Some, but not all, trans Nova Scotians no longer have to shell out thousands of dollars for sex reassignment surgery. On April Fools' Day, the province announced it would fund eight different types of sex reassignment/gender confirming surgeries for trans Nova Scotians. The procedures allow trans individuals to reflect on the outside the gender they feel inside.
When he heard the news, Halifax youth worker Jay Aaron Roy wondered if it was a prank. In December, Roy launched an online fundraiser soliciting donations for his chest surgery. Including recovery time and possible travel, the operation could cost as much as $8,000. As of this writing he had raised $693.
Roy thinks the move to fund the surgeries is a fantastic first step, but isn't sure what the announcement means for him and other trans guys. Mastectomy---the removal of breast tissue---is now covered, but he needs chest masculinization---an operation that includes reshaping---and it isn't on the list of funded surgeries.
It's also unclear whether the medical expertise to perform certain gender-confirming surgeries exists in Nova Scotia. Currently trans people travel to Ontario and Quebec seeking some surgeries on the list, including the procedure Roy wants. "There's just a big question mark," he says. "We don't know. Do we have these services?"
The province says as a first step toward surgery, trans people should speak to their family doctors to be assessed for clinical eligibility, receive any necessary counselling and, if they qualify, develop a transition plan. Roy spoke to his doctor last week, but his doctor was also unsure whether the surgery would be funded. "My doctor and I are asking the government, what does [this announcement] mean?"
Any medical services outside the province that happen as part of a patient's gender-confirming surgical plan are now publicly funded, according to the department of health and wellness. Operations including phalloplasty, metoidoplasty and vaginoplasty are not currently performed in NS.
Provincial spokesperson Tony Kiritsis says out-of-province travel costs for surgery are covered as long as the patient is pre-approved through MSI, and that the province is not funding chest masculinization or chest contouring. Kiritsis says the department of health plans to monitor demand for surgeries and solicit feedback from patients and the medical community to determine whether better care is needed.
In June 2013, NDP health minister Dave Wilson agreed to fund sex reassignment surgeries after previously stating there was a lack of medical evidence in favour of funding the procedures. During the election last fall, Stephen McNeil agreed a Liberal government would aid trans healthcare. The Nova Scotia Rainbow Action Project met with the new health minister Leo Glavine earlier this year. Since the announcement on April 1, the group has raised further concerns about barriers to trans healthcare.
Roy has a consultation on June 5 with a Nova Scotia surgeon who may be able to perform chest masculinization surgery. He is continuing his fundraiser, which can be found at gofundme.com/jayroyisaboy. -