Alberta's care for transgender kids a 'broken system,' say doctors

Posted on the kitchen wall of their northwest Calgary home, the Ruhland family has a resolution board — a safe place to share hopes for the year to come.

On the simple whiteboard, Pam Ruhland's 15-year-old son Sean handwrote a very poignant wish: "Start taking T." The "T" stands for testosterone.

Sean is a transgender teen. And while he is ready for the hormone therapy that can delay puberty and halt the changes in his body that don't reflect how he feels, a wait list at Alberta's only specialized and multi-disciplinary clinic for youth means that won't happen any time soon.

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"This is a kid that feels at odds with what their body is," said Pam Ruhland, whose son is facing another two and a half year wait. "It's hard to watch. Because you just want what's best for your kids. And what's best for this kid is to get this kind of help."

The Metta Clinic, based at Alberta Children's Hospital, is only open one half day a month. "To know [the wait] is that long because they're only open one day a month just seems really ludicrous," said Ruhland.

Advocates have launched a social media campaign calling for more funding.

Frustrated Physicians

And now doctors are speaking out as well. "[It's] definitely not enough," said Dr. Joe Raiche, a psychiatrist at the Metta Clinic. "I think it's merely scratching the surface in terms of volume." 

With a wait list of up to three years, Raiche says physicians have no choice but to triage patients.

Those who haven't started puberty yet are given top priority.

"And that's strictly based on resources and manpower. The clinic isn't operating enough to see everybody who needs to be seen as urgently as they do," said Raiche, who wants government officials to provide enough funding to expand the Metta clinic into a full-time service.

"For anybody waiting for any medical service, three years is far too long of a wait time. And definitely when you factor in the vulnerable, at-risk nature of this population, that's way too long."

System is 'broken'

The frustration is being felt in family doctor's offices as well. In his northwest Calgary practise, Dr. Ted Jablonski does a lot of transgender medicine.

Several of his young patients are on the Metta Clinic's wait list. 

"The tragedy is we do have experts in the city. But yet these kids can't get to them in a timely fashion or it's very, very difficult," said Jablonski.

The number of Alberta youth identifying as transgender has "exploded exponentially" in recent years, according to Jablsonki, who believes offering just a few hours a month of specialized care is simply not enough.

"Twenty years ago that might have worked. Today it won't work. It isn't working. It's broken. The system's absolutely broken."

Consequences 'horrific,' says doctor

Jablonski has a very strong message for government: young people are suffering.

"The ramifications if it's not dealt with properly are horrific," he said.

"These patients suffer horribly. Bad things happen. They have a lot of mental health challenges. They can manifest as hospitalizations, as suicidal attempts, substance abuse. I mean all these issues are real and they happen. This is a population tha's marginalized, that's at risk...So we have to deal with them."