Good news from Ontario health minister George Smitherman yesterday. Looks like OHIP could be changing to cover sex reassignment surgery. This from Xtra:
Helma Seidl is a counsellor who helps people prepare for their transitions.“There are lots of people who are very happy once they transition, who don’t want this surgery,” says Seidl. “But there are lots of people who waited because they don’t have the money — $16,000 per surgery or more. If we have it paid by they government, that will open up the opportunity to a lot of people.”
There are some details that need to be worked out before the coverage is a reality, but all and all a step in the right direction. Read the details here.
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five comments
How is this good news?
OHIP is supposed to be covering essential services. Forgive me, but I fail to see how sex reassignment surgery is an essential operation. Meanwhile, emergency room wait times are several hours, and sick people are kicked out of the hospital early due to lack of beds.
By all means, people should have the right to undergo sex reassignment operations. I don't get it, but it's really none of my business what other people do. However, sex reassignment is a non-essential operation akin to cosmetic surgery. I do not see how having an already over-stretched, tax-payer funded programs foot the bill is a good thing.
Posted by Rachel
May 16, 2008, 8:48 PM
Rachel: I certainly understand your concerns and agree that our health care system is stretched as it is (although I don't actually agree that srs is akin to cosmetic surgery). Turns out that the costs to the health care system to implement this are very, very minimal. From the Star:
"The decision is expected to cost a total of $200,000 a year because just "eight to 10" people annually are expected to pass the "very rigorous" psychological evaluation required before sex reassignment surgery, Health Minister George Smitherman said yesterday."
If you compare that $200,000 to, say, what smoking costs our health care system, it's EXTREMELY small. From the CBC:
"Tobacco-related diseases cost the (Ontario) health-care system about $1.6 billion annually. Smoking accounts for at least 500,000 hospital days each year and is blamed for more than $4.4 billion in productivity losses."
Posted by Stacey May
May 16, 2008, 9:05 PM
Rachel: I don't think you can really compare sex reassignment surgery with cosmetic surgery. Our gender is a huge part of our identity, especially in this incredibly gendered world, and you can't really begin to imagine if you haven't experienced it what it's like to go through life having everybody you interact with perceive you as something you're not.
It might not be essential in the life-or-death sense of the word, but for some people whose outward appearance doesn't match their own sense of themselves, it's a huge barrier to their happiness and wellbeing. If that's your standard, surgery for something like carpal tunnel isn't "essential" either, but it sure makes a difference in the lives of those who suffer from it.
As Stacey May points out, tobacco and alcohol-related injuries cost health services a phenomenal amount, but it's unethical to refuse to help people who take risks and come off badly from them. It's just as unethical to declare aiding somebody's psychological pain to be less important than outwardly obvious physical ailments. Healthcare is about compassion and about making sure people are healthy and thriving.
Yes, OHIP is and always will be overstretched. That doesn't mean we can just cut off funding for treatments we don't really "get".
Anyway, cosmetic surgery isn't all boob jobs and botox, it also includes things like reconstruction after disfiguring accidents. Should we declare that inessential too?
Posted by Cate
May 16, 2008, 11 PM
Cate: I agree with your comment that gender is an important part of our identity, and can see how it would be stressful to be constantly percieved as somebody different than who you are. But by saying that gender can be changed merely by anatomical surgery, are we not just feeding the prejudices? Are we not further enforcing the idea of gender as a polar-opposite, unflexible stereotype?
Concerning your point about reconstruction after disfiguring accident, to be honest, I'm not sure if I would support that being covered under OHIP. Where are we willing to draw the line, and what counts as a disfiguring accident? What if you are just unhappy with the appearance you were born with? I know that some day's I've looked in the mirror and wished that some part of me or other was different (evil media-brainwashers). I'd never go as far as surgery, but some people would. If I was the subject of prejudice because my breasts were too small, do I get a free boob job? I fail to see how this is different from sex reassignment surgery.
Stacey May: Thank you for the information about the amount of money that is used up on tobacco-related illnesses. I had no idea it was that high! If I was the health minister I would continue to pay for the treatments, but would ban cigarettes, which would gradually lead to an end to the unnecessary illnesses.
Posted by Rachel
May 17, 2008, 1:15 PM
Rachel:
SRS doesn't "change" gender. Gender is pretty much innate and a very important part of ourselves. SRS doesn't enforce the binary stereotype in the way you are suggesting. Those who NEED this surgery, who need to fully transition, are more at ends with their bodies than the typical person who seeks cosmetic surgery. In the same way a person who loses a limb in an accident and keeps expecting to see it there, a transsexual person has a mind that is configured towards one gender and expects their body to function in the way of the sex that does not "match" their gender. Transwomen, male-to-female transsexual women, don't just "want" breasts and hips; their minds expect menstruation and may even desire pregnancy. Transmen are often very repulsed by the feminine aspects of their body as well, and expect things typical of make bodies, such as facial hair. This dysphoria can not yet be fully corrected - we do not have the technology to alter one working set of genitalia into another set of working genitalia - but for many transpeople it's better than nothing.
This goes much beyond simple cosmetic surgery, like wanting larger breasts or a different shape of nose. This is matching up the body's sex to the brain's sex (gender).
Posted by Chris
June 16, 2008, 4:32 PM
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