Any way you cut it, health care costs

Edmonton Sun, Canada
Wed, April 15, 2009
Any way you cut it, health care costs
By MINDELLE JACOBS

You can have Cadillac health care. You want lots of doctors, no
waiting lists and coverage for virtually all your medical and
psychological needs? Sure.

But there's a price to pay. I know, you're already pinching pennies
because your nest eggs have been decimated and you're wondering how
you're going to put the kids through college.

Still, if you want unlimited health care, hand over half your
paycheque to the government.

And stop complaining. Did you think you could have low taxes and
broad-based, state-paid services?

Chiropractic procedures are no longer covered in Alberta. And the
province is no longer paying for gender reassignment surgery.

The transsexual community has vowed to take the issue to the Alberta
Human Rights and Citizenship Commission today on the grounds that
sex-change surgery is medically necessary.

Is the province dumping on transsexuals because it figures, probably
correctly, that Albertans won't make much of a fuss over delisting
operations for a tiny minority of people who feel trapped in the wrong
bodies?

Or does sexuality have nothing to do with it and is Health Minister
Ron Liepert simply trying to make difficult decisions on how to fund
health care in the face of a $4.7-billion deficit?

I am not opposed to state coverage of sex-change surgery because it
involves so few people.

As transsexual Michelle Drinkell pointed out on Monday, the $700,000 a
year the province hopes to save by delisting the procedure is a
"teardrop in the ocean" of the $13-billion health budget.

On the other hand, the decision over whether to cover medical services
shouldn't be based on numbers, emotion and complaints to human rights
commissions but on what we consider medically necessary.

That's the wider public policy discussion Albertans need to have.

Experts will tell you it can be incredibly psychologically damaging
for transsexuals who can't afford sex-change surgery.

BAD TEETH

But there are lots of people with bad teeth who grow up to be
depressed, timid, emotionally beaten-down individuals because they
can't afford dental work.

Others have facial disfigurations that cause them no end of teasing,
embarrassment and loss of self-confidence, yet the government won't
cover certain operations.

And what about diabetic supplies, optical services and prescription drugs?

Perhaps there should be a whole parade of Albertans marching to the
human rights commission.

Then again, is the human rights commission the right body to determine
what should be covered under the medicare umbrella?

It is properly the function of government to make these arduous decisions.

The trouble is, no one knows Liepert's plan.

It's highly unlikely, however, that he's intent on imposing "an
American two-tier-style health system," as the fearmongering Friends
of Medicare squawked yesterday.

Even the Alberta Tories realize that Canadians want to preserve our
universal access system, even as we experiment with reforms.

Because of rising health-care spending, Alberta could be facing "a
more strained fiscal future," warns a new University of Calgary report
on the sustainability of the province's medicare system.

Alberta can either control expenditures (angry patients), raise taxes
(angry voters) or create a health endowment fund to pay for future
medicare costs (expensive), the report says.

Pick your poison, folks.

MINDY.JACOBS@SUNMEDIA.CA
Copyright € ¦© 2009, Canoe Inc. All rights reserved.
http://www.edmontonsun.com/Comment/2009/04/15/9116231-sun.html

Province retreats on sex changes

Edmonton Sun, Canada
Wed, April 15, 2009
Province retreats on sex changes

By KERRY DIOTTE, LEGISLATURE BUREAU CHIEF

The province is bending a bit on cancelling gender-bender surgery.

Alberta Health Minister Ron Liepert said yesterday the province won't
snip sex-change operations out of this year's budget to save $700,000
as previously announced.

Liepert announced that in question period as more than two dozen
transsexuals and their supporters watched from the public gallery.

The minister told the House 26 Albertans are now "in the program" and
their surgery will be covered.

A further 20 people who hadn't been scheduled for surgery but were on
a waiting list for funding will now also be paid for, but the
procedure won't be funded next fiscal year, he indicated.

Health ministry spokesman John Tuckwell says that means the government
will have to come up with extra cash in the soon-to-be-passed 2009-10
budget to pay for the sex-change operations that can cost between
$18,000 and $70,000 and are performed in Montreal.

Opposition MLAs accused the government of trying to save money by
picking on a small minority group that's been told by physicians their
surgery is medically necessary. But Liepert said his ministry had to
make tough choices.

TOUGH DECISIONS

"This was not based on medical decisions," said Liepert. "This was
based on a number of programs we had to make ... There were some very
tough decisions that had to be made, everything from cancelling some
programs around youth suicide prevention to programs around certain
surgeries."

