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GRS: More than a little penectomy, orchiectomy, and vaginoplasty

| Sep 19, 2016
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Call it what you will: gender reassignment, gender correction, sex change or something else. For those born to one gender and undergoing the change to another it is a huge process involving many physical and emotional changes as well as learning new and different skill sets. So says at least one person about to undergo male to female genital surgery. Her Canadian government health plan is paying for this genital surgery but nothing more. She contends that their public health care plan should be recognizing there are other legitimate costs that go with her GRS that should be covered by the health insurance plan that she and all other income tax paying Canadians contribute to..

Here is some background. Several years ago the government of the Province of Ontario announced that it will again start paying for the surgery costs of those residents qualifying for gender reassignment surgery. In addition due to the shortage of doctors qualified to do this surgery in Ontario they would pay the cost of the surgery being done overseas.



That is the good news and at this point I’m sure many of our American readers would be saying ‘WOW that could save me thousands of dollars if my health care insurance would do the same’.

But wait, there is more cost to gender correction than just these three surgical operations, says Jessica, an Ontario male to female transgender patient who is currently undergoing her surgery and recovery in Thailand.

We Canadians have what is supposed to be a universal health care plan. By paying for health care costs through a payroll tax, a portion of our income tax and tax surcharges for the high income earners our government makes health care available to all regardless of their ability to pay. It is society taking care of each other and is a principle accepted in most of the world but not so much in the USA.

However it seems once we get past the broad principle there are problems with the fine print. “The devil is in the detail,” so to speak.

Jessica posted the following statement to a Yahoo Group for transgender members in the Ottawa area of Canada.

I leave for Thailand for SRS surgery on Sept 15th. OHIP is paying for the surgery itself. It is somewhat of a hollow victory for tg women. I feel good about that part of my transition, but it is not the final part. As a group, we are still allowing OHIP/provincial government and the federal government to denigrate us. I will return from Thailand underneath a horrific debt load. I will also have breast augmentation, to have breasts which are the average size for North American women. I will also have some other small procedures, but the total, with flights, hotel and all will cost OHIP 9K, Jessica close to 32K. OHIP does not cover any of the “aftercare”. Once the surgeon wipes off his knife, the $ kaching $ to Jessica starts. The other option is to wait for 18 months and wind up with surgery of (from what other tg women say) somewhat lesser quality here in Canada. I do not have 18 months. I have been waiting for 45 years.


It galls me that OHIP denigrates us. It sometimes appears to me that so few in the TG community rails against them … for the most part. What OHIP is telling me is that it will give me SRS surgery, in a very niggardly fashion. My own personal translation of that: “if we give you a female crotch so you have the ability to do “that”, then that qualifies you as a woman. It does not matter about your face. It does not matter about your voice. It does not matter about any other part of your body. Your crotch makes you female.”

The public ‘universal’ health care plan is paying about 20% of Jessica’s immediate surgery needs. They will allow her the vagina needs to be f—ked but not the breasts that are such an important part of female identity. They will pay for the surgery but not for the important recovery and aftercare process that helps her avoid possibly fatal infections.

Jessica continued:

I am tired of people calling me “sir” on the phone when I am careful to introduce myself as “Jessica, and yes I know I do not sound like a Jessica but I assure you I am female,” and they reply ‘thank you for calling, sir.’ I am tired of doing telephone banking and the person on the other end goes through endless security checks because the name on the account is female and the voice on the phone is male. I am tired of looking like a man in a dress, and having red-necks ram their shopping cart into mine, or other endless cruel looks, gestures or rude comments. I am tired of knowing I cannot drive through North Carolina and feel safe.  ‘Death of a thousand cuts’. Facial Feminization enables me to be female from the crotch up, and gives me dignity, and gives me SAFETY. Not just from the violence, but from the endless barbs that take away the ‘shine’ that others perhaps take for granted. Yes, it gives me a very elite and special social group, here, in Toronto, London, West Palm Beach, and some awesome support and really cool friends. We should have social dignity and always a “feel good” day just being alive. The fact that this ‘feel good’ page is within our group underscores that it is difficult for everyone, and it needs to be made easier. Every 29 minutes a TG woman is murdered. Every 8 minutes one is violently assaulted and/or raped. Our suicide rate…. higher than ANY other social group or people in the world. We need more.

