Transgender patients on their own after final appointments at Clinic 554

After five years of treatment at Clinic 554, transgender patient Nat Armstrong spent her last appointment Monday, taking notes on how to manage alone.

She said the phone call with Dr. Adrian Edgar lasted the better part of an hour.

Armstrong was given a year's prescription for her medication and got some last advice on how to ask for blood tests.

"I was told what lab tests to ask for, where my [hormone] levels should be and what to do, to adjust one way or another," she said.

Then she was advised to register with the government's orphaned patient waitlist, where 37,015 New Brunswickers are already virtually standing in line, wanting a family doctor.

Ellie Lukács is in the same boat.  

She had her last appointment with Dr. Edgar in late August, as the clinic was winding down its operations.

"[Dr. Edgar] said this will be the last time I see you, so here's all the refills I can give you for a year," said Lukács.

"He said, 'There's no one I can point you towards.'"  

"He referred me to [the government's registry] Patient Connect."

Lukács said she's been on hormone therapy for a few years, including estrogen and a testosterone blocker.

She said doesn't anticipate problems, but, at some point, she'll need lab work. 
 
"I don't have to do the testing like I used to before — every three to four months — but once or twice a year, I should be followed up with," she said.

Lukács said she knows what it's like to go years without a doctor and she's frustrated that it has happened again. 

"I'm absolutely discouraged," she said. 

Still not easy to ask for transgender care

Joselyn O'Connor, an advocate for transgender health, said not all physicians are comfortable providing it.

And she said patients may have a hard time asking.

"There are a lot of cases where ... health-care providers are unaware of how to be considerate or gentle with the situation," said O'Connor.

"They'll often try to defer to somebody else with experience or they'll just say, 'I don't' know what to do. I can't do anything about it.'

"We also hear, 'I'm going to look into this,'" said O'Connor. "Then taking years and years before they do."

O'Connor is the former chair of UBU Atlantic, a support group that keeps a private list of health-care professionals whom they consider to be open and educated about transgender health.

"We've had an issue in the past where some of these names got out and these people received some harassment," she said.

"So to prevent that, we just give that information to people who need that information."

However, she said, those people have long waiting lists, too, and there's no way around those.