The Process Leading Up to Surgery

So, this is all out of order, but I thought I might talk about the steps I needed to take to get bottom surgery. The topic might not be useful for everyone, but for anyone curious on how it works in my part of Canada this is the story.

The Prep Work

I had been speaking with my therapist on the process for a while, so I knew what was information was needed.  Our provincial trans health information page also specifies that two letters of recommendation are required so I knew that I would need someone else to create a letter for me. WPATH standards no longer require more than one, but my province is a little behind the times and afraid to change. Luckily, my endocrinologist was aware of this requirement, so early on he suggested a psychologist that I should see. So, for a while I had both a therapist and a psychologist to speak to.  In both cases, they were very happy to provide a letter of recommendation for the surgery. It’s not that they were quick, but it was clear to both that I had many signs of dysphoria and needed a change to my life.

Next, a communication to GrS Montreal to let them know I was interested.  This would have been back in late October 2023.  They replied within a day or two with some informational documents and a series of other forms and requirements to get the process started. These forms required appointments to both my endocrinologist and family doctor to fill out. By early December 5^th, I had the necessary information and sent the package to GrS Montreal.

First Contact

When GrS confirmed the receipt of the information I sent them, they said that I should expect to hear something from them within 6-9 months unless there are questions regarding the information provided. It should be no surprise that I was shocked when they reached out on January 24^th. This call was a preoperative call where they were confirming a few things and asked some questions on what my situation was for work, post-op care, and when I might be available for surgery.  

One of the most important questions from them was whether I wanted a cavity or not. The surgery can be done where a cavity is not created or it is created with little depth. In this case, there is much less post-op care and fewer potential complications. This option was tempting however I struggle with parts of me that I don’t perceive to be female already. If I was going to go through a major surgery like this, why not get my body as close to how I see myself.  I wouldn’t want to have this doubt of whether I should have done a full cavity hanging over me for the rest of my life.  Full depth vaginoplasty is not for everyone, but I knew that it was right for me.

The pre-op call was all very exciting but I wasn’t clear what it all meant. Did this mean that I was in queue for a call for a surgery date? Was this just clarification on some of the information? When I asked, the pre-op nurse let me know that yes, this was the last step before I get a call to schedule the surgery. Probably within the next few weeks. Holy crap… this was happening much quicker that I was thinking.  I wasn’t complaining but now I had to start getting my head in a different place. I also needed to start telling work that this wasn’t something that was going to happen at the end of the year, but possibly in the first half of the year.

One of the items that was concerning is that I was told there was no funding yet from the province. It was my understanding the GrS was responsible for making sure that this happened, but I soon learned that this was only the case for some of the provinces.

First Concern

So, I waited for the call for the surgery date… that never came. Anyone that has dealt with GrS knows that while they are good at answering questions, they are not always timely responses or providing information that keeps future patients up to date. I’ve read and experienced that you need to instigate communication to make sure that they are aware that you are interested and need an update. So, after about 2 weeks, now early February, I lost patience. I needed to know what was going on with the funding and if they were going to start calling for surgery dates. I reached out to the pre-op nurse who quickly passed me on to my GrS Admin representative. Turns out, there is a form that I needed to get my psychologist to sign and get into the province to they can pre-approve funding.  This is something I would love to have known back when I made my initial application.  So back to my psychologist for another appointment. Thankfully, he was very accommodating and quick so he had the form signed and it was on its way to the government within a day!

A week later, I received information that the pre-approval request was completed and approved by the government. This is when GrS was to submit the real request for funding.  The family and I were about to head off on vacation and it would have been nice to know what was going on before we left, but that was not to be. I was told that GrS would be making their application for the funding by the end of the following week.

The Waiting

Ok, so looking back, I realized I may have contacted GrS a bit too much while waiting to hear from them for the surgery date.  I think I wrote a couple of times to find out if they had received the official funding approval from the government. Another to see if they needed any other information. Probably wrote them about 5 times in total but, I had also heard that would be required. Eventually it paid off.

I was told by my Admin from GrS at the end of February that she would be making calls for the May, June, July surgery times soon. She also said not to worry, that she had saved a spot for me. Then in early March, I started seeing posts in Reddit that people were starting to get contacted for their dates. I started to panic. Even though my Admin told me that I had a spot, they could easily make a mistake and miss me. Did the funding delay push me to the back of the line or even worse, into the next block of dates starting in September? The spring timeline worked so much better for us because our older son Nathan would be home from school and Cathy and I would be able to travel together. I’m sure we would have figured out another way, but I was hopeful that I would get into the spring block.

About 10 days after seeing the first post on Reddit, I received the call.  It was March 21^st, late in the afternoon, and I had already conceded that this would be another day that I would not get a call. I saw the number on my phone with a Montreal area code and I got very excited. It was the news I was waiting for. There must have been a long list that the Admin had already gone through but there were still dates in June, July and even 2 dates in May. Knowing that I wanted to make the most of the time when Nathan was home and also to get it done as soon as possible, I chose a date in May. This would be after Cathy and my 23^rd anniversary. I was given the date of May 27^th with Dr Brassard, the surgeon I would have chosen. I panicked for nothing, but that was one more proof to myself that this surgery was something that I really needed.

Timeline Summary

The original information that I sent in was on December 5^th. They told me it would be 6-9 months before I likely would hear any response. 1.5 months later, I have the call for my Pre-Op consultation and then I’m told that I should get a call in a few weeks to hear a date for the surgery. 2 months later, I get the call for surgery dates.  So maybe there is some work to do on their side to estimate the timelines, or maybe I was lucky in that I had all the information in at the right time and then the funding pushed the date back. Regardless, from the time that I submitted my documents, to the date of my surgery, it was just under 6 months.  I know that I’m a lucky girl when it comes to the timelines. Many people have to wait much longer than I did.

Similarly, I was quick to see an endocrinologist and get my HRT too. I like to think that maybe the system sees me as someone that is low risk, highly motivated, and has lived long enough as the wrong gender. Maybe the Canadian medical system is taking pity on me, and it is working in my favour.