Doctor, advocates bemoan lack of access to gender-affirmation surgery in Sask.

Saskatchewan transgenderadvocates and a local physiciansay people wanting extensive gender-affirmation surgeries in the province are being forced to jump through too many hoops.

That's because the province does not allow Saskatchewan doctors to approve funding forpatientswanting complex gender surgeries.Instead, they have to seek that approval from an out-of-province doctor.

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One local doctor who works with transgenderpatients says the province needs to rethink the way it treats access to these surgeries.

"It's increasingly frustrating because we now have the expertise in Saskatchewan and yet people aren't able to get the approval for surgery funding in Saskatchewan," said Dr.LeanneBettin, a family doctor at Saskatoon's Community Clinic.

Bettinis currently seeing more than 140transgenderpatients.

Getting access

Saskatchewan doctors currently can perform reassignment procedures, like hysterectomiesand mastectomies,and those procedures are funded by provincial health insurance.

But more complex procedures involving genital reassignment, often referred to as "bottom surgery,"are not done in Saskatchewan and must be performed by doctors in other provinces.

In order to get approval for out-of-province surgeries and get them paid for by provincial insurance, transgenderpeople have to get approval from an out-of-province doctor. That can, in turn, lead to long wait lists.

'Make the outside the same as the inside'

Autumn Bourque, a transgender woman and executive director of Regina's Trans Umbrella Foundation, says for people living with gender dysphoria, waiting can be painful and harmful to their mental health.

"It's not just a make-believe thing. This is something that we deal with on a daily basis," she said. "Being able to make the outside the same as the inside is extremely important."

She said Saskatchewan is behind other provinces when it comes to reducing red tape for transgenderpatients.

"We need to get people faster through the system instead of bottlenecking them. We need to bring Saskatchewan in-line with the rest of the provinces in Canada,"Bourque said.

Advocates urge team approach

AmandaGuthrie, from OUT Saskatoon, says because for so manytransgenderpeoplesurgeryis considered a medicallynecessaryprocedure, it'sincumbenton the province to provide care.

Bettin and Bourque agree Saskatchewan needs a new, team approach to help transgenderpeople navigate the health system, whether they want gender-affirmation surgery or not.

Bettinsaid she would be happy to be the one approving people for surgery in Saskatchewan, but she said a team approach with a host of experts would be a better, more comprehensive strategy.

Province reviewing availability of physicians

A provincial spokesperson says fewer than 20 people haveaccessed out-of-province gender reassignment surgeries.

In a statement the spokesperson said"there are a limited number of professionals in the entire country with expertise in this very specific area."

"We will continue to review the availability of professionals in SK to provide these specialized services," the statement reads.