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Head of program’s resignation raises questions about accessibility to transgender care in Alberta

WATCH ABOVE: The gender program in Edmonton is without its leader after Dr. Michael Marshall resigned. As Jill Croteau reports, questions are now being raised about transgender care in Alberta.

Some psychiatrists on the frontlines of transgender care in Alberta fear their patients may soon face increased difficulty accessing certain health-care services.

With many transgender patients on waiting lists, which are in some cases close to three years long, some psychiatrists say the situation has the potential to get even worse for people seeking services like hormone therapy, gender-affirming surgery or even general mental health care.

The gender program in Edmonton is without its leader after Dr. Michael Marshall resigned. He recently spoke exclusively to Global News about his departure.

“It is with regret I had to leave and with a heavy heart I left,” Marshall said. “In order to work for a population that is underserved and vulnerable, there are certain requirements, and without those requirements it was a struggle to do so.”

Those requirements have to do with funding. Marshall’s entire team, with the exception of a part-time nurse, was funded by University of Alberta grants that Marshall himself secured.

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Those grants are expiring in early 2020.

“Securing grants as a means of providing care is not sustainable,” Marshall said.

“Difficulties were sufficient enough that it made continuing on impossible.”

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Mark Snaterse, the executive director for addiction and mental health at Alberta Health Services, issued a statement about the matter to Global News.

“There are no changes to AHS’ financial commitment to the gender program, and we’re committed to ensuring the services are available for clients who need them,” he said.

“Recruitment has begun for new physicians to support the gender program,” Snaterse added. “In the meantime, AHS will ensure there is appropriate coverage to continue providing specialized health and mental health care for transgender, gender non-conforming and non-binary people.”

According to AHS, there are 650 people on the waitlist at the Edmonton clinic.

Dr. Joe Raiche, a Calgary psychiatrist specializing in transgender care, said he is worried about what will happen to those patients.

“With the current gender program in Edmonton, if that will be dissolved or closed, that’s 3,000 to 4,000 patients no longer served, so where do they go?” he said.

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“The other psychiatrist is maxed out and doesn’t have a lot of capacity to absorb that, so do they come to Calgary? We are looking at trickle down that will impact the entire province and unless there’s a different system for transgender Albertans, it will add to that dismal wait time.”

Nick North is one of those transgender patients. He waited years for gender-affirming surgery and is waiting even longer for the revision.

Results post top surgery.
Results post top surgery. Courtesy: Nick North

“I am 68th on the waitlist for my revision right now,” North said. “It wouldn’t be good enough for anyone you love and it’s not good enough for us.”

He said navigating the system was almost impossible.

The \’North Kids\’.
The \’North Kids\’. Courtesy: Nick North
“It was really scary and confusing and complicated to try to figure out,” North said. “I had this truth about myself [and] this is what I was looking for my whole life, but I didn’t know how to go from being stuck here to the place I saw myself in the future.
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“I couldn’t just Google, ‘Oh, I have diabetes, now what do I do?'”

The 34-year-old father has five children. He has tremendous support, but said it’s been a challenge waiting.

“In many ways it’s torture because I knew I was years away from having this thing that felt it was as necessary as air.”

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And North hopes provincial politicians and health-care officials do something to close the gaps.

“You’re telling people, ‘Come out, we will love you and support you, but we actually won’t.'”

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