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B.C. government now pays for surgery changing women to men

The B.C. government will now pay for five female-to-male transgender patients per year to have surgery to construct male genitalia.
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Broadcaster James Gardner made no formal announcement when he signed on for the first time as a man. Some listeners called in to ask what happened to Sheila.

The B.C. government will now pay for five female-to-male transgender patients per year to have surgery to construct male genitalia.

The Ministry of Health’s review of the medical literature about phalloplasties last year showed “a limited success rate but a very high level of patient satisfaction,” which was a factor in the decision to fund the surgery, ministry spokesman Ryan Jabs said in an email to the Times Colonist.

º“Once we gather more information about the success and complications from this procedure, we will once again review the surgery and number of people waiting.”

About 50 individuals have been on a ministry waiting list since 2000 for the female-to-male procedure known as phalloplasty, he said. The Medical Services Plan has long covered male-to-female sex-reassignment surgery.

Advocates for transsexual people welcome the move, which reverses a policy from 2003 against phalloplasty because the procedure was deemed experimental.

“I think it is a huge step forward in recognizing the medical necessity of this procedure,” said Dr. Gail Knudson, the ministry’s chief assessor for eligibility for sex-reassignment surgery. Knudson is also secretary-treasurer of the World Professional Association for Transgender Health, which deemed phalloplasty a medical necessity in its 2011 standards of care.

Those on the waiting list for the surgery have been contacted, Knudson said, but she’s not aware that any phalloplasties have taken place.

Marie Little of the Trans Alliance Society of B.C. said the step brings the goal of equality closer.

“I always did think that not funding it was discrimination.”

In 2011-12, MSP paid for 23 male-to-female vaginoplasties, which increased to 38 in 2012-13, Health Ministry figures show.

Sex-reassignment surgery is covered by Quebec and Ontario, which restored coverage for phalloplasty in 2008. Alberta reinstated all sex-reassignment surgery in 2012, after cutting it in 2009 to save $700,000.

A phalloplasty to construct an artificial penis from the forearm costs $41,500, with testicular and penile implants adding $6,000 and $16,000 respectively, Health Ministry figures show. Vaginoplasty costs about $16,000.

Surgeries for B.C. residents will be performed at a private Montreal hospital, but patients must pay their own transportation costs. That makes it prohibitive for many trans people, said Dara Parker, executive director of Qmunity, a resource centre for the “queer” community. Sex-reassignment surgery is “the dominant issue of the decade” within the community, she added.

Knudson said it would be helpful to eventually review the policy of allowing five phalloplasties per year. One option is to clear the waiting list, and then decide whether to cap the number at five or make it as accessible as male-to-female surgery.

“We’ll see how it works — it’s certainly better than before,” said NDP MLA Spencer Chandra Herbert, who has pressed for the coverage in letters and conversations with the health minister.

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