Healthcare is a crucial resource that helps to improve overall quality of life, a human right, and an essential part of society. Health equity ensures that everyone receives the same opportunities to live happy and healthy lives. This includes the LGBTQIA+ community, who still struggle to obtain the care that they need to achieve their fullest health potential.
What is gender-affirming care and why is it so important? It is a range of social, psychological, behavioural, and medical assistance that affirm an individual’s gender identity. This includes a variety of healthcare services, such as hormone replacement therapy (HRT) and gender-affirming surgeries. For individuals that do not identify with their assigned gender at birth, medical and psychological healthcare is essential for improving mental health and overall well-being. Over recent years, American legislation has made a record amount of attempts to limit, ban, and criminalize gender-affirming treatment for gender diverse, transgender, and non-binary youth. Despite the scientific evidence demonstrating that many transgender and non-binary (TGNB) minors experience gender dysphoria — serious distress and impairment due to the deviation between a person’s sex assigned at birth and their gender identity — threats to healthcare access continue to violate their human rights. Without this care, TGNB individuals experience higher rates of anxiety, depression, and suicide. These recent events do not necessarily reflect what is going on in Canada, but they are frightening to the queer community nonetheless.
Fortunately, there are a number of regional gender-affirming healthcare services between New Brunswick and Nova Scotia. These services provide much-needed protection to TGNB individuals and those that experience gender dysphoria.
Hormonal therapy is pivotal for gender affirmation, as it helps with physiological masculinization or feminization for individuals with gender dysphoria. Consulting with a professional, such as a family doctor, to be assessed for physical and psychological preparedness, as well as giving informed consent about the risks, must be done prior to getting hormone treatment. The Government of New Brunswick provides drug coverage to eligible provincial citizens through the New Brunswick Prescription Drug Program for androgens, estrogens, and hormone blockers. Nova Scotia Pharmacare Programs supply coverage to eligible residents for hormonal therapies as well, while some medications are covered by regular benefits.
Gender-affirming surgery, also known as sex reassignment or gender confirming surgery, are surgical procedures that alter an individual’s physical appearance and sexual characteristics to match their gender identity and allow them to feel more comfortable in their own skin. There are a number of steps involved in the gender-affirming surgery process. The first step is to consult a family physician, nurse practitioner, or mental health professional for an evaluation of clinical eligibility. Once this eligibility is established and provincial medicare approves, a surgical plan can be developed with a medical team. Top surgeries (involving the chest / breast tissue) are available through Dr. Jayson Dool in Moncton, New Brunswick. Unfortunately, there are currently no services for bottom surgery in the province. In Nova Scotia, some surgeries are available in the province, while others are only available in a specialized clinic in Montreal through referral. Financial coverage varies depending on the surgery and which medical team is performing it.
There are many gender-inclusive clinics offering support to TGNB individuals and those with gender dysphoria, including the Salvus Clinic, the Transgender Health Team at the IWK (Nova Scotia). There is even a gender-affirming care clinic on campus at Mt. A! All mental health services and resources are covered by most insurance companies.
While the queer community in New Brunswick and Nova Scotia has access to gender-affirming medical care, there is always a need for more resources. Some of these services may not be entirely accessible to all of those that require it. With the ongoing struggle of health equity among minorities like the gender diverse, transgender, and non-binary, it is important to learn about the existing resources and advocate for better access to these services.
