British
Colombia, Canada — A transsexual B.C. man is
pleased that the B.C. Human Rights Tribunal has found the
provincial government discriminated against him by
refusing to pay the cost of completing his
gender-reassignment surgery.
Tribunal member Judy
Parrack ordered the health services ministry to pay
almost $30,000 for previous operations done in
California, plus the cost of completing the surgery and
$6,500 compensation for injury to the dignity of the
complainant, Louis Waters.
Waters, 44, is a
female-to-male transsexual who lives outside the
Vancouver area with his wife and two adopted children. He
is self-employed and has lived as a man since the early
1980s.
He estimates it will cost
$93,028 Cdn -- in addition to the $30,000 the government
has already been ordered to pay -- to complete his
gender-reassignment surgery in California. Female-to-male
surgery is not performed in B.C.
The cost to be paid by
government for the final stage of surgery is to be
negotiated, Waters' Vancouver lawyer Allan McDonell said
Thursday.
"He's very pleased," the
lawyer said of his client, who declined an interview
request. "He's actually spent more than $100,000 Canadian
so far." That includes flights to and from California,
drugs, operations and post-operative care in
California.
McDonell said his client
wanted to remain anonymous, but Waters filed his
complaint to get proper compensation and hoped to set a
precedent for other people seeking to have female-to-male
surgery.
"He didn't want anyone
else to go through what he's gone through," McDonell
said.
Waters and his wife had
to borrow heavily to pay for the first- and second-stage
operations, he added. Waters wasn't able to complete the
surgery because he couldn't afford it.
He testified at the
tribunal that once he started the process of gender
reassignment, he realized there was "no going back" but
never thought he would be left without a
penis.
After participating in
the required gender identity clinic program at the Clarke
Institute of Psychiatry in Toronto, he was approved for
gender-reassignment surgery, which involves a number of
steps, including phalloplasty -- the creation of a penis
by plastic surgery.
He went to California for
the first and second stages of surgery, but the B.C.
health ministry would only pay the physicians' fees at
the rate as if the surgery had been performed in B.C.,
which was substantially less than the amount Waters
paid.
Waters filed his
complaint to the tribunal in 1997, alleging that the B.C.
Medical Services Plan discriminated against him and
denied him a service or facility customarily available to
the public because of his sex and sexual orientation,
which contravened Section 8 of the Human Rights
Code.
The tribunal found there
was discrimination and ordered the health ministry to pay
Waters $29,749.21 Cdn for medical services already
received, $644 Cdn a day for the days Waters was at the
Recovery Inn in California, $1,000 for legal expenses
incurred as a result of the contravention and $6,500 for
compensation for injury to Waters' dignity.
The government is
reviewing the decision before deciding whether to appeal,
said Tara Wilson, a public affairs officer with the
ministry of health services.
The tribunal was told
that B.C. provides coverage for male-to-female
reassignment surgery, but considers phalloplasty to be
experimental surgery and does not provide coverage for
female-to-male surgery not performed in B.C.
This is not the case in
Alberta, which provides coverage for phalloplasty
($24,740), penile implant ($8,095) and testicular
implants ($2,845).
Most provinces across
Canada do not provide coverage for phalloplasty, although
Quebec provides coverage in exceptional circumstances
approved by the minister of health, and Newfoundland
provides coverage on an individual approval basis if a
candidate is assessed and recommended by the Clarke
Institute.
The tribunal heard
evidence that Waters had a difficult childhood and
adolescence, including depression and two suicide
attempts, one after he moved to B.C. in his late
teens.
Since he reported being
uncomfortable with his body, doctors recommended
reduction mammoplasty, which he had in Victoria in 1981,
paid for by MSP.
But the surgery didn't
help, Waters testified. He felt he was a man, so he began
living, dressing and working as a man.
He changed his name in
July 1985. In March 1988, he was issued a new birth
certificate reflecting his sex as male. On June 18 of
that year, he married.
When Waters was told that
no surgeons were doing phalloplasty in B.C., he began
looking in other provinces. Unable to find anyone doing
the surgery in Canada, he contacted a California surgeon,
who provided a quote of $47,000 US for the required
surgeries, provided were no complications.
He submitted the quote to
MSP, which said in a March 1, 1995 letter that it would
pay an estimated $2,998.
After consulting the
California surgeon in July 1995, Waters received further,
higher estimates, due to complications: $29,200 US for
the first stage of phalloplasty and $37,650 US for the
second stage.
In September 1995, Waters
had the first-stage surgery and testicular implants in
California.
When Waters returned to
Canada, his lawyer wrote to MSP seeking reimbursement of
$41,563 Cdn in medical expenses, which was only a portion
of what Waters had paid.
On Feb. 12, 1997, MSP
said it would only pay for physician services up to B.C.
rates. Waters said the restriction to medical services
being paid at B.C. rates did not apply to him because
phalloplasty was not being done in B.C., so he filed his
human rights complaint.
The tribunal decision
is available on the Internet Web site: www.bchrt.bc.ca