So…. the ‘feel good’ part of this end of the e-mail…. whoever you are reading this… you are not alone. There is progress being made, and above all, there is hope. Without the hope we feed the wrong statistic. I will report to the group when I return about what it was like and all that stuff….. love n’ kisses from the jungle… Jessica

I belong to the same support group as Jessica but I do not know her. I know that if I met her I would like her because at the same time as she is speaking out against the problem with how our medical insurance narrowly defines gender and listing the problems she regularly faces as a ‘female trapped in a male body’ (my words; not hers) Jessica is offering hope to others.

Jessica’s posting to the Yahoo Group elicited a fair number of interesting responses. From the supportive:

Dear Jessica,

I, like yourself was sent out of country for my surgery. After jumping through every hoop that the system required of me and the emotional and psychological stresses of dealing with the CAMH ( The Clarke institute at the time) in Toronto, I was approved by OHIP and sent to a surgeon in London, England whom I had never heard of and had to trust that our health system knew that he was qualified and good as a SRS surgeon. OHIP covered the surgical costs but I had to find the funds to cover my travel costs and subsequent lodgings, since I needed to recover a few weeks before being able to return to Canada.

it is ” feel good” nonetheless because ( for myself) it was and is a big part in finally feeling complete and I would have climbed Mt. Everest to get there and even though I was alone through it away from my friends and family and nervous (after all its a surgical procedure) The joy I felt in my heart was immeasurable! 

You brought up some very important issues that we still need to continue to fight and press our health care system to help us with and I think you addressed them clearly and we should discuss them more as a community but since this is maybe not the thread for me to go into those matters more deeply but will say that I totally agree that there’s a need for better help and support in order that we can live more fulfilled and secure lives as transwomen, not fearful that we will be abused and socially mistreated and that there will be many “feel good stories” for us to share and celebrate together!

I send you my best wishes and thoughts and my blessings for continued joy and happiness! hugs and kisses back!   Julie

To the Glass is Half Full:

Congratulations on your upcoming surgery and hope all goes well for you.

It is good that OHIP are paying for a portion of your expenses.

We have to remember that just 4 Short years ago OHIP did not pay for any portion of the SRS surgery, so the girls now are fortunate for what they are paying

5 years ago when one needed the SRS surgery they had to pay the full bill out of their own resources so we should be happy that they are at least paying a portion


To one member who while wishing Jessica well said that genital surgery was not for her:

Jessica, I am with you in spirit. Actually, I do not care what is between my legs, I have no desire for sex with a man, however, I live as a woman, and would like breast implants, and a few facial touch-ups. Good luck on your journey. Cheers Carol

What do you think of Jessica’s point? Should her health insurance plan be recognizing a larger basket of needs when it comes to gender reassignment/ correction?

Should the Insurance look at Carol’s point and allow the patient to pick what surgery best suits the patient’s needs. If girls such as Carol have a stronger need for breasts than genital reconstruction should insurance allow that option?

Whatever happens I wish Jessica and Carol well and look forward to meeting Jessica when she gets back to Canada or at her winter home in Florida.

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Category: Transgender Body & Soul

Linda Jensen

About the Author ()

Canadian writer Linda Jensen is a long time contributor to TGForum. Before the days of the Internet Linda started her writing with the Transvestian newspaper. Her writing ranges from factual accounts of her adventures to fiction although frankly sometimes her real life adventures are stranger than the fiction. Linda is married to a loving partner who upon learning about Linda said, "she was part of you before I met you. Although I didn't know it she was part of the package I fell in love with. I don't want to mess up that package." "Does it get any better than that?" asks Linda.

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