Petition Closed

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.

Letter to
Minister of Health for the Province of New Brunswick Ted Flemming
Premier for the Province of New Brunswick The Honourable David Alward
I am writing to express my extreme disappointment in the New Brunswick Healthcare system, and its lack of coverage for transgender individuals.

The term ‘transgender’ refers to a person who feels they were born in the body of the opposite sex, and that their anatomy does not match the gender they identify with. An individual may also identify as both genders, or not associate with any gender. Trans*gender individuals often seek the help of medical professionals to assist in medically transitioning, through Hormone Replacement Therapy and Gender Reassignment Surgery. Gender Reassignment Surgery (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). With Nova Scotia announcing this month that it will extend coverage for 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.

Common arguments against the coverage for GRS include that it’s elective or cosmetic surgery and not medically necessary, that it’s not a high priority, too expensive, and that it is morally wrong. Most who oppose GRS do so out of prejudice and lack of education on the topic. Contrary to popular belief, 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.

The cost of GRS varies for each surgery, but usually falls between $10,000-$60,000. The Nova Scotia Rainbow Action Project recently estimated that between 6-8 transgender Nova Scotians require surgery each year. Using that figure, based on population size, an estimated 5-6 transgender individuals in New Brunswick need surgery every year, which would require between $60,000-$360,000 (0.000023%-0.00014% of our yearly provincial health budget). 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 transgender 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.

This topic is extremely important to me and close to my heart. All transgender people deserve the same access to essential medical procedures that other Canadians enjoy. I urge you to show your support for the transgender community by extending coverage and making Gender Reassignment Surgery accessible to all transgender New Brunswickers.