Yesterday I got the news that I am now scheduled for the psychiatric and readiness assessment for hysterectomy funding. My appointment will take place in Victoria, BC next Wed Jan 14 at 10am.

The purpose of the assessment is to allow the two (possibly three) psychiatrists to:

  1. Make a recommendation to BC’s Medical Services Plan (MSP) about whether or not GCS is appropriate.
  2. Determine whether I meet MSP’s eligibility criteria for GCS.

Discussion topics may include:

  • General personal history: who I am, who I live with, what I do during the day, education, work, friends, hobbies, interests
  • History of gender identity concerns, from start to present day
  • Medical and mental health history, including medications taken in past/present
  • Substance use history
  • Family history
  • Transition process thus far, and future plans

Documentation I need to bring:

  • BC Care Card and picture identification (e.g., passport, driver’s license, BCID)
  • Name Change certificate
  • Letter from a client indicating length of time we have worked together, and a letter from supervisor in a volunteer position indicating the length of time I have been involved in volunteering. These are to confirm that I have met the MSP criterion of  “at least one full year of full societal cross-gender immersion”.

If the assessors agree that surgery is appropriate and that I meets MSP’s eligibility criteria, they will contact MSP and ask for surgery coverage to be approved. MSP’s GCS Review Committee will then review the assessors’ recommendations and my supporting documentation, and then decide whether to authorize surgery or not. MSP will inform me and my family doctor of their decision via letter.

MSP’s funding eligibility criteria

The patient must be sufficiently emotionally and psychologically stable such that although a delay in surgery may be disappointing, it would not be a crisis.

The patient must have had at least one full year of full societal cross-gender immersion. A patient can fulfill this criterion through full-time employment in a public workplace, full-time attendance at an educational or other training institution, significant time spent in voluntary service in a public occupation or any combination of the foregoing.

My only concern with these requirements is that MSP might take issue with my employment:  I’m self-employed and work at home. Is that going to count as public? My family doctor suggested that I take a second part-time job for a full year if I was concerned about meeting the requirements. Considering that I work more than 60 hrs a week already, I thought that was ridiculous. MSP is going to have to understand that telecommuting is valid—they have to catch up with the times.

However, I’ve also been told by a very reliable source that MSP rarely turns anyone down. I might be worried unneccesarily. In any case, I plan to answer questions regarding employment directly, offering up only the information required to properly respond.

There are four steps to obtaining MSP funding and getting a surgery date:

  1. Ask GP for referral to MSP
  2. Psych assessment
  3. a) MSP Review; b) Choosing Surgeon
  4. Surgical consultation

Of these, I have completed steps 1, 3b and 4. Only steps 2 and 3a remain. This means that if/when MSP approves the coverage, my next step will be to contact the surgeon and get a surgery date. When I had my consultation with the surgeon in November, he indicated that I could get a surgery date within 6 weeks of funding approval, so I’m hoping to have this all complete before summer.

The final piece of the puzzle is that I need to save more money for the month off work. I have a few things in the works to accomplish this.