS.
“The one thing that did feel really good was knowing that there was a roomful of trans activists,” he says.
Other trans activists who attended the meeting were more optimistic about what was said.
“What was so hopeful about the meeting is that somewhat senior members of CAMH seem to be listening to the concerns from the community,” says Hershel Russell, a local psychotherapist. “I think some of the new demands emerging from the trans community are that our treatment be the same as everyone else’s. We are the only group that is subject to being interviewed by a committee that decides on our lives.”
Russell says CAMH does have a long history of negative treatment of trans people, in particular from Kenneth Zucker, who heads up the child, youth and family program of the GIC, and Ray Blanchard, the head of CAMH’s Clinical Sexology Services. But he thinks activists should ignore them and work around them.
“I think it’s wasted energy,” he says. “Let them die their own quiet deaths, as quietly as possible. It would be very interesting to have under the roof both those who are perceived as dinosaurs and a progressive, cutting-edge clinic that could be world-class.”
Pigott says the two doctors did not come up at the meeting, although she does not deny the animosity toward them, and echoes Russell’s view.
“They weren’t discussed,” she says. “Most people don’t level criticism in the absence of the people being criticized. I think that probably where we’re going is not removing any level of service but adding to it.”
Anna Travers, the director of Rainbow Health Ontario which operates as part of SHC, says meetings with CAMH have been productive.
“On our end we’ve been talking to key members of the trans community to get their input,” she says. “I think it’s too soon to say what model we’ll end up with but I feel encouraged by the openness the ministry has shown and the openness that CAMH has shown.”
Pigott promises that CAMH will not unilaterally make any decisions.
“We did commit to the group on the 11th that neither we nor the Sherbourne, separately or together, would go to the ministry without checking in with the community.”
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