In January, the British Columbia Health Authority quietly released a document stating that, after March 31st, 2026, it will close the GrS Montreal pathway for transgender British Columbians to receive gender-affirming surgery. Instead, it will require all patients to be referred to the Gender Surgery Program British Columbia (GSPBC) at the Vancouver General Hospital in order to be covered by BC’s Medical Services Plan (MSP). This closure will significantly harm BC resident's access to genital reconstruction surgery (GRS) in particular, as it will inevitably extend the already years-long delays that the GSPBC currently experiences.

The GrS Montreal pathway takes an estimated 9-15 months from referral to complete a surgery (1). The Vancouver pathway takes between 12 and 16 months for patients to receive their first intake appointment. Wait times between intake and surgery vary, but GSPBC’s wait time is multiple years longer than GRS Montreal (1), (3). Additionally, the province requires all prospective patients for gender-affirming surgery to undergo a surgical readiness assessment (SRA) before referral. While an SRA can be performed privately, the wait time for a publicly-funded appointment is roughly a year. If the GRS Montreal pathway is removed, GSPBC will face even more demand, further increasing wait times. British Columbia would be the only province with this restriction, making it by far the worst Canadian province for accessing GRS.

When the province announced the decision to open GSPBC back in 2018, it was widely perceived as a relief for transgender British Columbians. This new restriction single-handedly nullifies any improvements made in healthcare access. While the provincial health authority's stated goal is to provide healthcare within the province, GSPBC does not provide remotely adequate service to meet the current demand.

These surgeries are directly associated with significant improvements in the wellbeing of transgender women and are recognized as medically necessary by the World Professional Association for Transgender Health (WPATH) — the foremost international authority on transgender healthcare (2). The delays caused by this decision impact access to medically necessary care, and will diminish quality of life for transgender people in British Columbia. As transgender British Columbians, we deserve better than the Provincial Health Authority suddenly, quietly restricting our access to these procedures. We deserve timely, transparent healthcare access. We are calling on the Provincial Health Services Authority to reverse the impending closure of the GRS Montreal Vaginoplasty pathway, to reverse the previous closure of the GRS Montreal Phalloplasty Pathway, and to support a fair healthcare system for all British Columbians.

References

1: https://www.transcarebc.ca/surgery/vagina-vulva-construction/referral-for-surgery

2: WPATH Standards of Care 8

3: https://vancouver.citynews.ca/2022/08/12/vancouver-trans-woman-surgery-access-barrier/

Are you a doctor, institution, or organization interested in signing on to our open letter? Please email us at tgirlsofvic@proton.me and we can add your signature to the letter anonymously or publicly. Signatures will be kept private until they can be shared with the intended recipients, but the text of the open letter can be viewed here.