TransAction NB’s statement on extension of coverage for gender-confirming surgeries

Today we are happy to share the government of New Brunswick’s announcement that they plan to implement Medicare coverage for gender-confirming surgeries and remove restrictions on changing identification documents. It has taken many years, countless hours of hard work, and serious dedication from NB trans people and our allies to get to this point. It is a relief to know that we have finally been heard and that our government has made the decision to take us seriously in the face of the wealth of contemporary research showing that for many trans people these procedures are medically necessary and appropriate identification documents ensure our safety. The announcement regarding Medicare coverage brings our province in line with all other provinces in our country, who already offer these services to their trans residents and in some cases have done so for decades.

We are still waiting for details on what surgeries the NB government plans to cover, what avenues people will have to follow in order to obtain this coverage, and when exactly the coverage will be put into place. Our hope is that the coverage plan approximates those offered in other provinces and allows for those who have had to pay out of pocket in recent years to be reimbursed. Being able to access gender-confirming surgery and appropriate identification documents will markedly improve the lives of NB’s trans residents for a number of reasons. Trans people are a seriously disadvantaged minority group; we have a high likelihood of experiencing violence, abuse, and ignorance in our day-to-day lives, and we face high levels of discrimination that prevent us from accessing adequate housing, employment, education, healthcare, and social services. These stressors, added to the physical and social dysphoria that many trans people experience, have been proven to lead to extremely high rates of anxiety and depression (>50%), and suicide attempts (43%) and ideation (77%) among trans people (TransPulse 2013). Access to gender-confirming surgery has been projected to significantly reduce annual suicide attempt (from 30% down to 11%) and ideation (from 35% down to 21%) rates among trans populations, and access to appropriate identification documents is projected to reduce suicide attempt rates from 30% down to 14% (TransPulse 2015). Combined these two factors make a large difference in trans people’s ability to move safely and comfortably through the world.

Being able to access trans-specific healthcare services under Medicare and appropriate documentation through Vital Statistics are two major steps forward in resolving the problems outlined above, but there are many areas where our province still seriously limits trans people’s ability to access the same opportunities and resources as the general population. There are trans people for whom gender-confirming surgery is not medically necessary or even desired, and there are a range of other difficulties that all trans people may face that will not be solved by access to trans-specific healthcare or ID. With this in mind, we would like to stress that TransAction NB will not be abandoning our attempts to improve the social landscape for trans New Brunswickers; we plan to continue targeting areas where trans people in our province are still seriously disadvantaged, not limited to:

– Access to health services unrelated to gender transition provided by competent and informed health care professionals;
– Including “gender identity” and “gender expression” as explicit grounds of protection under the New Brunswick Human Rights Act;
– Building mandatory education about trans people and other LGBQI2S+ identities into education programs for students and school staff and administration starting at the elementary school level;
– Increasing trans people’s opportunities to access the same level of education as their non-trans peers;
– Advocating for publicly-funded abortion access and education on other trans reproductive rights issues;
– Campaigns and events designed to increase public knowledge and understanding of trans people and identities;
– Collaboration with researchers, government officials, schools, workplaces, housing organizations, and other businesses and organizations to develop trans-inclusive policies and spaces.

Though today’s announcement is certainly a cause for celebration, we encourage our allies not to consider this the end of the fight for trans rights in New Brunswick. Coverage of gender-confirming surgery will remove a significant financial strain from those who would have previously been forced to pay out-of-pocket, and access to ID will increase trans people’s social mobility and safety, but significant effort is still needed to reduce the instances of violence, discrimination, and ignorance that still create difficulties for this vulnerable group. We would like to thank you all for your continued support, and we look forward to the improvements the future will bring.