Fiction fact-check: teen transition in Canada?

[Padma]

I'm writing a novel, and one of my characters is a teen from the UK who ends up with her dad in Canada when she's 16, and then she begins her MTF transition over there.

I just want to check: assuming they're living somewhere big and liberal, how feasible is it that 3 years later (at 19) she'd be eligible (or almost so) to get SRS? I'm assuming that with a very supportive dad and docs, she could get on hormones pretty quickly?

Let me know what you think.

[Adam (birkin)]

What province do you plan to have her live in? Some cover SRS, some don't. If she were to live in one that covered SRS then I would say three years would be very realistic. All the doctors I've seen here follow HBS pretty carefully, so if she started hormones, went full-time...3 years would be possible, yeah.

There is the issue of the waiting list also. I'm not sure exactly how long they are, but I imagine if she got her SRS letter right after completing her RLE (so a year on hormones), 2 years is not entirely unreasonable as a wait time.

[Padma]

Thanks. My plan is to have her reappear in the UK 3 years after leaving, having not yet had surgery but being ready to when they came back again (and now she's waiting to sort it out over here instead). Good to know it's a realistic timescale, I felt like it was. I was sending her and her dad to Vancouver - does BC cover SRS? Her dad's rich anyway, so I was just going to have him pay for it .

[Adam (birkin)]

I am fairly sure that BC does. But I think the RLE requirement for that is 2 years as opposed to 1 (I live in Alberta, and they have the 1 year rule here).

But if her dad is rich then I guess it doesn't matter too much, lol.

[Padma]

I'm going to be vague about where she was, it just needs to be realistic for my own OCD purposes .

[aprilrain]

Make her independently wealthy, ya know like someone left her money. then she could have surgery in Thai land whenever.

[Padma]

The money thing's complicated, I'm not going to explain it here, but she's going to end up having surgery in Canada and then coming back to the UK.

Anyway, thanks for the replies, all .

[A]

For Québec at least, it's:

Hormones at 18; 16 maybe with a very insisting person/very nice doctor combination.
One year of RLE. It can go down to 6 months depending on the case, according to my psychiatrist.
Then you can apply for surgery. Dr Brassard's waiting list seems to be relatively short. A few months; around 6, I think.

However, if your character had a late-ish puberty and got blockers when she arrived, she might look okay enough to go full-time before hormones, which would make her eligible to request surgery after just a bit of HRT, in theory.

Oh, but new permanent residents of Canada, in Québec at least, are not eligible to public health insurance for 3 months after they get their status. Also, waiting lists to see the evaluating/referring psychiatrist can be relatively long. Mine was a good 4 months long, if I remember well. Plus, a lot of them (mine at least) will keep you stalled for a year before referring to an endo.

You'll want to include those delays in your calculations.

[grrl1nside]

Hiya;

Yes BC covers SRS. One the complete RLE and they go for coverage under MSP (think NHS) then they will go to Dr. Brassard in Quebec for SRS. Teens can get blockers to assist with slowing down the teen hormones issues providing they have been working with their doctors. Then can go on E, I believe at 18 or is it 19. I'm not sure if they could go on earlier with parental permission. Others might now more about that. Yes, RLE was written up for 2 years but I believe there might have been a shift to 1 year...

Try this URL, for a bit of a flavour. I hope it works for you. There was a small series of 5 minute pieces on the news trying to give a gist of trans issues in BC.



By the way, I've lived in both countries and so has my partner so if you have any questions about Canada-UK things then ask away.

Good luck!

[UCBerkeleyPostop]

Since it is fiction why don't you just have her swallow a magic seed like in "A Florida Enchantment"?

[Jamiep]

Ontario provincial government srs is funded at Center for Addiction and Mental Health (CAMH) in Toronto. You can start transition at 18. Wait list is at least one year. RLE for hormones is 3 months and one year for srs. An immigrant has to live in Canada 3 years before applying for landed immigrant or applying for citizenship and the same as A stated re public health insurance after acquiring status. A person has to be working to get the public health insurance as they pay into the insurance via payroll deductions. You did state the she "ends up with her Dad in Canada when she's 16," if her Dad is already in Canada, he could already have "status," been working and she will be covered under Dad's public health insurance (OHIP Ontario Health Insurance Program) as family.

