Advocates push for gender surgery funding within Alberta amid years-long backlog in Montreal

For most transgender Albertans, genital surgery procedures are usually done at a private clinic in Montreal and paid for by the Alberta government.

But for those not willing to hop on the four-year waiting list or who might prefer a different procedure method to the one offered at the Centre Métropolitain de Chirurgie, their options are limited and expensive.

Albertans getting surgery within the province or internationally have to pay out of pocket for costs upwards of $20,000. Advocates say in-province surgery should be funded by the provincial government to increase accessibility.

Donna Battaglia, 54, was overdue for a procedure to remove her bladder and scrotum, which were damaged by cancer treatments.

During a consultation, she mentioned to her surgeon that she was desperate for bottom surgery. 

Battaglia had already transitioned and had breast surgery but was left waiting for an operating date in Montreal. She also had been given the green light by two psychologists and received funding from Alberta's Gender Reassignment Surgery Program.

Although Alberta does not fund in-province bottom surgery or have specialized clinics for the procedure, there are qualified and trained doctors in the province who can perform it. 

Battaglia's surgeon was one of them. He agreed to perform genital surgery along with her cancer correction surgery. 

"Here we have the people and the skill and the talent to do it," Battaglia said. 

The surgeon who performed Battaglia's genital surgery declined an interview.

Cathy Flood is a urogynecologist who specializes in bottom surgery recovery and most often treats patients who have had operations in Montreal.

She said having specialized clinics funded in Alberta would change the experience entirely.

"I feel like we could get a program going. We have the interest, we have the surgeons," Flood said. "But there has not been a push to get it done here from what I can see."

Provincial response

CBC News asked Alberta Health why the province does not have widespread genital surgery or dedicated clinics. Spokesperson Scott Johnston said genital surgery is "a specialized field and there are very few surgeons in Canada who perform this procedure."

Flood said the years-long wait time for people to get their surgeries in Montreal can take an immeasurable toll on their mental health, something Battaglia can attest to.

"For myself and most of the other people I know this is something that we needed to do or we were going to be dead," she said. "I came close to suicide twice over it."

So far, clinics that specialize in gender-affirming genital surgery are only in Montreal, Vancouver, and Toronto. Montreal is the only location that accepts out-of-province patients.

Flood said her Edmonton-based clinic has seen over 300 patients who have had surgery in Montreal since 2018. She said those could have been surgeries done in the province.

But she also said the Centre Métropolitain de Chirurgie does not offer training to interested surgeons. That means if a doctor wants to get trained in genital surgery, they have to travel to select places overseas.

Flood said trained practitioners in Alberta usually do not solely practice gender-affirming surgeries but the demand to do so is overwhelming.

"I think a lot of it is that there's just not the initiative, and we would be ready to start training tomorrow if we got the OK."

Because of the lengthy process, Battaglia worries many transgender people will suffer a poor quality of life.

"Before the surgery my entire body and my entire being felt like I was made of barbed wire and I was trying not to get stabbed, hurt, and poked by it all the time," she said.

Since her surgery, Battaglia says she finally feels complete.

"I was blown away, I never thought I'd be able to feel so complete in my body."