Coverage of gender-confirming procedures should be revisited, says patient

One of the first New Brunswickers to undergo government-funded gender-confirming surgery in the province suggests the coverage for various procedures is skewed in favour of men, and says that should be changed.

"As I sort of read a bit more about more of what's covered, it became obvious there were issues," said Olivier Hbert, a transgender man and one of the first patients,about his thoughts leading up to his September surgery.

The surgery involved the removal of hisbreasts.

• New Brunswick will now cover gender-confirming surgeries
• Transgender athletes thwarted in pursuit of university sports
• 3 years into transition, Saint John woman still conquering challenges

"There's a skew in favour oftransmen. People like me."

The New Brunswick government announced it would fund the surgeries in June.

Hbert saidhe's pleased "top surgery"is available within his home province but also saidthere's room for improvement.

Nervous about being a 'guinea pig'

The fourth-year St. Thomas University student originally planned to spend $10,000 to travel to Ontario and see a doctor who specializes in transitional surgeries.

While he did save money, he was nervous that remaining in New Brunswick meant potentially beinga doctor's first patient.

He said communication between him and the medical staff could have been better. He was given pamphlets for procedures that, while similar to his, didn't specifically address what he'd undergo.

He was also giveninformation in large amounts at a time,making it hard to process.

"I got a lot more information about what was going to happen to me that I was actually clear on and actually retained from my own research."

In the end, Hbert decided he was fine with being a "guinea pig" and was prepared if the results weren't as pristine as those from a more experienced doctor.

"Whatever," he said. "I'll be like a Cards Against Humanity card. 'An asymmetrical boob job.'"

What's covered isn't enough

A major point of contention for the 21-year-old is what's covered.

He learned thatliposuction, a $3,000 procedure, to remove some of the extra fat left over on the breasts for men and laser-hair removal for transitioning women aren't covered because they're considered cosmetic.

"If you want to get rid of a beard, you have to get each hair removed," said Hbert. "If you take estrogen, that hair that you've already grown is not going away."

As a man, he felt the coverage for women isn't as strong as it is for men.

While "bottom" surgeries are available for women, the student said laser-hair removal, breast augmentations and voice training aren't covered, even though they'reessential for these patients.

"Any surgery I would want to get as a trans guy, I pretty much had access to. If I wanted phalloplasty, which would be to have a penis made, I could get that done."

"Women don't have access to these deemed 'cosmetic' surgeries. It's sort of like being told, 'you can only be a woman to this degree.'"

Danger for transgender women

While Hbertsaid heunderstands why the government classifies those surgeries as purely cosmetic for others, he said the needs of transgender people are different.

"The reality is a trans woman who wants to have their hair removed but can't is at a far higher rate to be beat up by men who are like, 'you're a sissy' or 'you're a tranny.'"

Olivier Hbert documented his change in voice while taking hormones

7 years ago

Duration 1:29

Olivier Hbert is a transgender man and one of the first patients in the province to undergo gender-confirming surgery inside the province.

The Department of Health said it was unable to reply to CBC's request for an interview by deadline Wednesday evening.

Hbert said that while the coverage isn't perfect, he's happy he took the first step towards being a pioneer in the province.

"It's exciting,"hesaid. "It's cool to be one of the first people having access to this coverage and going through the process and realizing, 'Yes, it works.As rudimentary as this setup is, it's working.'"