Neither Nor, But Preferentially, Both

"K.S. is pleased with the Court of Appeal's decision, which is now the third unanimous ruling confirming that her gender affirming surgery is covered under Ontario's Health Insurance Act and the regulations."

John McIntyre, lawyer

 

"[K.S., who is in her early 30s], has experienced significant gender dysphoria since her teenage years, as well as physical, mental and economic hardships to transition her gender expression to align with her gender identity."

"The existence of different techniques to perform a vaginoplasty does not affect this conclusion. It was open to the drafters of the Schedule of Benefits to describe each specifically listed service in broad or narrow terms."

"Here the description chosen, 'vaginoplasty', is broad enough to encompass different techniques."

"As the [Health Services Appeal and Review] Board put it, a vaginoplasty without a penectomy is an insured service because it is still a vaginoplasty, a specifically listed service."

Ontario Court of Appeal 

The Ontario Court of Appeal is seen in Toronto   Photo by Colin Perkel /The Canadian Press

 

A transgender resident of Ontario who identifies neither as exclusively female nor male and whose wish it is to have both genitalia in nature assigned to either a man or a woman, has had her wish granted by Ontario's top court. And now the Ontario Health Insurance Plan (OHIP) has no choice but to cover the cost involved in a penile-retention vaginoplasty for this resident of Ontario, thanks to a unanimous decision by a three-judge panel of the Ontario Court of Appeal which confirmed a lower court's ruling that found the novel phallus-preserving surgery qualifies as an insured service under OHIP.

 

K.S., identified at birth as a male, had embarked on a legal battle with OHIP in 2022, when the provincial health insurer refused her application for a funding request to undergo surgery at a Texas clinic which specializes in constructing vagina, and sparing the penis. This is a medical procedure not available anywhere in Canada, much less in the province of Ontario. While making use of female pronouns, K.S. identifies as neither fully female nor fully male.

 

Because the proposed vaginoplasty would not be paired by a penectomy, OHIP argued the procedure, not specifically listed in its Schedule of Benefits, was not eligible for public funding. The requested surgery, OHIP argued, is furthermore considered experimental in Ontario, which also makes it ineligible for coverage. Dissatisfied with the ruling, K.S. applied to the Health Services Appeal and Review Board. In its turn the Board overturned the OHIP refusal of coverage with the argument that 'vaginoplasty' should be covered, irrespective of whether a penectomy as a separate procedure was included. 

 

The surgery, which is not available anywhere in Canada, involves creating a vaginal canal, or opening, without removing the penis. Photo by Getty Images

 

OHIP lost once more after appealing that decision to the Divisional Court, when the panel dismissed the province's appeal, declaring the surgery an insured service. Now, finally, the latest appeal saw the Appeal Court panel reject OHIP's arguments turning down the proposed surgery because it it is not recognized as an insured service, since removal of the penis will not accompany it. 

The original request to OHIP for prior funding approval for the surgical creation of a vaginal cavity and external vulva was submitted by K.S.'s physician; a request that clearly ssated K.S. did not wish a penectomy. Her doctor stated that because K.S. is "not completely on the 'feminine end of the spectrum", it was important for her to have a vagina while maintaining her penis. The Crane Center for Transgender Surgery in Austin Texas, "has an excellent reputation" for gender-affirming surgery, "and especially with these more complicated procedures".

 

The Appeal Court added that the World Professional Association for Transgender Health standards of care "expressly refers to 'penile preserving vaginoplasty' as a surgical option for some non-binary people", and also notes that "vaginoplasty 'may include retention of penis and/or testicle'." In finding for the plaintiff, the court ordered Ontario to compensate K.S.'s costs of $23,250. A financial burden that will include the cost of gender-affirming surgeries at the Texas clinic that range from $20,000 to $70,000 (U.S.), dependent on procedures undertaken. 

The Transgender Phenomenon Puzzle

"Peer influence during this stage of life is very powerful. As well as the influence of social media, the review has heard accounts of female students forming intense friendships with other gender-questioning or transgender students at school and then identifying as trans themselves."

