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Compartment 14B

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Wherein I take a current news event and use it to further my own agenda.

2008-05-21 - 11:49 a.m.

Ontario has recently decided to cover the cost of gender-reassignment surgery. While my personal opinion on this issue isn’t a strong one (I don’t really see it as a huge deal), what bothers me about it is not my tax dollars going towards sex-change operations per se, it’s about the fact that our medical system does not cover most alternative reproductive therapies (ARTs), which I feel is just as valid, if not more so.

If there was something wrong with your, say, circulatory system, trying to fix it would be covered. Need heart surgery? You can get it, and it’s covered by our universal medical care system, Canada-wide. The same goes for most of the body’s systems. Yet, if there’s something wrong with your reproductive system, you are up the proverbial creek because “why should other people pay for you to have a baby?” A reproductive endocrinologist diagnoses you with a condition which is hormone-related and means that you don’t ovulate regularly, if at all. This is clearly a case of something not functioning as it should in your body – you have a problem with your endocrine system, which has repercussions with respect to your reproductive system. Why is this not covered?*

The argument about the mental distress felt by people who believe they need gender-reassignment surgery because they believe they were born into the wrong body? Sorry, you cannot convince me that that distress is somehow higher or more important than that which is felt by a woman who cannot conceive on her own, but feels it is her unfulfilled destiny to have a child who is biologically related to her. And I believe that anyone who has spent any time looking at infertility blogs, forums and message boards would have to agree with me. I’m also certain that many scientists would agree that having children is an innate biological urge (I tried to quickly Google this topic but the first few links were to “childfree” sites that advocated suppressing this urge, and many other sites referred to the “biological urge to reproduce”, but stating its existence as a fact rather than giving a source of this information), and I would argue that this is more commonly felt than the inborn urge to outwardly display the characteristics of the opposite sex.

Now, I readily admit that this post is only the most superficial of looks at these two issues and doesn’t take into account things like the total cost the medical system would have to bear should ART be covered. But when I first started to suspect that trying on our own wasn’t going to get us anywhere and started to look at stuff like coverage of ART procedures, I was totally surprised to find that it was pretty much non-existent, and that that also held true for most private supplementary health-insurers here, and primary health-insurers in the U.S. To me it just wasn’t logical to not have provisions to fix something that’s obviously broken, especially when there are relatively tried-and-tested ways to do so. And, even though I’m less than 2 weeks (!) from having our second child, and we were lucky enough that our “fix” of using Clomid was relatively easy and inexpensive, I still feel the same way when contemplating this issue as a whole. Maybe my view is simplistic, but to me it is both logical and “feels” right.

So I guess the question is: what can be done about this situation? Certainly I'm not the first, the last, or the best to write about this issue, though I'd like to think that even raising it is useful if it gets people thinking. Hey, it's not much, but it's something.

*To be fair, IVF is covered in Ontario, but that’s if, and only if, both of your fallopian tubes are 100% blocked: if one is blocked and the other is problematic but not totally blocked, or if one is blocked but there’s another, underlying reason that an egg might not be released, or be able to travel on down to meet up with Mr. Sperm and implant – i.e. if there’s even a miniscule chance that you, in theory could conceive on your own – than you’re out of luck. And even many of the tests required to determine exactly what the problem is aren’t covered. And, as far as I know, Ontario is the only province with this coverage at all. And yes, IVF is expensive, but there are other types of ART which are much less so, yet as far as I know, these are not covered at all, in any province.

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