Federal Trans Employees Face Challenges in Accessing Gender-Affirming Care

Some federal public service employees in Canada are experiencing significant challenges in accessing gender-affirming care under the newly implemented provisions of the Public Service Health Care Plan (PSHCP). Although this change was anticipated to be a victory for transgender individuals, many workers are finding the process complicated and frustrating.

The updated plan, administered by Canada Life, includes coverage for various treatments such as mental health counseling, hormone replacement therapy, genital surgery, breast augmentation, pectoral implants, and even haircuts. Members of the plan are eligible to receive up to 80 percent coverage for these treatments, with a lifetime maximum of $75,000 for procedures performed in Canada that are not covered by provincial or territorial health plans.

Alexandra Lamaute, a 41-year-old employee from Dieppe, New Brunswick, shared her struggles in navigating the reimbursement process. After undergoing breast augmentation and facial feminization surgery last year, Lamaute was able to receive reimbursement after multiple submissions for further information. However, she is still awaiting nearly $14,000 for a body feminization operation she had in April, causing her to reconsider future surgeries.

Similarly, Amelia Hawk, a 42-year-old colleague residing in Shediac, New Brunswick, has encountered numerous issues with reimbursement. After coming out as transgender last year, Hawk expressed initial excitement over the new plan but quickly faced frustration as her costs were not fully covered. She has had to liquidate assets to afford additional procedures, and despite receiving partial reimbursement for her breast augmentation, she is left responsible for approximately $2,200 for the operating room costs.

Both women have reported distress caused by instances of being misgendered by Canada Life representatives, who used their former names during communication. Canada Life has acknowledged these errors and stated that they are working to rectify their records to accurately reflect members’ names and pronouns.

Members of Canada Life have expressed concerns over the exclusion of operating room and physician consultation fees from the coverage provisions. These costs can be significant and were included in other employer plans administered by Canada Life.

According to Dr. Kate Greenaway, the medical director of the Foria Clinic, waiting for gender-affirming care can lead to worsened mental health outcomes for individuals experiencing gender dysphoria. Access to such care through private insurance has been described as life-saving for many in the transgender community.