Edmonton Centre Liberal MLA Laurie Blakeman argued the province will
likely waste more cash than it will save by chopping the sex-change
procedure from next year's budget because government lawyers will have
to defend human rights challenges.
Click here to find out more!

Transsexuals have vowed to file numerous complaints as early as today
to the Alberta Human Rights and Citizenship Commission.

HUMAN RIGHTS

A human rights challenge in Ontario saw that province forced to
reinstate coverage of sex-change operations.

Edmonton-Strathcona NDP MLA Rachel Notley says Alberta will come off
as looking like rednecks nationally because it cancelled funding for
sex changes to save a small amount of money. That's exactly the
opposite of a recent rebranding program that boasts that Alberta is
open and tolerant, she said.

"This is an attack on the most vulnerable," Notley told Sun Media.
Because of the government's decision, "we will continue to look like a
backward group of folks to the rest of the country ... That's not how
Albertans are."

Premier Ed Stelmach said it was "fair and reasonable," that Liepert
extend the sex-change operation program for one year.

Axcella Zelensky said she already had her publicly funded operation in
January but was at the legislature to fight to see others continue to
have access to publicly funded sex changes.

"I was actually planning in the next little while to send a thank-you
card to the government, but I'm not sure whether I can anymore," she
told Sun Media.

Surgeries are a necessity, she said. "We never chose to be born into
the wrong body."

KERRY.DIOTTE@SUNMEDIA.CA
Copyright € ¦© 2009, Canoe Inc. All rights reserved
http://www.edmontonsun.com/News/Alberta/2009/04/15/9116406-sun.html

Transsexuals to battle over operation delisting

Edmonton Sun, Canada
Tue, April 14, 2009
Transsexuals to battle over operation delisting
By KERRY DIOTTE, LEGISLATURE BUREAU CHIEF

Alberta transsexuals are stepping up their fight for government-paid
sex-change operations.

Members of the community will be at the Alberta legislature today for
question period. Tomorrow, they'll march to Alberta Human Rights and
Citizenship Commission offices in Edmonton and Calgary to file
numerous complaints because the government is delisting sex-change
operations, also known as gender reassignment surgery.

Officials announced in last week's budget the province will save
$700,000 annually by no longer paying for the operations.

"It's devastating to live in a gender you can't associate with," said
campaign co-ordinator Michelle Drinkell, who was born a man and says
she's been approved by the government to have a sex change but isn't
sure if it will now be covered.

Drinkell is taking hormones, paying for hair-removal laser treatment
and working with a voice coach in her process of trying to become a
full-fledged woman - all of which has cost her "thousands of dollars."

"The $700,000 is a very small amount compared to the total value of
the $13-billion health-care budget," she said.

Continuing to fund the operations "works out to 19 cents per Albertan
per year. It's nothing more than a teardrop in the ocean."

Transsexuals and supporters are planning to show up at the legislature
about 12:30 p.m, then take in question period when the three official
parties square off about 1:45 p.m.

They plan to file official complaints tomorrow at 10 a.m. at the
Calgary and Edmonton offices of the human rights commission arguing
sex-change operations are medically necessary.

Drinkell says they're buoyed by results from Ontario where a human
rights challenge forced the government to re-list the operations.

Drinkell plans to have a sex change done even if she has to pay for it
herself. She said she's been taking hormones for about two and a half
years and now lives as a woman.

Delisting the operation will have profound psychiatric effects on
people who've been diagnosed as needing a sex change, she says.

The suicide rate among transsexuals is already about triple the rate
of the non-transsexual Canadian population, she said.

Edmonton transsexual Cynthia Paish, 36, said her life and the lives of
others are in limbo because of the funding cancellation. Her sex
change surgery to become a woman was scheduled for August 24 but has
now been cancelled, she said.

Paish worked 12 years as a car audio installer but is now studying
esthetics. She's not 100% sure her operation will still be covered but
tries to be optimistic.

"It makes me really mad," said Paish, who is paying $100 a month for
hormone therapy on her own and plans to show up at the legislature.
"They're basically playing with people's lives. You really are trapped
in the wrong body."

Health ministry spokesman John Tuckwell said delisting sex-change
operations was a way to save the province money.

"The minister has acknowledged he's had to make some tough decisions
and this is one of them," said Tuckwell.

"He needed to find some additional funds to support some initiatives
for seniors' continuing care and $41 million was put into that
strategy," he said.