Did we just muddy the time line of your story with all this complication?

Good luck.

Jamie 

[Padma]

Heh, this is fun! No, she and her dad both land in Canada when she's 16, so I'm going to have to have him pay for it all. I'm therefore more concerned with whether (if money's not the issue) she would be able to get hormones at 16, since her dad stipulated that she do it all with proper medical care, and not self-medicate (once he realised she was prepared to do this however she could).

I should explain that a lot of this is back-story that doesn't actually get mentioned in the book. I'm not writing one of those inform-the-public-disguised-as-fiction stories, it's just that one of the significant characters is trans - but I want to make her story authentic, even though readers don't get to hear all of it. I don't want her saying "this is what happened" if "this" isn't actually possible - there are already a lot of impossible things happening in there, I at least want this to be plausible!

So I want her going through proper medical channels in Canada, but not to be worrying about cost. In the end, she's going to get surgery (privately) in the UK rather than Canada (because they're back here to stay) so she'll have to get her letters from her Canadian health carers to set that up.

It's weird how stuff like this is so important. But it is.

[Jamiep]

I'm therefore more concerned with whether (if money's not the issue) she would be able to get hormones at 16, since her dad stipulated that she do it all with proper medical care, and not self-medicate (once he realised she was prepared to do this however she could).

Okay, so in your story Dad has given parental consent although with all things explained to the girl, she can also proceed on her own by informed consent. Either way the girl could start transition before 16 years of age. There you go.

Hope this helps.

Jamie

[Padma]

Thanks. On we go...

[eli77]

It's best to go to the source. This is the primary gender therapist in Vancouver: http://www.drmeladypreece.com/Home.html. She's very nice. Why don't you send her an email and ask if she'd be willing to help answer a couple questions about how the system works there?

[Padma]

Thanks, I'll do that. I'll probably place them in Vancouver anyway, since I want her to get a chance to see all that amazing NW Coast art . I'm a huge Bill Reid/Beau Dick fan (I'm going to sneak them into the story by the side door, somehow...)

[A]

I want to say some things about immigration.

1. 3 years of living in Canada after becoming a permanent resident is necessary for citizenship, yes. But citizenship is only the right to vote and to obtain a passport. For everything else, permanent residents are the same as citizens.

2. Unless Ontario is especially weird and unfair, I seriously doubt you need to work to have public health care. If that were the case, then the poorest people, those without a jbo, would be required to pay enormous amounts if, say, they have a heart attack. Unless we're talking about the US, it doesn't make sense.

3. When someone is successfully accepted by immigration - say, as a qualified worker - any family they bring with them is accepted as well and becomes a permanent resident at the same time as them.

[Padma]

Fortunately, my character already has dual nationality (Irish and Canadian) because her dad is Canadian (her mum was Irish).

I find this process in writing fascinating, where I have to know all there is to know about a character's background, even if 90% of their story never makes it to the reader. I like to refer to this stuff in passing, in exchanges between characters for example, so the reader can figure some of it out for themselves by osmosis. I don't like stories that try to explain everything out loud.

By the way, my character closely resembles Watts from Some Kind of Wonderful - wow .

[Jamiep]

@A,

Your point 2. This is how OHIP or now OHP is funded.

http://www.bpmmagazine.com/02_archives/2006/february/premium_tax.html

Jamie

[A]

That was too long, honestly, for me to read in my current state of poor concentration and motivation. So you're positive that Ontario only offers health care to people who have a job (and minors, I hope >_>)? I'm speechless. No, actually, I'll speak. What the heck do they think they are, the US?! Geez. I didn't know there was such a rotten thing in Canada, much less in the relatively liberal Ontario. I might have expected that of Alberta, but Ontario... >.<"