Davin News Server

On 4/25/25 02:26, 51st State wrote:
> The Court of Appeal says OHIP must cover surgery for a resident seeking to
> have a vagina constructed while leaving penis intact
> 
> Ontario's top court has ruled the province must cover the cost of an out-
> of-country, penis-sparing vaginoplasty for a 'transgender and non-binary
> resident'Å¥ who wishes to have both female and male genitalia.
> 
> In a unanimous decision released this week, a three-judge panel of the
> Ontario Court of Appeal confirmed a lower court's ruling ordering the
> Ontario Health Insurance Plan to pay for the patient, identified as K.S.
> in court records, to undergo the novel phallus-sparing surgery at a Texas
> clinic.
> 
> The latest ruling is the third unanimous decision in K.S.'s favour.
> 
> '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 its regulation,' K.S.'s
> lawyer, John McIntyre, said in an email to National Post.
> 
> The legal battle between K.S., whose sex at birth was male, dates to 2022,
> when the Ontario Health Insurance Plan (OHIP) refused a funding request
> for surgery to construct a vagina while sparing the penis, a procedure
> this is not available in Ontario, or anywhere else in Canada.
> 
> OHIP argued that, because the vaginoplasty would not be accompanied by a
> penectomy, the procedure isn't one specifically listed in OHIP's Schedule
> of Benefits and therefore shouldn't be publicly funded. OHIP also argued
> that the requested surgery is considered experimental in Ontario and,
> thus, also ineligible for coverage.
> 
> K.S. appealed to the Health Services Appeal and Review Board, which
> overturned OHIP's refusal, arguing that 'vaginoplasty' should be covered,
> whether a penectomy, a separate procedure included on the list of publicly
> funded sex-reassignment surgeries, is performed or not.
> 
> OHIP appealed that decision to the Divisional Court but lost again after
> the panel dismissed the province's appeal and declared the surgery, which
> leaves intact a functioning penis, an insured service.
> 
> The province's latest appeal was heard on Nov. 26. The three-judge appeal
> court panel rejected OHIP's arguments that the proposed surgery isn't an
> insured service because it won't be accompanied by removal of the penis '
> a penectomy 'neither recommended by K.S.'s health professionals nor
> desired by K.S.,' according to the court's written decision.
> 
Simply amazing!
I want it all!
I want it both ways!
And I want all of you to pay for it!
---------- Court - OK, sounds fine to us.

> 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 court said.
> 
> K.S.'s doctor submitted a request to OHIP for prior funding approval for
> the surgical creation of a vaginal cavity and external vulva. The request
> made it clear that K.S. wasn't seeking a penectomy.
> 
> In a letter accompanying the request, her doctor said 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, adding that the
> Crane Center for Transgender Surgery in Austin, Tx.,'has an excellent
> reputation' for gender-affirming surgery, 'and especially with these more
> complicated procedures.'
> 
> The appeal court ruled that the divisional court did not err in holding
> that the requested vaginoplasty is listed in the Schedule of Benefits,
> with or without an accompanying penectomy.
> 
> 'The existence of different techniques to perform a vaginoplasty does not
> affect this conclusion,' the appeal court's written decision reads. '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,' the court said.
> 
> '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.'
> 
> The World Professional Association for Transgender Health's standards of
> care, the appeal court added, also 'expressly refers to 'penile preserving
> vaginoplasty' as a surgical option for some non-binary people and also
> note that vaginoplasty 'may include retention of penis and/or testicle.''
> 
> Ontario has until June 23, 2025, to seek leave to the Supreme Court of
> Canada.
> 
> 'As this matter is within the appeal period, it would be inappropriate to
> comment further,h said a spokesperson for Ontario's Ministry of the
> Attorney General.
> 
> In dismissing OHIP's appeal, the court ordered Ontario to pay K.S. $23,250
> in costs.
> 
> Gender-affirming surgeries at the Texas clinic range from US$10,000 to
> $70,000, depending on the procedures performed.
> 
> https://nationalpost.com/news/canada/ohip-coverage-penis-sparing-
> vaginoplasty
>