Dear Vicky,

I am very sympathetic with respect to the fact that the medical costs linked to your transition will probably be very high in the US, making what may be a difficult time in your life even more frustrating. I must let you know, however that although the healthcare system in Canada is renowned for its general accessibility (see ‘sicko’ by Michael Moore), it is only this way because of the hardworking taxpayers who keep it going…

Permit me to give you a crash course on Canadian Healthcare:

– In 1946, after a long shortage of doctors in Saskatchewan (one of the Canadian provinces), Tommy Douglas, then the premier of the province, (a Scottish-born Baptist minister and a prominent social democrat) passed the Saskatchewan Hospitalization Act, which guaranteed free hospital care for most of the population. He had hoped to make coverage universal, but there was insufficient funding at the time. – In 1950, Alberta created a similar program, which provided coverage for 90% of the population.

– And in 1957, the federal government passed the ‘hospital insurance and Diagnostic Services Act’ which outlined five conditions : public administration, comprehensiveness, universality, portability and accessibility. These remain the pillars of the ‘Canada health act’ which we have today and which you can access via this link: «http://laws.justice.gc.ca/en/ShowFullDoc/cs/C-6///en

http://laws.justice.gc.ca/en/ShowFullDoc/cs/C-6///en

Now, Canada is composed of Provinces and Territories, each having jurisdiction over the management of its own healthcare. So, healthcare here is not federally controlled, it is provincially controlled and the laws are slightly different as you move from east to west. I will speak for the province of Quebec, because this is where I work. You can read the criteria for obtaining public health insurance in Quebec on this website: (RAMQ – Quebec government website)

«http://www.ramq.gouv.qc.ca/en/citoyens/assurancemaladie/arriver/sejour.shtml»>http://www.ramq.gouv.qc.ca/en/citoyens/assurancemaladie/arriver/sejour.shtml

Essentially, in order to get a health card in Quebec, one needs to meet these criteria:

«These persons may be entitled to have Health Insurance Card if they:

* are in Québec temporarily to work;

* have received a study or training scholarship;

* are the spouse of the worker or trainee and are accompanying that person;

* are a dependent of the worker or trainee and are accompanying that person»

You can read information on how to get a health card in the other provinces by accessing the appropriate sections of the Health Canada website via this link: http://www.hc-sc.gc.ca/hcs-sss/delivery-prestation/ptrole/index-eng.php

To find out what is covered for people who do have a valid health card in Canada, you can start by looking at the Egale Canada website. I came across an article there which specifically deals with SRS: http://www.egale.ca/index.asp?lang=E&item=1086

* In Quebec, there is a very popular (private) plastic surgery clinic specializing in SRS which accepts people from around the world and is run by a certain Dr Pierre Brassard. You can access info about him here: http://www.drbrassard.com/clinique_ang.htm

-As for hormone therapy, any person with a valid health card may see an endocrinologist and be prescribed hormone therapy, the cost of which would be mostly carried by the public system. Please note that the rules here are such that you need to see a recognized therapist for at least three months before going to see the Endo, as you will need to bring a letter attesting to the fact that you are ready psychologically to starts hormones, according to the Benjamin Standards of care. Similar rules apply for SRS.

For local montreal/Quebec info,

-you can contact people in the local Trans community via the ATQ website (Association des Transsexuels et transsexuelles du Québec). The website is in French but members are mostly bilingual and are very friendly «http://www.atq1980.org/old/»>http://www.atq1980.org/old/

-Another organization which might help is called: ‘Action Santé Travesties et Transsexuelles du Québec (ASTT(e)Q)’ , which deals specifically with Trans health. «http://cactusmontreal.org/en/astteq.html»>http://cactusmontreal.org/en/astteq.html

-I also recommend the blog of Jillian Page, an editor for the Montreal Gazette who is a transsexual woman. Her blog is called `Patent Pending`

http://communities.canada.com/montrealgazette/blogs/patentpending/default.aspx