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Editorial: Being a transgender activist in Nova Scotia is tiring

Being visibly transgender is tiring. You must smile and say “have a nice day” when someone misgenders you, because you feel like an asshole correcting someone saying “thank you” just because they added an unnecessary “sir” to the end. It’s tiring when my own process of applying for an orchiectomy falls on the back burner because I’m too busy and too tired from advocating for everyone's ability to do so. Being a transgender activist in Nova Scotia is tiring. The government needs to pick up the slack.

Gender Affirming Care (GAC) ranges from being able change your name and gender marker on documents, to hormone therapy, surgeries, and simply being treated with respect by doctors.

Gender Affirming Care Nova Scotia (GACNS) is a policy consultation group advocating in Nova Scotia and the other Atlantic provinces for better gender-affirming care. They have been active since 2021 and published their policy statement to the NS Department of Health in 2022. They are a group ahead of their time, fighting for the rights of gender-diverse people in Nova Scotia. Nova Scotia is the province with the highest percentage of queer people in Canada, yet one of furthest behind in providing them care.

The degree with which gender diverse Nova Scotians must become familiar with their provincial health and political systems to find a doctor that will respect them is appalling.

prideHealth logoprideHealth (that's how they write it) is part of the Nova Scotia Department of Health and Wellness. It serves the entire province when it was designed to serve just the Halifax central area. prideHealth serves as patient triage, community educators, and queer advocates to other branches of government. It has only two full-time employees. The province’s webpage on gender affirming care provides minimal explanation of the processes involved and includes no directory of how someone can access this care.

The level with which gender diverse Nova Scotians must become familiar with their provincial health and political systems to find a doctor that will respect them is appalling.

GACNS in the 2022 Halifax Pride Parade
Halifax Pride Parade 2022

In July of 2022, I met Riley, Olivia, and Felix of (GACNS) when volunteering with them and walking with their float in that year's Pride Parade. Since then, GACNS has lost half their core volunteer capacity. They currently have two volunteers and are on a one-month hiatus due to burnout.

And, since then, I’ve befriended Felix, one of the volunteers who had to step back. He is amazing and genuinely cares about his community, but he works a full-time job and faces transphobia in his daily life. Felix is an avid power lifter. He inspires me to keep going to the gym and be proud of my body. Yet, a lack of understanding and training for trans bodies by gym management and an increasing amount of hate, transphobia, and neo-Nazi rhetoric by a small, but loud group of patrons has made him feel unsafe at his local powerlifting gym.

On October 11th, 2022, the Nova Scotia Standing Committee on Health met in the legislature building to discuss the topic of gender-affirming care. I viewed this meeting from the gallery along with about 20 community members.

Riley spoke on behalf of GACNS as a witness. During the first fifteen minutes of the meeting it became clear none of the MLAs were aware of any of the things I’ve mentioned so far. Representatives from The Department of Health and Wellness and The Office of Addictions and Mental Health were also witnesses. When pressed on a timeline for improvements to GAC they could give none. The meeting ended with Riley expressing how overworked and tired community activists are. To the officials present they stated that “ally is a verb.”

After the meeting, I emailed my local MLA, Brendan Maguire who was one of the liberal representatives present at the health committee meeting. I expressed my disappointment in the elected officials present and implored him to educate himself and do better. On February 13th, 2023, The Aids Coalition of Nova Scotia (ACNS) published a letter to Premier Houston titled “Responding to Gender, Sexual and Reproductive Health in Nova Scotia”.

The letter outlines improvements ACNS wants Nova Scotia to make in those areas. When I saw this letter, I forwarded it to MLA Maguire asking him to support it and expressed my willingness to discuss the topic with him.

To my surprise, his secretary responded and booked us a meeting. The day of our meeting ended up being a snow day, so I spent my morning reading through GACNS’ and ACNS’ letters marking important sections and taking notes. I was nervous when MLA Maguire called. I told him how surprised and grateful I was for him meeting with me, then got right to the point: I asked him if since October 11th, The Department of Health and Wellness have given him any updates on their plans to improve GAC.

They have not given him any updates. I asked him if since the meeting, he has read GACNS’ policy or ACNS’ letter. He admitted he hadn’t. I read through the important points of ACNS’ letter for him. In this process his unfamiliarity with the topic became apparent. I had to explain to him what “U=U” means, what “PrEP” is, and what HIV self-tests are. To his credit, he responded positively to these improvements in HIV care.

His lack of awareness didn’t surprise me. I expressed to him that I don’t think this information is as well-known as it should be within the queer community. This could be attributed to how ACNS has not had its funding increased in years and has limited promotional and educational abilities because of this.

In response, MLA Maguire expressed his interest to work with ACNS going forward. He told me that The Nova Scotia Department of Health and Wellness is having its budget meeting on March 23rd. I asked him to request increased funding for prideHealth and ACNS at the meeting. He ended the meeting with an invitation to correspond with me on the topic going forward.

Budget 2023-2024 was released March 23rd. In it, $1.9 Million is allocated for “for initiatives to help improve equity in our healthcare system”. One of the three initiatives listed in the section is “Expanding prideHealth across the province”. $1.7 million is allocated to “meet increased demand for gender affirming surgeries”. 

Making an estimation using salaries in the low range for these positions, the positions GACNS recommends to be created at prideHealth could be funded. The investment in “gender affirming surgeries” hopefully will make top surgery available in Nova Scotia again and decrease the need for people to travel out of province for GAC. 

The $17.7 million allocated for mental health initiatives hopefully makes the mental care usually required and associated with the process of GAC more accessible. 

These improvements are being well received by the Trans community but some, myself included, believe this is still just the beginning of offering care representative of our population and needs.