Sex reassignment surgeries will soon be funded under MSI, Nova Scotia Health Minister David Wilson announced Wednesday.
In a reversal of his recent position, Wilson said yesterday his department would remove section 4.8 from the Physician’s Manual. The section says “gender reversal (trans-sexual surgery)” is not insured under MSI.
On Oct. 1, 2012, Nova Scotia Rainbow Action Project member Lucas Thorne-Humphrey emailed the minister to ask that section 4.8, along with its transphobic description of sex reassignment surgery, be removed. NSRAP received Wilson’s response eight months later on June 3:
“I apologize for the delay in my response. I wanted to ensure that serious consideration was given to your request. …I regret to inform you that due to the lack of high quality scientific evidence to support the efficacy of the long-term outcomes of these procedures and lack of a strong economic argument for their benefit, the department is not in a position to grant your request at this time.”
In response to Wilson’s letter, NSRAP encouraged people who disagreed with the minister’s position to communicate their concerns to his department.
When asked to explain his apparent flip-flop on the issue, Wilson said evidence-based research provides a base for policy, but in decision-making, an attempt to understand the LGBTQ community is often omitted.
Wilson said his decision was consistent with a change last fall to include Nova Scotians who are transgender under the province’s human rights legislation.
“…[O]ne of the things that I’ve done is try to educate myself more and learn more about the issue itself, and realize that we needed to do something here, there’s been barriers in place for far too long, for years and years in the province.”
“…[O]ften what government needs to do is often do the right thing and this is the right thing to do and I fully support it.”
‘Still some work ahead’
“We were pleasantly surprised by the change in direction,” NSRAP chair Kevin Kindred said Wednesday. “Overall there’s still some work ahead, but it’s a really good day for us and for the trans community in Nova Scotia.”
Despite the good news, it will take time for sex reassignment surgeries to become accessible to Nova Scotians who are transgender, Kindred said.
“The barriers are both at law and more generally.”
Section 4.8 was the first and most important barrier to remove, he said. Now the province has agreed to remove it, a fee schedule will need to be negotiated.
“Once that’s in place, there’s another level of barriers that we need to understand and continue to address as well.”
For one thing, Kindred said, “the level of access to doctors who are aware of the issues facing trans patients is inconsistent across the province.”
Most trans people leave their communities and travel to Halifax to have surgeries, he said.
“We think there needs to be an effort to increase that basic level of care across the province, and the level of education among the medical communities about the realities of trans people’s lives.”
In the short term, Nova Scotians will continue to travel outside the province to undergo some surgeries, Kindred said, because there are only a handful of specialists who perform them.
In order to eliminate these barriers within a reasonable time frame, Kindred encouraged supporters to stay in touch with the government.
“We’re celebrating but we’re not quite taking our foot off the gas yet.”
Funding allocated for surgeries
Wilson wouldn’t say how much funding his department had allocated for sex reassignment surgeries.
His department expects to fund six to eight surgeries a year, he said.
Kindred said Wednesday the price range was $30,000 to $60,000 per surgery, depending on the type of surgery.
At those rates, the department could expect to pay $180,000 to $480,000 per year.
“We feel confident within our department’s budget that we can respond to the demand,” Wilson said Wednesday.
