With Nova Scotia announcing this month that it will extend coverage for Gender Reassignment Surgery (GRS), New Brunswick and Prince Edward Island are now the only two provinces in Canada that continue to deny coverage for this medically necessary procedure. GRS is a broad term covering several different surgeries, often referred to colloquially as ‘top surgery’ (mastectomy- removal of breast tissue, or breast augmentation) and ‘bottom surgery’ (including, but not limited to: hysterectomy- removal of the uterus, metoidoplasty and phalloplasty- creation of a penis, or vaginoplasty- inversion of the penis to create a vagina). GRS is essential for transgender patients and is medically necessary. The Transgender Standards of Care used by physicians in Canada cites surgery as a necessary step in transitioning. The Canadian Human Rights Tribunal has also ruled that it is an essential medical treatment, and its decision was upheld by a Canadian federal court in 2003. Despite this, and the overwhelming consensus in the medical community about GRS, it has been 10 years and New Brunswick is still lagging behind the rest of the country on this important issue.
Without surgery, transgender people are higher risk for depression, severe anxiety, self harm, and suicide. An estimated 43% of transgender people attempt suicide in their life time- higher than any other demographic. The extreme dysphoria experienced can be so severe it may leave an individual unable to sustain a job or their studies; they might struggle to have meaningful relationships of any kind, and everyday social situations can become very stressful ordeals.
It is not just problematic and personally upsetting for transgender people to not have surgery, but is sometimes even dangerous – many transgendered people are the victims of hate crimes. Without surgery, many transgender people are unable to ‘pass’ as the opposite gender. This puts them at higher risk of discrimination in their daily lives as well as in employment, housing, education, and travel; they are often refused service and harassed on a daily basis. This may include being turned away at a gym, mocked and stared at in a restaurant, interrogated at an airport, or shouted at on the streets. In many areas, transgender people living as the opposite sex without surgery who are ‘outed’ are high risk of being physically assaulted, the victims of hate crimes and police brutality, and are sometimes even murdered. No other supposedly ‘elective’ or ‘cosmetic’ surgery impacts an individual’s rights, freedom, and safety in the way GRS does.