Money and Sex (or Gender... or... whatever...)

[bcholmes]

First up, w00t to California!

Second, this announcement has been making the rounds on my friends list: OHIP (the Ontario Health Insurance Plan) will be re-listing sex reassignment surgery (SRS). While that sounds like a good thing, there are some seriously icky footnotes. First, they only expect to cover between 8-10 surgeries a year. That's not a big number. Seriously, I know about twice that many trans people who probably want OHIP-covered SRS, and I'm sure that I don't know even a sizable fraction of the total trans folk in that category.

Second, the Centre for Addiction and Mental Health (CAMH) is gatekeeping the process. CAMH is just the new name for the (Jurassic) Clarke Institute, which is not well-respected by many trans people I've met. Of all the people I've known who've had dealings with the Clarke, I know exactly one who didn't hurl chunks at their programme.

For my part, I had SRS in the period when it was delisted. OHIP coverage for SRS was ended by a former "Progressive" Conservative government under Premier... (wait for it)... Mike Harris. The delisting was mostly the result of noise that came from two Tory MPPs, Frank Sheehan and Marcel Beaubien. Marcel Beaubien applied his political skills toward lofty goals like pressuring the provincial government to do something about the uppity natives occupying Ipperwash National Park

I've had three trans surgeries. I had an orchidectomy in around 1998/1999 (more often called an orchiectomy in the States, I'm given to understand). It was quite a hassle because Ontario had just delisted SRS and the surgeons I spoke to were very concerned about political fallout if they tried to perform the orch in a public hospital. I ended up spending (I think) $1500 CDN -- about half of that cost went to rent an operating theatre in a private plastic surgery clinic.

I had vaginoplasty in November, 2002. I had vaginoplasty in Portland, Oregon and my surgeon was Dr. Toby Meltzer. At the time I booked my surgery (which was about a year and a half earlier), I had seen a number of surgeons present at trans conferences, and one of the big factors, for me, was his technique for constructing the clitoris, which just... hmmm... sounded the most sensible to me.

Vaginoplasty cost me (if memory serves) USD $15,000. Kate Bornstein once remarked that her vagina cost more than her car, and while I can't quite make the same claim (the Prius doesn't come cheap), this is easily the largest expense I've ever had other than the Prius and the various places I've lived. And at the time I paid for SRS, the exchange rate from Canadian to US dollars was abysmally low, so really, the expense was half-again that amount.

Lastly, at the beginning of April, 2003, I had my third surgery, labiaplasty. I'm pretty vague about the cost for labiaplasty but somewhere in the neighbourhood of USD $6,000 is ringing a bell. Dr. Meltzer performed my labiaplasty, but by that month, he'd just set up his new clinic in Scotsdale, Arizona.

I haven't factored in costs for hotels, flights and other transportation, required therapy sessions, hormones or other drugs (I still have leftover Vicodin from my vaginoplasty). (Of them all, hormones have been the least of a burden, as my insurance plan covers them). And electrolysis. I have had more fookin' electrolysis than I care to say. Name a body part and chances are that I've had electrolysis there.

I'm fortunate in that I didn't need breast augmentation, nor did I partake of facial feminization surgery (FFS). And no vocal surgery, hair treatments or shaving of the adam's apple (my adam's apple has never really been visible). And no "revisions" to fix up anything not quite right the first time around.

But those aren't trivial expenses. Now, I've got a good job, and I could afford to pay those expenses. But I have reason to believe that I'm not a representative trans person in that regard. I know too many trans folk on welfare or disability. Or just chronically underemployed.

Now, despite how much I dislike the idea of two-tiered health care, I'm grateful for the fact that I could sidestep the official OHIP process, and hire the surgeon of my choosing. The records of the surgeons in Canada, the US and southeast Asia are fairly well-documented in trans communities. CAMH, if they follow their previous practice, will send the 8-10 transfolk whom they approve to publicly-funded surgeons in England rather than, say, send them to a private clinic in Montreal. I think that's a little dumb, personally.

I was at a Queer Open Mic night in San Francisco the other night, and there was one performer who spoke about body issues and about the pressure for women to remove hair. And at one point she said something like, "I'm sure I don't have to convince this crowd about the huge problems of plastic surgery..." And I know what she means. And yet... I sum up the money I've spent on changing my body. I know I can just say, look, this is different. But there are fuzzy edges. (Am I insufficiently feminist because I've had the hair on my legs permanently removed?)

It occurs to me that I don't tend to talk about this sort of thing very much. In many trans circles, it's all one can do to steer a conversation away from hormones and surgery. And in non-trans circles, well, it scares the horses.

Comments

[sonjaaa.livejournal.com]

Wow, I just assumed they'd use a Canadian surgeon like Brassard. Who's in the UK??