(Part of GayCalgary and Edmonton Magazine‘s coverage of the delisting of GRS in Alberta)
It came in as registered mail. This was good news of course, so when I’d received the notice, I ran down to the postal outlet to collect the envelope that would have news about my eligibility for surgery. I knew what the letter should say because of a conversation with Alberta Health a couple days prior, so I was pretty excited. I was to be one of the “46” (we still can’t figure out who is all included in that number) who was to be grandfathered through before funding for Gender Reassignment Surgery (GRS) would be completely cut off. And then the girl behind the desk at the postal outlet said, “I need to see some ID.”
The bubble burst fairly quickly at that. I pulled out my Driver’s License, trying to keep my thumb over the “M” specifying gender. She pulled the card from my fingers, made a note and then stiffened for a full second when she saw the dreaded M. Without moving her head, she glared up at me, crooking an eyebrow. Then, after a pause, she tossed my license and the letter at me, saying nothing as she waited for me to leave.
Yay. Outted again in a small town.
Of course, for me, it’s still good news. Once I have the surgery later this year… then get my letters from the surgeons declaring that GRS has been performed… and then get them notarized… and then have an examination with my family doctor to get a letter from him… and have that notarized… and pay all the registry fees for processing the Birth Certificate change… and pay all the fees for the D/L change… and pay for all new ID cards… and I’m sure I missed a few other steps in there somewhere, I’ll have to check…. But once I’ve done all that, I can be a person again (it’s a good thing I wasn’t born in B.C. where this process gets complicated). For the larger part of an entire community, though, that personhood is now another $20,000 (if MTF) to $100,000 (if FTM) away. In an age of inflated rents, falling wages and dwindling McJobs, just breaking even financially is difficult enough — the Alberta Government seems to want to make the sex trade a reasonable career path for the unemployed, underemployed and moderately employed transsexuals who are seeking to fix their lives.
$700,000 isn’t much in a $13 Million health budget — it works out to 19 cents per Albertan taxpayer. But it’s often inaccessible to individual transsexuals, who are often facing stable employment concerns and economic marginalization. Health insurance plans, too, often make a specific exemption of GRS, even though all major Canadian and American Medical bodies recognize it at a medically necessary procedure (the American Medical Association restated this in June of last year for this reason). So the option of private health care funding is rarely there, either. Albertans and Health providers like to pretend that GRS is cosmetic surgery done on a lark… never mind the therapy, real-life test that extends sometimes to 3 or 4 years in Alberta or the other hoops that no cosmetic patient would ever have to jump through. In reality, it is something that can bring closure to an anxious, distressful, dysfunctional phase of life. In reality, one of many things that have been made inaccessible to Albertan transsexuals by delisting the surgery is personhood.
Imagine being outted every time you buy cigarettes or go to the bar. You apply for a job, and sometimes it is there again: “let’s see your driver’s license.” Imagine the person carding you and then loudly drawing attention to you with their vocal objections — or even some clerk trying to be nice and say “oh, you’re transgender, that’s cool” and unintentionally informing everyone in the line behind you. With the strict gender binary we’re forced to live, each of these moments opens an opportunity for prejudice, confrontational hate speech, “moral” pontification or at least the cold shoulder, passive aggression and poor service. And it doesn’t stop there. Passports have few provisions — you can get a temporary passport IF you’re scheduled for GRS surgery, but under new changes, it can no longer be renewed. And if you’re stopped at the U.S. border with an appearance that doesn’t match your gender marker on documentation by a border officer’s standards, you can be held indefinitely by Homeland Security. In my own case, I am unable to obtain a Metis card which would make available to me some valuable education programs, because I need a copy of baptismal certificate and the Catholic church that baptized me flagged the file and refused once they figured out what my name change indicated.
This is only one example of the true cost of delisting GRS coverage. It will mean the difference between taxpayers leaving the Province — or worse, turning to illegal means of obtaining cash — versus developing into comfortable, secure, confident, creative and productive individuals. It will mean an increased cost of mental health beds used to treat transsexuals for depression and anxiety, or holding them after their latest suicide attempt (suicide being an abnormally high statistic among pre-operative transsexuals). It will mean the cost of psychiatrists and social workers needed to monitor the everyday. It will mean the judicial fees of charging, prosecuting and incarcerating people who have turned to theft or prostitution… and perhaps human rights abuses suffered by imprisoning male-to-female transsexuals with men and housing female-to-males in psychiatric hospitals (which is the Federal government’s policy). It will mean the expense of addictions counseling and recovery. It will mean the cost of hospital fees of transsexuals who have been victims of violence from people who have reacted extremely negatively because of who they are… or the cost of a murder trial, if it were to come to that. Even when you put it into terms of dollars saved minus dollars lost / cost, delisting GRS and forcing many transsexuals to live in the in-between almost indefinitely does not make sense.
And of course, sometimes you have to look at it under the sterile microscope of cash, because that is the language that Albertans listen to. The bigger picture is not always obvious, and the Alberta Government is counting on the moral furore to cover the larger agenda. After all, there are some 40 health cuts in development, all tests to see what Albertans are willing to tolerate: will they tolerate cuts to drug benefits if it only affects seniors? Will they tolerate cuts to suicide prevention programs if they only affect Native youth? In the case of GRS, it allows them to test whether medically-necessary procedures are likewise touchable (even without consultation with the medical community and without consultation on how it will affect the patients in question) if they only affect a small and unpopular community. We’ve seen the slashing done to our health and education systems in the 1990s, the non-reparation made to these systems during the boom years, and now the suggestions of more slashes to further drive toward two-tier health under the guise of “recession.” We’ve seen the Government play comparative games, saying, “oh, we need to cut Downs’ Syndrome care so we can pay for cancer patients’ needs,” so that different communities in need can compete with each other for compassion and salvation. The system was not being fixed when it could have been. Instead, it is being dismantled, and the Conservatives saw an opportunity to prey upon Albertans’ inclination to discriminate in order to send up a test balloon.
Unfortunately for them, it hasn’t all gone according to plan. When even the Calgary Sun begins an article on the delisting with “What, there weren’t any crippled puppies around for Ron Liepert to kick?” it becomes very clear very quickly that not all Albertans are buying it. People are contacting their MLAs and expressing their concerns. The outpouring, even if just from people who simply don’t want to see the Province go down the same legal road that it did with Delwin Vriend, was unexpected, and appreciated beyond words. The outcome is still up in the air, with debates still proceeding and the budget still days from being finalized.
This response is because people are starting to see the human cost. They are starting to realize what it means to be in legal limbo, what it means to be lost in the margins, what it means to be at risk of alienation, discrimination or violence because of who we are. Albertans may not understand why we need to make a change in life as drastic as changing gender, but they are seeing that it is clearly something done because of a real and present need, considering all that is risked and often lost in that process.
Now if only the Provincial Government could be enlightened on this fact.