Edmonton·Video

Transgender Albertans say they're facing longer wait times for hormone replacement therapy

With more people now seeking hormone replacement therapy, is the number of doctors who are comfortable working with transgender people keeping up?

'It's terrible. The attempted suicide rate is very high,' says psychiatrist

Advocate Valerie Keefe shares the struggles transgender Albertans face with long wait times. 0:39

When Valerie Keefe started hormone replacement therapy seven years ago, it took her close to a year to get the medication and move forward.

Today, she says it can take far longer to see a doctor for referrals and hormone medication.

"It's vulnerable people in a position of crisis while they are being forced to wait to prove that they are 'trans enough' to doctors that barely see them at all," said Keefe. 

"Once you get your endocrinology sorted, and when you give the brain that something, it no longer feels that extreme stress."

When she stopped getting refills of her hormone medication through her endocrinologist, Keefe had to find a general practitioner to prescribe her more. But the doctor she saw referred her to a different endocrinologist who wouldn't give her the prescription she needed.

"That endocrinologist said he had the option of declining to treat trans patients and not deal with trans medicine," she said.

With more people seeking to transition now, the number of facilities with doctors who are comfortable working with transgender people hasn't expanded to match that growth, she said.

'There shouldn't be a barrier'

Dr. Lorne Warneke is one of five psychiatrists in Alberta who work with transgender patients.

Warneke says it can take six months to find the right general practitioner who will give a referral to a psychiatrist, and psychiatric wait lists can be anywhere from six months to a year or longer.

The patient then has to wait about three to four months to see an endocrinologist for a prescription.

"It's terrible. The attempted suicide rate is very high," said Warneke.

"[Transgender people] can't move forward in terms of relationships and their life until they get the necessary treatment and the hormones. The hormones are the most important thing."

Warneke said Alberta Health Services needs to hear more about the barriers that transgender people in the province face. "They need to understand the plight of these individuals and respond by hopefully providing better resources," he said.
Dr. Lorne Warneke has been working with transgender patients since 1978. (CBC)

He added that medical students also need to be taught more about transgender patients.

"We have to impress upon doctors that this is an important area to get up to speed on. It has to be introduced in greater detail in the medical school curriculum. Right now there is very little taught about this," he said.

"There shouldn't be a barrier between a physician and a patient."

Steps forward

Despite the challenges, Warneke is optimistic that the situation for transgender people is improving. 

He cites Bill 10, the bill passed in 2015 which broadened the definition of gender identity and gender expression in Alberta, as a major step forward.

Marni Panas, a senior diversity and inclusion adviser for AHS, said the health service is working with the University of Alberta's Faculty of Medicine and Dentistry to give medical students the knowledge they need to provide proper care to transgender patients.

"We're looking at redeveloping four years of curriculum to include diversity throughout all four years, for all diverse populations," Panas said.

In addition to frontline health-care providers, AHS is also working to educate administrative staff about how to provide services to transgender Albertans.

emily.rendell-watson@cbc.ca

@erendellwatson