"[In later childhood and into early puberty], online experience may have an effect on sense of self and expectations of puberty."

"[The challenges autistic children face, despite being articulate and intelligent] can sometimes  make it hard for these young people to express how they are feeling about their internal sensations, their gender identity and their sexual identity." 

"[Gen Zs and younger Millennials have different beliefs about the] fluidity and mutability of gender than older generations. Attitudes have changed at speed."

Cass Report, U.K. review of child and adolescent gender care

Trans, Gender Non-Conforming, Lesbian, Gay, Bi, and Two Spirit organizations and allies gathered at Washington Square Park for the 15th Annual Trans Day of Action on June 28, 2019.  Erik Mcgregor/LightRocket via Getty Images

The Report is neutral in the sense that it supports neither the current 'social contagion' debate, nor the insistence of trans-specific lobbyists that children's rising uncertainty about their birth gender designation must be respected and interpreted as a need for such children to be offered transition therapy. The recently published and disseminated Cass Report led by British pediatrician Hilary Cass simply presented its findings, most of which would displease those who accept at face value the blase attitudes of groups who unquestioningly accept the need to transition children to improve their health and future prospects.

The surge within today's society seeing gender-distressed children referred to gender clinics is alarming to many, all the more so that medical societies and specialists appear to have accepted the arguments of trans-supportive groups that it is wrong to question children, their motives and their wishes. The contentious impression that many young people identify as trans as a result of "social contagion" in peer groups and promoted through social media sites is infuriating to committed transgender support groups.

This Report of recent vintage concluded that the rapid increase in numbers of children committed to transitioning their gender identities and the acceptance of their choices cannot be attributed to peer pressure and social media influence alone, for the rapid increase or why gender dysphoria has become so strikingly common a presentation when predominately biological males transition to biological females, a phenomenon that "is unlike that in any prior historical period".

The Report researchers noted that gender-distressed minors and their parents discussed with them issues about online information that describes normal adolescent discomfort as a possible sign of being trans and that particular influencers have had a "substantial impact on their child's belief and understanding of their gender". The term "social contagion" is disliked within the trans community. "Simplistic explanations of either kind (all trans people are born that way/it's all social contagion) do not consider the wide range of factors that can lead young people to present with gender-related distress and undervalues their experiences."

On the other hand, "de-transitioners" have described on social media, in blogs and published studies, being influenced by Tumblr, YouTube videos and online communities into transitioning. Another argument is that no evidence exists to support "transness" can be socially contagious, or a TikTok video can "totally destabilize" the gender identity of a child. Unless, of course, it is the sheer volume of the push toward acceptance of transitioning coming from a myriad of sources, all of which young people pay heed to.

Neurodiversity represents conditions like autism spectrum disorder and ADHD, with studies suggesting trans and gender-diverse people are three to six times likelier to be autistic than cisgenders. According to a Canadian study of 174 youth aged 15 and under referred for puberty blockers to any one of ten gender clinics operating in Canada, 81 percent were born female. Two thirds of the referrals had at minimum one other comorbidity diagnosis beyond gender dysphoria, such as anxiety, depression, ADHD or autism.

There were reports from some parents of natal girls that "their children had been through a period of trans identification", later recognizing they were not trans after all, but same-sex-attracted females. Speaking at a focus group, a gender-diverse youth made the observation that "a lot of trans people make YouTube videos which I think is a (major) informational source for a lot of people". Biological factors have not changed in the last ten years yet the disproportionate number of birth-registered females now identifying as trans or gender-diverse presents as a puzzling social/biological phenomenon.

Transgender pride flag. Angela Weiss Getty Image

"[The Cass report didn't surprise] thoughtful professionals who provide this care. Since 2014, we've noticed this upward trend in overall referrals and from certain demographics, namely biological females and those who are neurodivergent."

"We have to avoid extremes -- 'all these youth are transgender and will continue to identify as another gender for the rest of their life', or 'it's all due to social influence'."

"[Many young people have benefited from social, medical or surgical transitioning, but an increasing number of others] have not only stopped their transition but have also regretted it as well."

