Doctor, advocates bemoan lack of access to gender-affirmation surgery in Sask.

Saskatchewan transgender advocates and a local physician say people wanting extensive gender-affirmation surgeries in the province are being forced to jump through too many hoops.

Transgender people in Sask. face long wait lists for complex surgeries

Dr. Leanne Bettin is a family doctor in Saskatoon, who is currently seeing more than 140 transgender patients.

Saskatchewan transgender advocates and a local physician say people wanting extensive gender-affirmation surgeries in the province are being forced to jump through too many hoops. 

That's because the province does not allow Saskatchewan doctors to approve funding for patients wanting complex gender surgeries. Instead, they have to seek that approval from an out-of-province doctor.

One local doctor who works with transgender patients says the province needs to rethink the way it treats access to these surgeries. 

"It's increasingly frustrating because we now have the expertise in Saskatchewan and yet people aren't able to get the approval for surgery funding in Saskatchewan," said Dr. Leanne Bettin, a family doctor at Saskatoon's Community Clinic. 

Bettin is currently seeing more than 140 transgender patients.

Getting access 

Saskatchewan doctors currently can perform reassignment procedures, like hysterectomies and mastectomies, and those procedures are funded by provincial health insurance. 

But more complex procedures involving genital reassignment, often referred to as "bottom surgery," are not done in Saskatchewan and must be performed by doctors in other provinces. 

In order to get approval for out-of-province surgeries and get them paid for by provincial insurance, transgender people have to get approval from an out-of-province doctor. That can, in turn, lead to long wait lists.

'Make the outside the same as the inside' 

Autumn Bourque, a transgender woman and executive director of Regina's Trans Umbrella Foundation, says for people living with gender dysphoria, waiting can be painful and harmful to their mental health.
Executive director of the Trans Umbrella Foundation, Autumn Bourque. (Autumn Bourque)

"It's not just a make-believe thing. This is something that we deal with on a daily basis," she said. "Being able to make the outside the same as the inside is extremely important."

She said Saskatchewan is behind other provinces when it comes to reducing red tape for transgender patients. 

"We need to get people faster through the system instead of bottlenecking them. We need to bring Saskatchewan in-line with the rest of the provinces in Canada," Bourque said.

Advocates urge team approach 

Amanda Guthrie, from OUT Saskatoon, says because for so many transgender people surgery is considered a medically necessary procedure, it's incumbent on the province to provide care. 

Bettin and Bourque agree Saskatchewan needs a new, team approach to help transgender people navigate the health system, whether they want gender-affirmation surgery or not. 

Bettin said she would be happy to be the one approving people for surgery in Saskatchewan, but she said a team approach with a host of experts would be a better, more comprehensive strategy. 

Province reviewing availability of physicians

A provincial spokesperson says fewer than 20 people have accessed out-of-province gender reassignment surgeries.

In a statement the spokesperson said "there are a limited number of professionals in the entire country with expertise in this very specific area."

"We will continue to review the availability of professionals in SK to provide these specialized services," the statement reads. 


Charles Hamilton is a reporter with CBC Saskatoon.