A face to the issue of delisting GRS

As many of you will know by now, the Alberta government has delisted services for both chiropractic treatments, of which they paid a grand total of $14 per visit, and of Genital Reconstruction Surgery (GRS) for Transsexual (TS) people.

As a Transsexual the latter is an issue particularly close to my heart. I was lucky, in that my surgery took place several years ago. Having this surgery has allowed me to increase my overall health to a very large degree. I don’t succumb to depression, suicidal ideation or self-injury nearly as bad as I did when I was preop. Sure I still get the winter blues and they can be pretty bad at times, but they’re molehills compared to the mountains they were prior to August of 2002 (when I had my surgery). I can look myself in the mirror now, and I can smile, instead of wanting to punch out the mirror. I can have a healthy sex life with a partner, where the partner is interested in who I am, rather than what I am (which is a major problem for preop TS people). I don’t have to hide my true nature from any potential partner. I don’t have to lie to my partner, family, friends or coworkers about the most basic element of my identity as a person
anymore. The reduction of stress from that alone is truly priceless. According to people who knew me before, they are amazed at how much more comfortable I appear to be in my own skin. I truly am not the person I was before.

When I was preop (before I had GRS), I was extremely shy, withdrawn, angry and I was for all intents and purposes, virtually unable to participate in even the most basic elements of life to any real degree, all because I wasn’t comfortable being me. I had to present a façade as to what people expected me to be, rather than present who I was.

For me, GRS literally saved my life. Ten years ago, literally, I wrote out the pros and cons of what my options were in regard to transitioning. On the transition side, I realized I could lose everything. Including but not limited to my home, health, work and even my life. All in the effort to transition gender roles, so that I, as the woman I knew I was from day one, could be “up front”, that I could live openly as who and what I really was. That was the con & pro, respectively. Then I looked at my options for staying in the role contrary to my identity, contrary to who and what I was at my core, to stay presenting as a male. I could see easily that at the least, I would continue to be miserable, depressed and indeed more than a little stressed and all the health problems that go with that, such as cardiac problems (which run in the family as it is), stress induced diseases such as depression, gastro-intestinal distress and ulcers and
ultimately, the very real probability that I would have committed suicide well before the 10 years were up. Even so, I could see I would be no farther ahead to achieving any semblance of happiness in my life if I continued.

So I chose to risk everything, in order to achieve the slim chance at some sort of meaning to my life.

In April of 1999, I did what is commonly referred to as “going full time”. I renounced the identity that had been forced on me, and started to live my life as who I truly am. As Leslea Katherine Herber, and as the woman I was at my core. It took time to learn how to live as a woman. No one is born knowing how to socialize in a given gender role. I was 28 years old and had been forced to learn how to be a male. Every time I tried to live as a female prior to this point, I had encountered usually severe gender enforcement. From when I was born (I was born intersexed, but due to “guidelines” of the time, even the doctor started out with insisting I be given a very masculine name, rather than one that could remotely be construed as even androgynous. I was supposed to be named Leslie.) and all through my childhood and early adulthood people insisted I be male, not be a sissy or worse. I even tried to do so to myself, joining the military in a
misguided effort to “kill or cure” my strong desires to be a woman. None of it stuck. It took years for me to transition gender roles. It was difficult and I had severe health problems during the transition. Some unrelated, many directly related to transition and complications from both being born intersexed (which became apparent when I went on hormones) and from severe mismanagement of my hormonal care from poorly educated doctors. Doctors are not given any serious training on how to deal with feminizing hormone treatments, intersexuality or complications and how to deal with them. Suffice to say I had to become an extremely well informed patient for my own health’s sake.

In August of 2002, I went to Montreal. I had funding through my Alberta health care plan to get the GRS. In short, the surgeon used my masculine genitalia to create female genitalia. I’ll never bear a child and I don’t have a cervix. But as time goes on and cells die off and are replaced, my tissues become no different than any other woman who has had a hysterectomy and removal of their cervix. Due to the intersex condition, I do get minimal hormonal fluctuations and irregular periods. Not all TS woman get the last bit. They do get the genitalia though, and the parts do work just the same as a woman who has had a complete hysterectomy, including the cervix. Due to an unrelated condition damaging my health to the point I could not work and if it were not due to Alberta health funding being available to people like me, I would have been completely out of luck to have a chance to live my life as who I truly am at heart.

