Transgender Ontario residents who want genital transition surgery have previously had to go out of province — or even out of country — to get the medical care they need.
But last week, Ontario Health Minister Eric Hoskins announced that in 2018 the surgery will be available here. Women's College Hospital in Toronto will become the second location in Canada to offer the surgery. Currently, Dr. Pierre Brassard's Centre Métropolitain de Chirurgie in Montreal is the only place to get the genital transition surgery — often referred to as gender confirmation or gender affirming surgery — in Canada.
"It's an area that has had a lot of under access and under-served populations in Canada," said Cheryl Woodman, the chief of strategy for the hospital, in an interview with Craig Norris on CBC Kitchener-Waterloo's The Morning Edition Wednesday.
"There's been quite significant wait lists in Canada and in Ontario, to have transition-related surgery," she said.
In the spring of 2016, the Ontario government changed rules around how people who wanted gender-affirming surgery could get referrals. Initially, Ontarians had to go through the Gender Identity Clinic at the Centre for Addiction and Mental Health in Toronto, to get a referral. But last spring, the government changed the regulations to allow any qualified health practitioner to refer patients.
Hard to find surgeons
The biggest challenge the hospital faces is finding qualified doctors and nurses who are experienced in these types of surgeries.
"We do have surgeons who can provide what we call 'top' surgeries — chest and mastectomy, chest masculinization and mastectomy — but those complex 'bottom' surgeries, it's very challenging to find qualified providers to do that," said Woodman.
"For the surgeon to remain competent and have the highest level of expertise, there has to be a critical volume that the surgeon would do to maintain this, Dr. Brassard in Montreal does over 400 surgeries a year," she said. "It's not that there would be a lot of surgeons in this area in the country, but it's very important that we have more than the one that we currently have."
"Certainly the training is extensive and the ongoing learning is extensive," she said.
The need for more surgeons was highlighted last spring in the aftermath of a fire at the Montreal clinic.
Brassard told CBC Montreal last year that the clinic usually performs seven surgeries a week, and had to postpone some in order to repair the clinic. Brassard mentioned one patient had even quit his job in anticipation of having the surgery, and the clinic had to pay for his ticket to return to Ontario when the surgery was postponed.
Plan is to offer surgeries in 2018
Woodman said it's hard to know exactly what the demand is for the surgery, as people often go to private clinics, and so they may not be counted in government data.
However, between 2015 and 2016, the Ontario government covered 158 transition-related genital surgeries. All but 10 were done in Montreal, according to Woodman, who says that some patients choose to travel to the U.S. or to Thailand.
Woodman says the hospital's goal is to begin the surgical program in 2018, a goal that Minister Hoskins specified in his announcement on Thursday.
Because Women's College Hospital is an outpatients hospital, Woodman said they'll partner with another hospital to offer inpatient care.