Room for improvement in trans health care in B.C., activist says

VANCOUVER - Lauren Sundstrom can laugh about it now, but at the time it was happening, it was embarrassing.

"I had gone to this clinic previously, I guess, as a child, and so when I gave them my care card number, they pulled me up in the system as my old name and my old gender," Sundstrom said.

Sundstrom is transgender, and she says her recent experience at a health clinic in Vancouver is too common for people like her.

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"The person at the desk meant well, but she basically announced to the whole room that my gender was wrong in the system," Sundstrom told CTV News Vancouver. "While I do carry the label of activist -- I'm proud of being trans, I carry no shame about it whatsoever -- sometimes when you're wanting to get treated for a sickness or whatever is going on with your body, you don't want that being announced to the whole waiting room."

"There's moments for activism and there's moments where you kind of just want to keep your privacy," she added.

Sundstrom is 30, but she started transitioning when she was 16. Her health care card and her records with British Columbia's Medical Services Plan have been updated to show the correct name and gender, but she finds she still deals with what she calls "residual weirdness" around identification when trying to access health care.

As an example, Sundstrom pointed to another experience she had a few years ago. She went to a Metro Vancouver hospital emergency room in a lot of pain, and the person who checked her in printed her wristband with her old name and gender on it, even though her care card had the correct information.

"Why is it up to me to make sure that my name and my gender are right on my charts? That's ridiculous," Sundstrom said. "Nobody even thinks to double-check these things, and it's just -- it's incredibly frustrating to have to advocate for myself when I'm in those situations."

The reason for the discrepancies between official provincial records that have the correct name and gender for trans patients and records at clinics and hospitals that may not comes down to technology, according to the provincial Ministry of Health.

"The B.C. Ministry of Health maintains a central patient identification database which contains information on all people in the publicly-funded health system in British Columbia," the ministry said in a statement. "However, the way information is transferred from PharmaNet to point-of-service systems in hospitals, clinics and pharmacies is run by various third-party software and there are sometimes functionality issues with these technologies."

The ministry also pointed to the work it has done to improve trans health care in the province in recent years, noting that B.C. recently became the first province in Western Canada to offer lower-body gender-affirming surgeries.

Additionally, British Columbia saw 234 gender-affirming chest and breast augmentation surgeries completed between January and August of this year, the ministry said.

To address Sundstrom's concern that health care workers aren't aware of or thinking about these issues, the ministry pointed to training programs it offers.

"Trans Care BC offers online cultural safety training that includes ways to respectfully ask and collect demographic information that considers the needs of gender diverse patients," the ministry said. "Since the program launched, there have been more than 100 in-person workshops and webinars have been presented by Trans Care BC and more than 4,350 participants across all five health regions in the province."

Sundstrom said she recognizes that B.C. has a "fairly robust" trans health care program, but added that there are still significant gaps in what's covered.

She pointed to electrolysis or laser hair removal, prescription coverage for hormones and facial feminization surgery as areas where the province could be doing better for trans people.

"We really need to get away from this idea that genital surgery is the transitional surgery and what makes a person a 'man' or a 'woman,'" she said. "We know that's not true. And we know that different trans people require different transitional services … I'm thankful for what we do have, and I know that we are better than some other provinces, but as far as trans health care goes globally, really, we could always be doing better."

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