WATCH: In recent years, Alberta has made some changes impacting transgender people, but many feel our healthcare system still has a long way to go. Su-Ling Goh explains.
EDMONTON – Imagine hiding your true identity for years. Then, when you finally find the courage to reach out to a doctor or psychologist, they can’t – or won’t – help you.
That’s the experience of many transgender people, says Dr. Kris Wells of the University of Alberta’s Institute for Sexual Minority Studies and Services.
An understanding family doctor or psychologist can help a patient access hormone therapy, which is essential to many with gender identity dysphoria: conflict between a person’s physical gender and the gender they identify with.
“I have this very masculine male coming in here – physically masculine – but in their head, they’re all feminine,” says registered psychologist Cory Hrushka, describing a typical patient. “They go on estrogen and all of a sudden their depression dissipates; they feel a lot better.
“Things start to make a lot more sense to them, and they become happier.”
Hrushka, who specializes in sex therapy, says research points to a biological cause of gender identity dysphoria. During fetal development, when male and female chromosomes don’t match male and female hormone levels, a baby can be born with the genitals of one sex, but the hormones of the other.
“Most people tend to want to put it at either a boy or a girl, when really it’s almost like a continuum of gender dynamics.”
Hrushka referred Marni Panas to an endocrinologist for hormone therapy in February 2013. A year later, Panas, who was designated male at birth, started living as a woman.
“I just really became me and… I’m just at peace.”
Panas says she’s lucky she found Hrushka. And she feels fortunate that her family doctor of 15 years remained supportive after her transition.
“Rather than the typical ‘man’ appointment where he says, ‘strip down to your socks and underwear and I’ll be back in a second for the examination,’ he gave me a gown.”
Panas works for Alberta Health Services, where she helps improve patient experience. She regularly speaks to health care professionals about treating transgender patients with sensitivity and respect, and the need to use correct pronouns and names, or to ask when it’s not clear.
WATCH: She has become a voice for the transgender community in Edmonton. Marni Panas sits down with Su-Ling Goh to share her story.
Not all transgender people choose to have sex reassignment surgery. But if they do, they must have their diagnosis of gender identity dysphoria approved by one of a very few, specific psychiatrists in Alberta. The wait time to see them is about two years. Then, the wait for surgery – which, in Canada, is only performed in Montreal – is about another two years. Alberta funds 25 sex reassignment surgeries per year.
The system reflects society’s understanding of gender identity dysphoria, says Wells.
“[It] is where sexual orientation was 30, 40 years ago: still largely considered a disease, a pathology, a sickness.”
He would like to see more facilities in Canada like Klinic in Winnipeg, where lesbian, gay, bisexual and transgender people can get healthcare from a multi-disciplinary team, with no risk of discrimination.
Panas says young people, in particular, need supportive healthcare professionals, pointing to statistics that show almost half of transgender people have attempted suicide.
“I can’t imagine being 13, 14, 15 and being rejected by your family and being sometimes kicked out of home and you’re alone and trying to navigate this world in a body you don’t belong in. At my age, it was almost impossible.”