The Road to Phalloplasty, Part 2: Funding Frustrations

UPDATE, OCT 14, 2014: MSP has removed the 5 per year cap on phalloplasty and metoidioplasty funding as of a couple of weeks ago. Confirmed with MSP today. It’s not yet clear how this will work out in practice but it means there won’t be 10 or 20 year wait times for funding.

Also see:


I’ve started and stopped writing this post many times now. This is a topic that I find very frustrating, and it feels like there’s little that I can do to change things. But I know that I’m not the only one in this situation and that there is a way to to get these concerns voiced, so here are some facts and a call to action regarding the dire situation of surgery funding for trans men in British Columbia.

Background

In September 2012, Medical Services Plan (MSP) revealed that metoidioplasty and phalloplasty for trans men would now be covered services in British Columbia. A total of 5 men per year will be funded.

Jean-Luc understands my frustration.

Jean-Luc understands my frustration.

Since then, MSP has been compiling the names of trans men interested in these procedures into a wait list. As of Spring 2014, that wait list had grown to exceed 50 individuals which means that anyone added to the list now faces a minimum 10 year wait for surgery funding. (And the list may be longer now. A new video from BC Trans Advocacy Day, see below, has the list at 95 individuals, which means a 20 year wait for anyone being added to the list now.) Are there other procedures with wait lists this long in BC? I don’t know but I doubt it.

The Ministry of Health does not yet have a contract with GRS Montreal to provide these surgeries. MSP cannot say when this contract will be finalized. GRS Montreal told me that MSP is “unresponsive.”

Additionally, MSP has had trouble putting together an aftercare team in Vancouver–specialists who can assist with post-operative complications. Now, an aftercare team in Vancouver is of little help to those of us who live a distance from Vancouver. I mentioned to MSP that I already have a local Urologist interested in providing my aftercare and asked if they would like his name so that he could be a contact for other trans men on Vancouver Island. They expressed no interest.

The clock will not start counting down wait times for funding until the issues of a contract and aftercare are resolved. Yet MSP cannot say when these issues will be dealt with.

On paper, MSP is funding GRS for trans men. In practice, they’re not.

Did You Know?
In 2011-12, MSP paid for 23 male-to-female vaginoplasties, which increased to 38 in 2012-13, Health Ministry figures show. Source: Times Colonist

Taking Action

I’ve been in communication with a lawyer at Vancouver’s Community Legal Assistance Society (CLAS) for about a year to find out about the feasibility of a class action human rights complaint against MSP. I learned that while remedies in human rights cases tend to have less power than those litigated in court, filing a complaint has a couple of advantages: lower cost and a process that is intended to stop discrimination. Even cases that never make it to a hearing can influence positive change. But it’s not an overnight solution. These things take time.

Then, this past summer, I learned that I wasn’t alone in seeking out legal recourse. Enter: BC Trans Advocacy Day. From what I understand, the process that led to this initiative began with Vancouver lawyer barbara findlay, who suggested that trans people in BC need to work together to address the issues around surgery access. The long term goal of BC Trans Advocacy Day “to put pressure on the Ministry of Health and if that fails, to go through the courts as a human rights case.” Here’s more detail from the BCTAD website:

The BC Trans Advocacy Day is an event to create systemic change addressing the BC Ministry of Health’s failure to provide safe, accessible and timely trans surgeries to people in BC. The goal of this two day process is to develop effective strategies to improve access to surgical care in BC.

This event has two parts:
Part 1, November 2, 2014: a day for community dialogue to identify problems, solutions, and plans for making systemic change.
Part 2, TBD: a day to launch these plans into action.

Trans community members, allied health professionals, and additional supporters are invited to join us to put this process in motion. To view an agenda of the day, click here.

The BCTAD website has a page that lists the calls for change, check it out here.

BC Trans Advocacy Day has an Indiegogo campaign running, seeking to raise $2500 to help pay for the costs of holding the event, including space rental, hiring ASL interpreters to make the event accessible, supplies, and hopefully travel vouchers to help people attend.

They also made this slick video highlighting the issues:

It’s time to send a message to the Ministry of Health and MSP. If you are a trans man in BC considering either metoidioplasty or phalloplasty, or if you are an ally, please consider attending the event on November 2 in Vancouver, contributing to the Indiegogo campaign, or getting in touch with BCTAD via their website about contributing your valuable skills.

I haven’t even touched on how these issues are affecting me and my Road to Phalloplasty. That will have to wait for Part 3. Stay tuned.

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