Vancouver trans woman opens up on barriers to surgery access

A Vancouver trans woman is sharing her story about her transition journey, in the hopes of improving access for others wanting to go through similar procedures.

Andy Warner, who alternates between she/her and they/them pronouns depending on the situation, began hormone treatment in the summer of 2020. A one-year process is required, Warner says, before undergoing what’s known as lower/bottom surgery.

The following summer, they started to explore surgical options, with the goal of having surgery at a relatively new clinic in Vancouver. Warner began trying to get on waitlists in Vancouver and Montreal at that time.

And she says it was an ordeal.

“For me, lower surgery was something that was always really important to me,” Warner told CityNews in an interview. “In fact, part of the reason I didn’t come out for so long was because I knew you had to fly to Montreal, and you had to come home and pay for all of this. When I found out they were opening up a clinic in Vancouver for lower surgery, I thought, well maybe now’s the time, then the pandemic hit.”

And while the emergence of a Vancouver surgery option was appealing, the process was long and often not straightforward, says Warner. Following consultations with a surgeon in September 2021, she says it wasn’t clear whether she was actually on a waitlist.

When they checked on their status for surgery in Vancouver in April of this year, it was suggested it could still be another two years of waiting.

“There’s no real education system for trans people to seek their own care,” Warner said. “There definitely wasn’t a clear process for what was necessary to access lower surgery, and what was optional.”

Due to that long wait, Warner then finalized her application for surgery in Montreal. She said a lack of clarity around hair removal for surgery in Vancouver also factored into the decision.

“Montreal does not require pre-operative hair removal, because they do that….within the surgery,” Warner said. “But in Vancouver, it’s required that you get electrolysis for — sometimes it can be years.”

Submitted photo

Warner said even that hair removal instruction for Vancouver changed. Initially, she was told in September 2021 that hair removal was required, but then later this year was told it was down to patient choice.

Now Warner will be going ahead with surgery in Montreal next month, but wants people to know there is room for improvement within the system in B.C.

While the province of B.C. will cover the cost of the surgery, Warner will have to pay for her flights to and from Montreal, post-operative care, plus accommodation and food for three months.

As a result, their brother has started a GoFundMe to help raise those funds.

“I have the privilege to be able to talk about this, though it is extremely sensitive and personal,” Warner said. “I have an immediate blood family and chosen family that supports me, and I have a workplace that’s not threatening to fire me over this. And that is more than so many trans people have. Often, when you hear of stories like this, it’s white, more privileged trans people that are able to speak about their experiences, only because we are given more breaks from society to be able to talk about these really difficult issues.

“Most trans people are struggling to survive, and yet everyone thinks — at least everyone that is cisgender seems to think — we are on top of the world and we all have as much money as Caitlyn Jenner, but she’s really the worst example to look at for trans people.”

After years of waiting for this moment, Warner is calling on the B.C. government to do more to advance timely and comprehensive access to transition surgery.

“I would love for everyone to take a look at what the Yukon recently passed in terms of trans care coverage,” Warner said. “They recently rolled out pretty big infrastructure for trans people to get a number of procedures covered, to give more choice, really, to trans people. It should be us to decide what’s best for our health. Whether that’s deciding between the pill, the patch or the injectable form of your hormones, or whether that’s deciding lower surgery is more important for you — but for some women, it’s facial hair removal, and that’s not covered by B.C., and I don’t think it’s covered by many provinces.

“But for many trans women who are transitioning through HRT (hormone replacement therapy) later in life, that’s one of the biggest things that they would like to see covered. But it’s something that I don’t necessarily need for myself. My point is that trans people have different needs, because we have different life experiences.

“When the government prescribes a specific process for each of us to go through, it doesn’t empower us. If they want to be progressive and if they want to say ‘we are behind trans people, we support you, we love you,’ they should actually talk the talk, and walk the walk.”

CityNews has reached out to the B.C. health ministry and the Provincial Health Services Authority for comment on this story, and to clarify how long the waitlist for the Vancouver clinic is at this time.

In a statement from the Ministry of Health they say around 380 people are on the consult wait list, and the average wait time for consultation with a B.C. surgeon is about 18 months.

They say 95 surgeries are forecasted for 2022-23, up from the 46 surgeries done in 2019-20.

If you’d like to contribute to the fundraiser Warner’s brother set up on her behalf, you can visit GoFundMe.