Toronto transsexuals want op subsidy

Four transsexuals who say the Ontario government`s decision to stop funding sex change operations in 1998 left them trapped halfway between the sexes will have their case heard this month. Martine Stonehouse, a support worker with the Toronto school board, said she couldn`t afford to finish her transition from male to female after the province removed sex-reassignment surgery from the list of procedures covered by medicare five years ago. Now she and three other transsexuals will go before the Ontario Human Rights Commission to try to force the government to fund and finalize their sexual transformations. "To leave any patient halfway through a recognized medically necessary procedure is medically and morally unethical no matter what the condition is," said Stonehouse, who prefers to be referred to as a female. The Ontario government stopped funding sex-reassignment surgery - which reconstructs the genitalia - on Oct. 1, 1998. Prior to that date, Ontarians could have their surgery paid for provided they went through a standardized two-year program that included: psychological assessments, hormone treatment, and a "real life test" in which patients had to live as the other gender, full time, for one year. The Gender Identity Clinic at the Centre for Addiction and Mental Health in Toronto would then approve patients for the government-funded surgery. Between 1980 and Sept. 30, 1998, about six or seven surgeries were recommended by the clinic each year, at a combined annual cost to taxpayers of about $122,000. When the government stopped funding the operation, a limited clause gave coverage to those who had been approved by the clinic, but hadn`t undergone surgery. "People who we had written letters of approval for prior to that date did get their surgeries covered but that was a limited number," said Maxine Petersen, a psychological associate at the clinic. "There were a lot of people who were in the process and hadn`t reached that point of approval, but were certainly headed in that direction." Stonehouse was caught in that awkward position. She began living full time as a woman in 1987 and started hormone treatments, which caused her breasts to grow, voice to raise, and sex drive to drop about ten years later. She wasn`t approved by the clinic before the funding was dropped, and said she can`t afford the surgery - which can cost up to $20,000 - on her own. Stonehouse said the government should pay for the surgery since it is a medically recommended solution for her condition, which makes her feel like she`s a woman trapped in a man`s body. The outcome of the hearing will likely hinge on whether or not sex-reassignment surgery is deemed a "medically necessary" procedure - a designation that makes a procedure fundable under the Ontario Health Insurance Plan. "I would say `medically necessary` would probably be the main criteria that led to (the surgery`s) de-listing," said Health Ministry spokesman John Letherby, adding that the decision would have been made by an "adequate and fair cross-section" of medical professionals who are hired annually to make those kind of recommendations. But lawyer Susan Ursel, who will represent three of the complainants when the hearing begins on Sept. 23, said the government`s decision was "inhumane" because her clients suffer from a medically recognized disorder. "They`ve taken a stance that doesn`t seem to be supported by the majority of medical professionals in the field," said Ursel. "These people have been diagnosed with a gender identity disorder. They have a profound disjuncture between the gender identity (that) society may have assigned them and who they feel they really are," she said. "So expecting them to conform . . . comes about only through extreme personal sacrifice by them." Petersen, who has been working at the Gender Identity Clinic for the last 20 years, agrees. "Nobody would choose this as a preferred way of living if they had the choice," she said. "This would not be it, because there are too many painful, painful losses." Petersen said that may be why the clinic`s active case load - about 250 to 300 people at any given time - didn`t drop even after the surgery was de-listed. Canadian provinces that cover the costs of the surgery include Manitoba, Saskatchewan, Alberta and Newfoundland.