'Trans identities are identities, and not a condition,' says advocacy group

An Alberta advocacy group is calling for a change in the way the province provides hormone replacement therapy for transgender individuals, describing the system as one that treats their identity as unhealthy.

The current system has created unequal barriers for patients to gain access to hormone replacement therapy, said Sandra Azocar, the executive director of Friends of Medicare.

"Right now, what we are practising is the psychiatric model that requires the health care professionals to diagnose a psychiatric condition before providing the hormone replacement therapy," said Azocar.

"They're forced to basically receive a pathological diagnosis, then undergo extensive counseling — or even dangerous real-life experience — where they have to live in the preferred gender role."

Unequal access

That's not how everyone gets assigned hormone replacement therapy, she added.

Hormone replacement therapy can be used to treat the symptoms of menopause, without the need for a psychiatric diagnosis. 

"So basically what we're saying is trans-identities are identities and not a pathological condition — and people should be receiving the medication that they need.

"The principles of medicare are based on equal access for all, regardless of the contents of your wallet or if you're a  trans person in this country… And that's why we're concerned about the health disparities and discriminatory practices faced by trans people in Alberta when it comes accessing hormone replacement therapy."

According to Azocar, Alberta's policy — described as a gate-keeping model that can result in wait times of up to two years to begin treatment — runs contrary to the informed consent model practised in places such as Vancouver and Chicago.

Informed consent is a money saver

It would also save the health care system money to move to informed consent.

"Costs for psychiatrist and endocrinologist referrals would be avoided, a win for a government looking to 'bend the cost curve' in health," said Azocar.

"We also know moving to an informed consent model is a manner of harm reduction, as trans patients who do not get medication when they need it may seek out street drugs or engage in self-harm and even commit suicide. We can save lives by removing these barriers."

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