The Ministry of Health and Long-Term Care announced plans to make changes to Regulation 552 of the existing Health Insurance Act, in a Nov. 6, 2015 news release. The proposed amendments, which are posted for consultation on the provincial government’s official website, would bring Ontario’s current requirements for accessing insured sex-reassignment surgery in alignment with the World Professional Association for Transgender Health (WPATH) standards.
In recent years, the number of Ontario citizens that require access to gender identity support and services has increased. On June 4, 2015, the Affirming Sexual Orientation and Gender Identity Act (ASOGIA) unanimously passed the Ontario legislature. ASOGIA affirms the rights of lesbian, gay, bisexual, transgender, and queer communities within Ontario, and provides some amendments to the 1991 Regulated Health Professions Act, alongside the Health Insurance Act. The changes proposed by the Ministry of Health and Long-Term Care on Nov. 6, 2015 would implement further revision in regards to the processes and efforts involved in the change of sexual orientation or gender identity.
The Ontario Health Insurance Plan (OHIP) covers payments for necessary medical services, prescribed health facility and hospital services, as well as certain therapeutically necessary practitioner services. Presently, sex-reassignment surgery insured by OHIP is a service for patients of the Gender Identity Clinic (GIC) at the Centre for Addiction and Mental Health (CAMH) in Toronto. Individuals seeking OHIP insured sex-reassignment surgery must first enroll at CAMH while also receiving recommendations for the surgery from professionals at the GIC. The proposed amendments to the Health Insurance Act would allow transgender people seeking sex-reassignment surgery to receive recommendations for the surgery outside of the CAMH and the GIC through referral from any qualified healthcare provider across the province.
Referrals will continue to be based on already existing criteria that meet internationally recognized standards for health care. The amendments are expected to come into effect in early 2016.
In the Nov. 16, 2015 news release, Ontario’s Minister of Health and Long-Term Care, Dr. Eric Hoskins, explained that the proposed amendments “[are] one way by which our government is demonstrating its commitment to ensuring high quality and equitable access to care for all Ontarians.”
The expanding access to health care services for transgender people within Ontario is a part of the province’s plan for building an improved Ontario via the Patients First: Action Plan for Health Care agenda. The Patients First agenda seeks to provide quicker access to proper care, the information they need to remain healthy, and a system of healthcare that will be sustainable for future generations.
“Every Ontarian has the right to be who they are,” said Hoskins. “Our health care system should reflect this vision, which is why we are improving access to sex-reassignment surgery.”
Anna Travers of Rainbow Health Ontario—a provincial program part of the Sherbourne Health Centre devised to promote the health of Ontario’s LGBTQ communities—made note of the effects that the proposed changes to the Health Insurance Act will have on transgender people seeking sex-reassignment surgery.
“One of the most vulnerable times for trans people is when they are ready for surgery, but face a prolonged wait,” explained Travers. “This change would reduce wait times by allowing many trans clients to get surgical approvals from their own local primary care teams. We [at Rainbow Health Ontario] look forward to working with the Ministry to operationalize this change.”