KERRY.DIOTTE@SUNMEDIA.CA
Copyright © 2009, Canoe Inc. All rights reserved.
http://www.edmontonsun.com/News/Alberta/2009/04/14/9104791-sun.html

'I felt so trapped'

Edmonton Sun, Canada
Sun, April 12, 2009

'I felt so trapped'
Transgendered individuals to launch lawsuit to get surgery funding reinstated
By CLARA HO, SUN MEDIA

Sarah King lost jobs, friends, relatives and, most devastatingly,
custody of her daughter when she made the decision to transition from
a male to a female.

But like many other transgendered individuals, it was a decision King
needed to make in order to survive.

And for many, the transition cannot be done without gender reassignment surgery.

Now the 33-year-old self-employed businesswoman is spearheading a
class-action lawsuit against the Alberta government after it announced
it would no longer fund gender reassignment surgeries to save about
$700,000 in its budget.

"By delisting gender reassignment surgery, the government is
performing capital punishment or execution on that person," King said.

She cited examples of transgendered individuals hurting themselves
because of their gender identity disorder.

King said she will go to court on Wednesday in the hope of obtaining
an injunction that will force the province to approve funding for
everyone on a gender reassignment surgery waiting list and then
eventually relist funding.

King and other members of the local transgendered community are in
talks with the same law firm that represented Delwin Vriend, a gay
teacher who took his case to the Supreme Court when he was fired from
his job for his sexual orientation.

The landmark case forced the province to protect gays in its human
rights legislation more than 10 years ago.

Currently, more than 16 people are represented in the lawsuit -- and
that number continues to grow by the day, said King, who was recently
notified that funding for her own gender reassignment surgery,
scheduled for January, had been cancelled.

Dominic Scaia is one of those individuals fighting to have the funding
reinstated.

"Somebody stole our hope away," said the 26-year-old.

Scaia moved from British Columbia to Alberta two years ago to have all
the necessary surgeries to fully transition from a female to a male.

When he was living as "Donna" years ago, Scaia said he was deeply
depressed, very self-destructive, and promiscuous, and was taking
drugs and cutting himself.

A friend helped him realize that if he didn't transition, he would
eventually harm himself. He immediately started taking the necessary
steps to become a male.

He saw a psychiatrist, took hormones, lived as a man for two years,
and obtained funding approval from the province to have chest surgery,
scheduled for November.

Now he's unsure if that approval still stands.

"I bawled my eyes out," he said when he heard the funding had been
cut. "I felt so trapped."

CLARA.HO@SUNMEDIA.CA
Copyright © 2009, Canoe Inc. All rights reserved.
http://www.edmontonsun.com/News/Alberta/2009/04/12/9088846-sun.html

Sex change funding cut may take heavy toll

Edmonton Sun, Canada
April 11, 2009

Sex change funding cut may take heavy toll

By MICHAEL PLATT

For Michelle Ann Duff, it wasn't a choice. Sex-change surgery was a
decision between an early grave or a new life as a woman.

"I had two choices: number one was to make a gender change, and number
two was to jump in front of a subway car," said Duff, 69.

The Ontario woman faced a much bigger leap of lifestyles than for the
relatively few Canadians who undergo the life-altering switch every
year.

In 1985, as the soon-to-be "she" boarded a plane to Belgium for a date
with a sex-change specialist, Michael Duff was a world-acclaimed
motorcycle racing star, Canada's own record-setting grand-prix hero.

Retired and with three children from two marriages, Duff abandoned the
uber-macho world of pistons and leather to start a new life as a
woman.

"I hate that overused cliche, a woman trapped in man's body, but
that's basically it," said Duff. "It's been shown time-and-time again
that the only way to connect for a person with gender dysphoria is to
make the outside the same as the way they feel inside."

Gender dysphoria is a recognized psychological condition which causes
distress and depression. In Alberta, the condition is considered
serious enough to qualify victims for sex-change surgery, paid for by
the province for the past decade. Or, at least, it was.

On Tuesday, while hiking the price of beer and cigarettes, the
province also yanked funding for transgender surgery, supposedly to
cut $700,000 a year out of a $13-billion purse. Petty doesn't begin to
describe the few pennies saved by cutting funding to the 10 to 20
Albertans who undergo the surgery each year.

Already, there's talk of a human rights complaint -Ontario faced a
similar challenge and lost in 2008 - but those awaiting their turn for
change are devastated.

"I've been on hormones for two years and dressing as a female, and
then they do this - how is this even possible?" said Paris, a Calgary
male-to-female gender converter, who asked her name be changed to
avoid recognition. "I've been waiting to get on the waiting list - now
I have no idea what I'm supposed to do."

Those who have started the surgery, which can take more than one
operation, will have their change covered by Alberta Health. But those
like Paris, who are still functionally of their birth gender, are out
of luck.

