A Toronto resident's first-hand account of his humiliating experience at a local fertility clinic has shed light on the health-care barriers transgender people face when they're trying to start a family.
Alex Abramovich wrote in The Advocate about his experience as a transgender man undergoing in-vitro fertilization and having his eggs removed.
The story, Trans Men Need the Competent Fertility Care I Never Got, was posted on Wednesday and quickly became one of the international LGBT publication's most-shared stories. By Friday, it had already been shared more than 16,000 times.
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"The story has received so much attention, much more than I ever expected," Abramovich, a researcher at the Centre for Addiction and Mental Health, told CBC's Metro Morning.
"By sharing my story, my hope was that I could help another trans person so no other trans person has to feel as alone going through this as I did."
Starting a family
Abramovich has always wanted children. For most of his life, he said, he assumed he would carry his own child. But that changed when he came out as transgender and started taking testosterone.
"After discussing all of our options, my wife, Caroline, and I decided that the closest we would ever get to creating another human together would be to fertilize my eggs with donor sperm and to then implant the embryo into Caroline for her to carry the baby," he wrote in The Advocate.
That meant going off testosterone for a brief time, which was not an easy decision to make.
"Going off of testosterone made me worry about dealing with extreme body dysphoria — that discomfort over the mismatch between my physical sex and internal gender identity."
Knowing that the process would be emotionally and physically draining, Abramovich and his wife decided to make sure they could find a fertility clinic that would be welcoming to trans patients.
Ultimately, they decided on Mount Sinai's Centre For Fertility and Reproductive Health because it had a good reputation and a trans-inclusive policy.
On his first visit to get an ultrasound, he was given a dressing gown and made to wait in a room full of women.
"A nurse came out of the ultrasound room to get the next patient to come in, and I'll never forget the look of shock on her face when she saw me. As she walked away, she turned around three times in this small space, almost to make sense of what she was seeing, to make sure that I was actually real," he told Metro Morning.
"This caught the attention of the other patients and now everyone's staring at me. I feel completely humiliated, like I don't belong there."
Abramovich called the clinic to complain about what he says later turned out to be the first in a series of humiliating incidents.
"Every time I complained, I was promised that the next appointment would be better. But it actually never got better, it only got worse."
'All I ever expected was to be treated like a human being like anybody else.' - Alex Abramovich
At his next appointment, he says a group of physicians openly discussed the details of his health care in front of a group of female patients, and one of the nurses on duty repeatedly referred to him as "her" and "she." Despite his wife's corrections, he says the nurse did not apologize and repeated the slight.
What's more, he said his medical file was mislabeled: "Female patient."
Abramovich told Metro Morning that he understands that transgender fertility is a "complex issue" that not everyone is familiar with.
"But treating someone with dignity and respect is not a complex issue. That should be very simple."
Mount Sinai did not comment on the specifics of Abramovich's allegations, but told CBC News in an email that the treatment of transgender patients is an important issue.
"We work very closely with leaders of the LGBTQ community to ensure that access to care, including fertility, is inclusive, accessible and compassionate," Dr. Ellen Greenblatt, the fertility clinic's medical director, and Marylin Kanee, the hospital's human rights director, wrote in a joint statement.
"In cases where we do not meet the standards set out in our policies, we take immediate action to investigate and remediate the situation. This includes extensive training and ongoing research about how to improve access to care. The health-care sector must continue to work as allies to ensure that we are addressing the needs of the trans community, and Sinai Health System is committed to upholding our reputation for leading in this area."
Abramovich told Metro Morning he expects more from medical professionals at a large Canadian hospital with a transgender-inclusive policy in place.
"We're talking about a speciality clinic where the patient is expected to pay thousands and thousands of dollars out of pocket."
There is some good news in all of this, he said. His wife Caroline is now five months pregnant.