Prison system grapples with transgendered inmates

KATHLEEN HARRIS, QMI Agency

, Last Updated: 6:23 PM ET

OTTAWA — The Conservative government has ordered an abrupt halt to funding for federal inmates getting gender reassignment surgery.

Documents obtained by QMI Agency under the Access to Information Act suggest at least four offenders have sought the operation since 2008 - a controversial procedure that is not covered for many Canadians outside prison.

“The courts have ruled that CSC must provide essential medical services to inmates. However, we do not believe that sex change surgery is an essential medical service or that Canadian taxpayers should pay for sex change surgery for criminals," Public Safety Minister Vic Toews told QMI Agency.

“That’s why CSC has been directed not fund such surgeries in the future,” he said. The directive was made to the Correctional Service of Canada (CSC) on Friday.

The ATIP documents obtained by QMI Agency are heavily censored, and CSC would not confirm how many surgeries have been granted or publicly paid for, citing the Privacy Act.

One background document says there are usually 10-16 transgendered inmates in custody at any time, with half to three-quarters taking hormones and about one or two requesting gender reassignment surgery each year.

Before the minister's directive, CSC followed a 2001 Canadian Human Rights Tribunal decision and a 2003 federal court ruling that require the consideration of sex reassignment surgery as an "essential medical treatment."

"CSC is legislatively mandated to provide every inmate with essential health care and reasonable access to non-essential mental health care that will contribute to the inmate’s rehabilitation and successful reintegration into the community," said CSC spokeswoman Sara Parkes.

The cost of surgery and associated procedures varies depending on the individual patient's needs and based on consultation with recognized external experts, Parkes said.

According to CSC health services policy, pre-operative male-to-female offenders with gender identity disorder (GID) are held in men's institutions, while pre-op female-to-male offenders are held in women's institutions. CSC has received requests for both types of surgery.

Offenders diagnosed with gender identity disorder are accommodated with due regard for vulnerabilities with respect to their needs, including safety and privacy, Parkes said. The surgery is only considered when the offender has satisfied internationally recognized criteria for at least one year before incarceration and must be recommended by a recognized gender identity specialist.

Mickey Wilson, a Lethbridge, Alta., landscaper who underwent gender reassignment surgery 15 years ago, said provinces such as Alberta have "delisted" the surgery to save money or for political reasons.

Withdrawing funding could lead to increased mental health problems, despair and even suicide, he said.

"Inmates are also people, and inmates are not always guilty of heinous crimes," he said. "They may have been caught doing something against the law - it doesn't strip their basic rights. And in our country that includes health care."

Wilson tried to commit suicide several times - the first time in elementary school while growing up in southern Ontario — and lived miserably on social assistance before his surgery. His life "blossomed" after the operation, and now he is a successful, productive member of his community.

Wilson does not know any trans offenders, but said it must be intimidating and frightening to be confined in such a closed setting divided by sex.

Kevin Gaudet, federal director of the Canadian Taxpayers' Federation, doesn't support public dollars going to gender reassignment surgery for law-abiding citizens, let alone criminals.

"Health-care spending is rationed, so the question is, on what ought those precious tax dollars be spent - and many provincial governments have decided that gender reassignment surgery doesn't fall on the list of the important allocation of precious taxpayer dollars. It's an easy decision to understand - pay for it yourself," he said. "So it ought not to be allowed just because these people happen to be in a federal jail."

A 2008 letter from then-public safety minister Stockwell Day to a Canadian constituent said the provision of sex reassignment surgery would occur only in "highly exceptional circumstances" and that non-essential service, including ancilliary surgeries such as breast implants, are not covered by CSC.

Trevor Corneil, a B.C. physician with expertise in gender identity disorder, says there is much misunderstanding around GID, with many Canadians viewing sex reassignment surgery as expensive and "cosmetic."

"The public is very sensitive to their health care dollars, and there's a lot of misunderstanding about whether it's a choice or not, "he said. "It is not a choice. Your gender is not something you choose, it's something you're born with. And the actual anatomical sense may differ from your gender."

Corneil said in the long run, it is cost-effective to support people through the procedure because it makes them more productive, happy and healthy citizens. And that should apply for every Canadian.

"It's not about whether you're a criminal or not - it's about what your health-care needs are," he said.

kathleen.harris@sunmedia.ca


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