Sarah, a trans woman in Victoria, was shocked and ‘disappointed’ to learn that B.C. residents who wish to undergo gender affirming lower surgeries (vaginoplasty) can no longer take the MSP-funded GrS Montreal pathway. This means longer waiting times, putting pressure on the trans community who are already waiting for a life-changing surgery.
Hoping to make a change, Sarah joined a group of trans women in Victoria who came together to create the Trans Victoria Forum, filing a petition asking the province to reverse the decision, arguing it will significantly elongate wait times and restrict access.
The decision made by Trans Care BC on Jan. 13 said that instead of the GrS Montreal pathway, surgeries for B.C. residents will be provided only through the Gender Surgery Program (GSPBC) in Vancouver, noting that they prefer in-province care.
Accordingly, patients who have a complete referral submitted by March 31, defined as both a surgical readiness assessment from an approved assessor and a referral from a primary care provider, will still be processed at GrS Montreal, and no existing surgery dates will be cancelled.
Sarah, a core organizer of the petition, told Victoria News that many trans people who already wait years to receive access to the surgery find this development disappointing.
“These surgeries are very, very important. These surgeries are life-affirming and can be life-saving. Waiting for these surgeries for trans people is a very vulnerable mental state,” Sarah said.
The petition says that the GrS Montreal pathway usually takes nine to 15 months from referral to surgery, while GSPBC patients wait 12 to 16 months just for an initial appointment, with the surgery following several years later. Now that the Montreal option is removed, all the demand from B.C. goes through GSPBC, which only has two surgeons for the whole province.
Sarah explained that before being included in a surgical wait list, patients are required to complete one or more surgical readiness assessments. Publicly funded assessments can take nearly a year to access, and many patients wait longer to become eligible than they do for surgery itself, she said.
The petition notes that gender-affirming genital surgeries are recognized as medically necessary by the World Professional Association for Transgender Health, and are linked to important improvements in quality of life for transgender women.
Going forward, Sarah explained, they are planning to present the petition to the parties responsible for the closure in order to spur some action. Through the petition, they also wanted to make noise about the development and how it affects the community.
If patients are not given the Montreal option, organizers of the petition are asking for alternatives in the province with more facilities to expedite the process.
“Lowering the barrier to entry. For example, if you are waiting on hormones, the only publicly funded options to get a hormone readiness assessment, which is required to access hormones – when I went through it, it took me about a year to get that appointment, and that was, in its own way, a very frustrating experience,” Sarah explained.
In case the pathway is not reopened, the trans community expects that there will at least be increases in funding and capacity at GSPBC.
“Otherwise, B.C. goes from being one of the best provinces for accessing this care to one of the worst,” Sarah said.
The petition had more than 500 verified signatures at the time of the interview, with organizers planning to formally present it to provincial health authorities in the coming weeks.
Victoria’s Lea left a comment on the petition saying, as someone who has full intention of receiving GrS, this development is daunting and regressive.
“Wait times to access GrS already make the operation barely feel accessible. What will this do to the next generation of trans women in need of this step of gender affirming care?” she wrote.
“We must consider that removing the pathway to Montreal will actively harm our people. This should not happen without a sufficient alternative or greater access to trans health care here in B.C.,” Erin wrote.
The petition is available online at www.change.org/p/keep-the-grs-montreal-pathway-to-vaginoplasty-open-in-british-columbia?