Looking back to 2009 when I first started seeking provincial government funding for bottom surgery, I’m glad I didn’t know that it would take this long to obtain it. But obtain it, I have: BC Medical Services Plan (MSP) has confirmed that my funding application has been approved. My application faced some hurdles because I had to justify that I could not get treatment in Canada, and because the surgeon I selected was not one of the MSP-approved surgeons. With my application approved, I believe this will open the door for other trans men in BC to also have surgery with Dr. Jens Berli at OHSU in Portland, and so I share my victory with these guys as well.

with-berli

Since bottom surgery funding for trans men was reinstated in September 2012 in British Columbia, I’ve had to overcome numerous hurdles to access it. Initially, only five trans men per year were to receive funding. At #13 on the wait list, that put me in the third year of funding. Obviously, that’s not how it played out.

  • The first hurdle was the creation of the wait list itself. That took MSP over a year to complete. By Spring 2014, over 50 guys were on that list, and by fall over 95, putting wait times at up to 20 years! Thankfully…
  • The five per year cap was removed in October 2014.
  • By this point, MSP had still not established a contract with GRS Montreal (where surgeries were to be performed.) GRS Montreal told me that MSP was “non-responsive” with regards to the contract.
  • Next, was the assessment hurdle. Because my assessment had taken place in 2009, it was deemed necessary for me to have another. Unfortunately, there was no funding available for assessments! That was resolved in April 2015 and I had the assessment that August (because there was a wait list for that too, of course.)

Now, it’s important to note that before a surgery date can be obtained, the patient has to have a consultation with the surgeon, and surgeons have wait lists for consultations that average 3-12 months. The patient will also require at least 8-12 months of hair removal for phalloplasty, often more. Finally, wait lists for surgery dates can stretch at minimum 6-12 months and up to five years. Ultimately, it took three years after funding was reinstated for a MSP-funded phalloplasty to take place.

  • As I’m not a good candidate for surgery at GRS Montreal, my next hurdle was to make a special application for out-of-country funding. I was assured that this would be “no problem” because MSP had just funded a phalloplasty in Belgium. However, MSP wanted the application submitted by a third-party Canadian surgeon experienced with phalloplasty, and there was no one available who fit this description.
  • I waded through limbo from August 2015 until January 2016 when I reached out to Trans Care BC for help. How could I access out-of-country funding? After all, others had accessed it. Everyone was very nice and tried to help but I heard a lot of, “I can’t tell you, the system keeps changing.” Change is good, right? But my case just kept falling through the cracks, despite my persistent advocacy.
  • Finally, in February 2017 I got good news: there was now an approved doctor who could write the application. However, there was also a wait list for submitting the applications.
  • Thankfully that wait wasn’t long and my application went in by mid-March. Most applications were getting processed within 4-6 weeks I was told, but mine would end up taking a little longer.

Every day the wait/weight was heavier. It was 50/50. There was a distinct chance that the application would be denied because Dr. Berli was not on MSP’s list of approved out-of-country surgeons (which includes Drs. Crane, Chen and Schechter), or due to cost.

But this week I got the news I was hoping for: my surgery with Dr. Berli at OHSU will be funded. Amazing! (This is the first MSP-funded gender reassignment surgery at OHSU since the ’90s when MSP funded Vaginoplasties there with Dr. Meltzer.)

I had a consultation with Dr. Berli earlier this year in Portland. He struck me as a caring and talented surgeon, with a strong dedication to trans healthcare. The transgender health program at OHSU is substantial in its mission and services, with a large team of multidisciplinary providers. It’s really much more in line with what Canadian provincial healthcare prefers to fund, versus private practices. Dr. Berli and OHSU are great options for me for many reasons, and I imagine that other trans guys in BC will make the same conclusion and head to Portland for surgery as well.

I now have a whole new series of hurdles to overcome, and eventually milestones to celebrate, but today I’m just happy to have climbed and scraped my way over this almost 8-year hurdle. Onward!

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