NSRAP: Call to Action: Amend MSI Physician's Manual

On October 1, 2012, as part of our ongoing efforts to push for SRS, the NSRAP Health Committee chair Lucas Thorne-Humphrey wrote to the Honourable David Wilson, Minister of Health and Wellness, on behalf of NSRAP.

The letter detailed many of our concerns relating to trans* health. It discussed the health disparities facing trans* Nova Scotians. The letter outlined the support from important stakeholders such as the NS Human Rights Commission and Doctors Nova Scotia to removing article 4.8 from the MSI Physician’s Manual (which prevents surgeries related to trans* health). It also described our previous meetings and stalled communications with Minister Wilson’s predecessor (Maureen MacDonald) and requested support for expunging article 4.8.

We did not receive a reply until 8 months later on Monday, June 3. The response from Minister Wilson is as follows...

“Lucas Thorne-Humphrey,
Nova Scotia Rainbow Action Project

Dear Mr. Thorne-Humphrey:

Thank you for your letter e-mailed on October 1, 2012, requesting support from the Department of Health and Wellness to remove clause #4.8 from the MSI Physician’s Manual Preamble, which prohibits the approval of billing codes for surgical procedures relating to transgender health in Nova Scotia.
I apologize for the delay in my response. I wanted to ensure that serious consideration was given to your request. Departmental staff was directed to do a careful policy review, including extensive research and consultation with other provinces regarding procedures that are currently insured and the short and long-term health outcomes.
I regret to inform you that due to the lack of high quality scientific evidence to support the efficacy of the long-term outcomes of these procedures and lack of a strong economic argument for their benefit, the department is not in a position to grant your request at this time.
I appreciate your patience and understanding while we have deliberated on this issue.

Original signed by

David. A Wilson

c. Kevin McNamara, Deputy Minister, Department of Health and Wellness”

We are disappointed that even after such an inexplicable delay, the Minister was not able to see the clear evidence in support of this request. However, we are renewed with passion to push for progress in improving health care for trans* Nova Scotians.

The Department of Health & Wellness is fully aware of the poor state of trans* health care in our province and also of the significant progress made in other provinces in Canada. NSRAP, as well as the many departments of health in other provinces in Canada whom do provide funding for surgeries related to trans* health, clearly disagree with our Ministers interpretation of the “evidence.”

This response has also failed to address language used in the Physician’s Manual and the institutionalized transphobia that would see discrimination against a group of this nature to continue to be written directly into policy.

Minister Wilson we implore you to do what is right for our trans* citizens and remove article 4.8 from the Physician’s Manual to allow consideration of public funding for some surgeries and medically necessary procedures related to trans* health.

We ask community members and allies to join in our campaign. You can do so by:

  • Writing to the minister using our campaign letter (at http://nsrap.ca/srsletter). Make sure to add personal details as to why this issue is so important to you.
  • Signing a copy of our petition to ask for the removal of section 4.8 from the MSI Physician’s Manual. Copies of the petition will be circulated at Pride events across the province throughout the summer.
  • Downloading a copy of our petition and collecting signatures in your community.

Find out more about our campaign, visithttp://nsrap.ca/transrights.
Together, we can ensure equality for all Nova Scotians.

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