"Many of these youth will say they have been harmed, [that social factors influenced their reasons for transitioning."

Dr. Joey Bonifacio, Toronto pediatrician, expert in gender medicine, specialist in adolescent medicine, St.Michael's Hospital

Placing Women At Risk -- Again

"Correctional Services Canada has a duty to accommodate based on gender identity or expression, regardless of the person's anatomy [i.e. sex] or the gender market on identification documents."

"This includes placing offenders according to their gender identity in a men's or women's institution."

December 2017 Agency commissioner directive to Correctional Service of Canada

"This is a great example of the value of having these community meetings ... because I consider myself to be a fairly strong advocate for LGBTQ2 issues and fairly aware of all the different pressures and this wasn't one that I'd ever thought of [town hall meeting when a 'transgender advocate' complained of 'torture' to house prisoners in facilities not consistent with their declared gender identity]."

Liberal Prime Minister Justin Trudeau

"All transfer requests to a different institution type [i.e., men's to women's or vice versa] are assessed on a case-by-case basis and require an Assessment for Decision that includes a security classification review and a transfer recommendation."

Updated 2022 directive to CSC

 

It became standard practise in 2018's Canada for prison authorities to routinely house transgender females in women's prisons to honour their need to be among women, the gender they identify with. Those born female who are incarcerated are joined by men who have 'transitioned' to female as a routine matter of prison policy, a change from the time when all men were housed in prison facilities meant for men identified by their physical characteristics.

Another country felt it was time that they too respected transwomen's 'rights' to recognition as female and to thus integrate them into female populations in their prison system. First Minister Nichola Sturgeon of Scotland agreed that transgender inmates be transferred to women's prisons. Then lived to regret it when several examples of women's prison transfers resulted in transgender females raping female prisoners. 

 

So: in @Nicola Sturgeon's Scotland, transwomen AREN'T women if they're convicted double rapists, like Adam 'Isla Bryson' Graham.  J.K. Rowling, Twitter

 

The public learned that their government agreed to requests by transwomen found guilty of rape before declaring themselves the opposite gender. Public anger resulted in the government reversing itself, announcing that transgender criminals with 'any history' of violence against women no longer would be transferred from a  men's to a women's prison based solely on their gender self-identification.

In Canada, a number of instances have become public where offenders convicted of severe sex crimes were able to obtain transfers to women's prisons, made legal from 2018 forward. In an Ontario prison last year the Grand Valley Institution women's prison welcomed Catherine Lynn who when still a male murdered an upstairs neighbour in 1995 and abused the corpse as a sex partner.

Another, Adam Laboucan, was convicted of sexually assaulting a three-month-old baby, but now identifying as Tara Desousa, effected a transfer from a men's prison to a women's simply by declaring  himself female. In the light of public backlash, a clarification of transfer policy was effected directing prison officials to exercise judgement, rejecting a transgender inmate transfer on the basis of previous sex crimes.

This refinement reflecting pure common sense however, was objected to by the Canadian Bar Association, holding it to be transphobic and possibly unconstitutional for prison officials to weigh the issue of biological sex. "In our view [the directive is based on the incorrect assumption that people are fundamentally men or women [or intersex] based on biology at birth"; incredibly as it seems for a professional body at law.

A recent internal report released by the correctional service revealed the presence of 99 "gender diverse offenders" in the Canadian prison system, 18 of whom applied for transfer to another prison that would match their gender identity, the vast majority of whom were transwomen. Tellingly, transgender women inmates were identified as being disproportionately likely to be incarcerated resulting from sexual violence committed while living as their biological sex.

A former inmate at the Grand Valley Institution, Heather Mason, gave her personal view born of experience that the transfer policy resulted in "sexual assaults, physical assaults, harassment and othr issues". But no one seems to be interviewing and listening to the women with respect to their dignity and security; the woke community has infiltrated all professional bodies and government agencies to an excruciating extent belying the intelligence of common sense.

 

Activist Heather Mason does not want to see a sex killer in a womans prison. Photo by HEATHER MASON /FACEBOOK