Consider this. In Alberta, if you smoke and get lung cancer and heart disease, your heath care is covered. If you go skiing and break a leg, you get a cast, no big deal. If you even are dumb enough to drink and drive and are in a wreck, you go to the hospital and are treated. All of those involve making a deliberate choice. I never had a choice in how I was made. I didn’t have a choice even as a child, when the doctor had a 50/50 chance of guessing right, and he got it wrong. I’ve paid the price since.

When it came to a choice, it was the choice between risking my life in the short term, to gain the long-term benefits for the rest of my life, which will presumably be many decades to go. The other choice was to choose to be miserable and face severe health risks and extremely probable death at an early age. There’s a rule for TS people called the 50% rule. That of all TS people who are born, 50% never see 30 years of age, as a direct result of being TS. I beat those odds. When you factor in how many TS people die that were not out as TS, who were closeted and who die in such a way as for suicides or murders to be classified as something other than related to being TS, but who did die as a direct result of being TS… Suffice to say I’m actually in quite a minority.

The Alberta government delisted GRS in order to save $700 000 out of a 13 billion dollar budget. That’s a savings of 0.00541%. It works out that the cost per Albertan per year for GRS is 19 cents. That’s less than 1/5th of a dollar, to save the lives of up to 16 Albertans per year. Albertans, who also pay their taxes, contribute to the societal mosaic of the province and who are the sons, daughters, parents, aunts, uncles and grandparents of other Albertans. Add to that, that GRS has in excess of a 90% success rate. TS people have to prove they’re transsexual to 2 qualified gender therapists, one of which must be either Dr John Brooks at Alberta hospital in Edmonton, or Dr Lorne Warneke at the Grey Nuns hospital, also in Edmonton. They must live for at least a year, during their transition from one gender role to the other, before they can get surgery. Due to waiting times for the surgeons who perform the surgery (they’re extremely busy
doctors), the wait time tends to be at least 2 years. During which time, they can quit at ANY time. These people face the real probabilities of being harassed, dismissed and otherwise treated poorly during the entire time, merely for being “between genders”. They can even face police harassment, merely for using a bathroom reflecting their gender presentation, simply because they are not legally that gender. If they use the other bathroom, they face the same issue, because they look out of place. Worse, a male to female in the men’s washroom faces the very real probability of violence from intolerant men who choose to see a freak, rather than a person trying to go pee. In short, TS people run a literal and extreme gauntlet to prove they are who and what they say they are. Suffice to say, those who are not likely to succeed, are usually weeded out long before they get to the surgery. This is one of the reasons only 16 people per year were
approved.

GRS has been deemed by every reputable medical and psychiatric organization on the planet, as being essential to the well being and health of TS people who pursue it. It’s such a small percentage that do seek it that it’s really worth funding, to keep the costs of refusing to fund it in check if nothing else. Refusing to fund does increase the cost on psychiatric services and medical services. Long-term preop HRT complications are more severe than simply allowing the surgery and removing then unneeded medications. For example, antiandrogens for TS women (those going from male to female) include liver failure, DVT (Deep Vein Thrombosis, often with Estrogen contributing as well), chronic gatro-intestinal damage and even death. Once post op, there’s no need for antiandrogens, and estrogens can often be switched to more liver friendly options. After 10 years on hormone treatments (the time it takes for the Estrogen to finish feminizing the body,
much like natal women… Those born completely female), even it can be reduced a bit if the patient wants to, without serious problems. In short, not funding will cause complications to those TS people who are denied the one treatment that has proven time and again to solve much of both their physical and mental health issues.

In both Ontario and BC, GRS surgery being funded through the provincial health plans, has been designated a human rights issue. In Ontario, their supreme court even ordered the relisting of GRS on that basis. In Alberta it’s not a matter of IF it should be relisted, but when will it be relisted. The human rights complaint that is already being prepared against the provincial government, will cost far more than the $700 000 the government thinks it will save by this denial of essential care.

I could go into detail as to why I think that GRS was really delisted… But it presupposes some pretty dark motivations on the part of those people elected to serve ALL Albertans. Suffice to say I hope that those who don’t believe in equality for all people, don’t get their way in this matter.

So help the TS people of Alberta get the medical treatments they need. Write to your MLA. Write to them all for that matter. Write to the various ministers for health and finance. Write to the premier. Remind them that they are there to represent the people of Alberta. Not just the ones they may approve of, but of all the people of the province. Include 19 pennies. Let them know you’re willing to contribute your part to saving the lives of 16 Albertans and that they should smarten up and listen to the people. All of us.

Leslea
Proud postop transsexual woman