P.E.I. to cover gender reconstructive surgeries

The province will expand coverage for gender-confirming surgeries for P.E.I. residents, Health and Wellness Minister Robert Mitchell announced in the legislature Wednesday.

The medically-necessary gender-confirming surgeries, also called sex reassignment, can be accessed through the medicare program.

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"I have met with members of the transgender community; I know how important this issue is to them," Mitchell said. 

Surgeries covered 

The announcement brings P.E.I. in line with what is available for gender-confirming surgeries in most other provinces. 

For some, these surgeries are a matter of survival and are essential to quality of life.— Cybelle Rieber

The surgeries covered will help Islanders transitioning from female to male including mastectomy with chest masculinization, as well as Islanders transitioning from male to female.

A full list of surgeries can be found on the province's website.

Surgeries involving reconstruction will be performed out of province.

P.E.I. doctors will perform removal surgeries including hysterectomy, mastectomy without chest masculinization, oopherectomy which is the removal of ovaries, orchiectomy which is testicle removal, and penectomy or penis removal. 

"Anyone who's in the early days of looking at this type of surgery — this is an open road for them now with no barriers, with lots of opportunities, so we're pretty excited about that," said Mitchell.

'Matter of survival'

"It's a huge step in the right direction," said PEERS Alliance Executive Director Cybelle Rieber. The new surgeries are an important step for the health and well-being of transgender and non-binary Islanders and their supports.

"For some, these surgeries are a matter of survival and are essential to quality of life," Rieber said.

Rieber applauded the current government for listening to the concerns of PEERS and the PEI Trans Network and people from the trans community. Having the acknowledgement and understanding of the medical necessity of these surgeries is essential to create a supportive and inclusive environment, she said.

"We are confident that as this new coverage is rolled out, pathways to access will be clarified and capacity around trans healthcare services, more broadly, will be expanded." 

'Recognized medical condition'

"Gender dysphoria is a recognized medical condition that, left untreated, can result in high levels of anxiety and depression," said Mitchell.  

Gender dysphoria is the stress people feel when their gender expression doesn't match how others see them. 

Islander Russell Louder, who identifies as neither male nor female, said they are experiencing this. 

"It's caused an incredible amount of stress for myself. These procedures are harm reduction, they counteract that — I can't even begin to speak to the importance of it," Louder told CBC News in the legislature hallway after the announcement. 

Louder has been trying to raise $10,000 to cover their own mastectomy with reconstructive chest masculinization in a private clinic in Ontario.

"So knowing that this could potentially be funded by the government in the near future is incredible," Louder said.

And while Louder is "overjoyed" with the news of the new surgeries, they are still anxious about navigating the health care system to access these procedures.

"Just in my past interactions with doctors simply not being aware of how to talk with a transgender patient of what is available."

Next steps

Health PEI said a patient considering gender-confirming surgery should visit their family doctor, nurse practitioner or mental health professional to be assessed for clinical eligibility. Health professionals will use the criteria established by the World Professional Association for Transgender Health (WPATH), an assessment required to insure the surgeries.

The assessment involves a psychiatric assessment and prolonged medical management before surgery is considered. A patient has to receive the go-ahead from a physician and approval by the province before work will begin on a surgical plan.

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