"It's not the same as getting a boob-job," said Paris, who describes
the change as essential to a person's identity, unlike cosmetic
surgery.

A Facebook group, Reinstate Gender Reassignment Surgery Funding in
Alberta, already has in excess of 300 members, and a campaign has
started a letter of complaint, along with 19 cents, to the province.
That 19 cents represents the per-Albertan cost for funding the
surgery, highlighting the pittance at stake, cash-wise.

On the human front, the cost could be incalculable: the Facebook group
already contains messages from despondent patients hoping to undergo
surgery, which they can't afford without funding.

"My chest surgery date is coming up in November, and if it's not
covered at that time.. I will not be able to pay for it myself ... so
I'll have to go without ...which will most likely result in me feeling
hopeless and suicidal," wrote Dominic Scaia.

Kristopher Wells, a researcher at the University of Alberta, said the
province is facing a serious legal battle, which will end up costing
far more than $700,000.

"They made this cut without understanding the personal and legal
implications," said Wells. "A human rights complaint will be filed -
that's the talk in the community at this point."

MICHAEL.PLATT@SUNMEDIA.CA
Copyright € ¦© 2009, Canoe Inc. All rights reserved.
http://www.edmontonsun.com/Comment/2009/04/11/9081746-sun.html

Calgary Sun, Canada

Fri, April 10, 2009

Transsexuals gear up for fight

Decision to cut funding for sex reassignment surgery appears bound to
fail in courts

By ANDREW HANON

EDMONTON -- "This," says Kris Wells, "could be the next Vriend case."

The provincial government is about to drag all Albertans into yet
another costly, shameful and needless legal battle -- this time over
the decision to stop funding sex-change surgery.

And like the landmark Delwin Vriend Supreme Court case that forced
Alberta to protect gays in its human-rights legislation a decade ago,
or former premier Ralph Klein's pigheaded -- and ultimately futile --
fight with Ottawa over same-sex marriage, this is one the government
cannot win.

After all, last year Ontario was forced to reinstate funding for
sex-change surgery after losing a human-rights case.

The Alberta government politicians insist their decision wasn't based
on morality. They say they had to "de-list" the service in order to
save about $700,000 in the provincial budget.

Yeah, right.

Yes, that's the same budget that will see overall program spending
hiked $1.1 billion and a total deficit of $4.7 billion, the most
profligate in Alberta history.

Activists are already fighting back, first with political pressure,
then through human rights complaints and if necessary, all the way to
the Supreme Court of Canada.

Wells, of the Institute for Sexual Minority Studies and Services at
the University of Alberta, said a campaign is underway to pressure a
government health committee, which will make the final decision on
whether to cut the program next week.

Meanwhile, others are planning to flood the Alberta Human Rights
Commission with complaints.

Failing that, there's always another court challenge based on the
Charter of Rights.

"Often it's only a matter of time before the right person comes
forward and is willing to litigate for change," Wells says.

Dr. Lorne Warneke, the only psychiatrist in Alberta who specializes in
transgender issues, says it's a common misconception gender
reassignment is elective surgery and shouldn't be tax funded.

"It's not. It's a well-known condition that people are born with," he
says, adding that if left untreated, it "can cause tremendous
psychological anguish and distress."

Warneke, who runs the transgender clinic at an Edmonton hospital, was
not consulted or even notified that the funding would be cut.

Up to now, he's approved 16 people a year for the surgery, which is
usually performed in Montreal.

Alberta Health has said anyone who has had their funding approval will
still get the surgery, but Warneke said at least 16 of his patients
have been caught in a limbo where he's approved them but the
government hadn't yet green-lighted the funding.

Then there are dozens of others who've begun the long assessment
process -- which includes hormone treatments and living for at least a
year as the opposite sex.

"I'm completely screwed," says Jan Lukas Buterman.

Buterman, a 40-year-old teacher, began the process in 2007 and lives
as a man. "My surgery and follow-up treatment will cost about
$60,000," Buterman says. "How do you save up for that?"

For many transsexuals, borrowing is out of the question because
discrimination keeps them underemployed.

Buterman's driver's licence has him listed as female, and can't be
changed until he completes all surgery. "So now, if I go to a store
and try to pay with a credit card and they ask for ID, I have to show
them this," he says.

At best, it's embarrassing. At worst, he can be accused of having a forged ID.

ANDREW.HANON@SUNMEDIA.CA
Copyright © 2008, Canoe Inc. All rights reserved.

http://calsun.canoe.ca/News/Alberta/2009/04/10/9075496-sun.html