'It's life-saving': Addressing pandemic backlog in gender-affirming surgeries crucial for trans community, expert says

The coronavirus pandemic has contributed to some health-care mayhem in Canada, pushing an already overloaded system to the breaking point.

Cancelled surgeries, disruptions in staffing and colossal wait times have been reported across the country, with a Canadian Medical Association report out Tuesday outlining how delayed treatments or missed health-care services due to pandemic restrictions may have been a factor in more than 4,000 excess deaths unrelated to COVID-19 between August and December of 2020 alone.

Access to gender-affirming surgeries for trans and gender diverse people is no exception.

Vice President of Strategy and lead for sexual and gender health programming at the Women’s College Hospital in Ontario Jack Woodman told CTV’s Your Morning that the situation is critical.

“Throughout COVID-19 we have seen so many inequities exposed and exacerbated and transgender healthcare has been one of the big ones,” Woodman, who uses they/them pronouns, said Tuesday. “There’s already really limited access points for gender-affirming and related surgeries… so the pandemic didn’t create just a new burdensome waitlist for these surgeries, it exacerbated a really serious issue that already existed.”

Woodman said that demand for gender-affirming surgeries has been increasing “exponentially” in a trend over several years, while health-care system capacity and resources have not kept up.

The Women’s College Hospital was home to Canada’s first gender-affirming surgery program, and as Woodman pointed out, is the only public hospital in Ontario providing those surgeries.

“If we are ever going to remove the current bottleneck [we will need to work] with our government partners to find solutions and, like all surgical programs that were impacted through COVID-19, there’s a host of factors that influence the wait times,” they said. “I won’t give you an exact number, but I can tell you the waits are too long and that wouldn’t be accepted without immediate action across other certain types of surgical care.”

MENTAL HEALTH CARE IS CRUCIAL

Woodman said the positive impact of gender-affirming surgeries on the mental health and well being of trans people and gender diverse people is life-changing, and they referred to Canadian actor Elliot Page’s quote to Oprah that their surgery, and living as their true self, was “life-saving.”

Page has been celebrated for sharing images of himself shirtless post-op and thriving after coming out as trans last December.

“The casual posts that Elliot Page did, what made that so significant, is that their celebration of visible trans-ness is having a wide impact. He is actively influencing how people see trans bodies,” Woodman explained. “Of course we don’t all have a six-pack like Elliot and the diversity of trans bodies should all be celebrated but the visibility is so important to a community that has had so little positive representation in the media.”

For LGBTQ2S+ people in Canada, especially trans people, mental health is a major issue as is accessing mental health care.

According to Statistics Canada, almost half of transgender people in the country have seriously considered suicide, with that rate reducing if they are able to have a completed medical transition with gender-affirming surgery, according to the Centre for Suicide Prevention.

Another study by Trans PULSE in 2013 found people who decided to transition medically and surgically, but who are facing wait times, are at their most vulnerable, with close to 30 per cent of those surveyed attempting suicide the previous year.

Woodman said the fact that Page is exuding comfort in their body is a “beautiful thing.”

“Page is showing more than his body, he is demonstrating the profound impact that gender-affirming surgery can have for those individuals who do need it,” they continued, emphasizing that not every trans person needs to get surgery. “For those that do [get surgery], it just really improves their mental health and quality of life and Elliot page is absolutely right – it can be life-saving.”

In Ontario NDP MPP for Toronto Centre Suze Morrison has introduced a private member’s bill to create a Gender Affirming Health Care Advisory Committee, which if passed, would see the creation of an advisory committee to review the state of the province’s transgender health care and create recommendations for improvement.

“Transgender and gender diverse people experience so much invalidation in our society and healthcare has been no exception to that,” Woodman said. “There’s so much to consider beyond surgical access, safe and respectful care is probably the most important.”

Woodman also decried the “gatekeeping” for trans people seeking and accessing healthcare, using Ontario as an example, which requires two qualified professionals to sign off on gender-affirming surgery for genitalia – one of which needs to be a medical doctor.

“Then you have to go through additional governmental approval processes, and this doesn’t exist in any other healthcare realm, so to some degree it puts trans people in a position to almost have to prove their gender,” Woodman said. “We need to shift the needle on this.”

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The following is a list of resources and hotlines dedicated to supporting people in crisis:

National Residential School Crisis Line: 1-866-925-4419

Hope for Wellness Helpline (English, French, Cree, Ojibway and Inuktitut): 1-855-242-3310

Trans Lifeline: 1-877-330-6366

Kids Help Phone: 1-800-668-6868

ShelterSafe (a national list of women’s shelters and transition houses): sheltersafe.ca

Canadian Resource Centre for Victims of Crime: Call 1-877-208-0747 or Text: 1-613-208-0747