Accessing gender-affirming care at McGill can be overwhelming, intimidating, and time-consuming. As we reach the mid-point of the Change-of-Coverage and Opt-Out Period, which falls between Aug. 14 and Sept. 27—The Tribune brings you a guide to SSMU’s Gender Affirmation Care (GAC) Plan, which was first introduced in Fall 2023.
Who is eligible?
The GAC Plan falls under the dental portion of SSMU’s Student Care Plan, meaning that it automatically covers both international and domestic undergraduate students. Canadian students can change their health insurance coverage between Aug. 14 and Sept. 27, or between Dec. 11 and Jan. 30 if they begin the academic year in the winter term. During this period, Canadian students can unenroll from SSMU’s Health and Dental Plan, or choose to enroll their spouse and/or dependents. This option is not available to international students. Since SSMU offers the GAC, it is exclusively available to undergraduate students at McGill’s Downtown Campus.
What does GAC cover?
The initiative is meant to supplement provincial coverage and the International Health Insurance (IHI) plan—provided by McGill and insured by Medavie Blue Cross. Therefore, when looking to submit a claim to insurance provider GreenShield for reimbursement, students must first check if their existing healthcare insurance covers it.
The only procedures that are not covered across all 13 provinces and territories and are thus guaranteed to be eligible for coverage through the GAC are vocal surgery and vaginal dilators. However, since gender-affirming healthcare options vary across Canada, students may be able to claim a variety of procedures like breast augmentation, facial feminization surgery, tracheal shaving, and laser or electrolysis hair removal that may not be covered by their provincial insurance or the IHI plan. Fertility preservation is not covered by the GAC.
The GAC covers a maximum of $5000 CAD per procedure, with claims for reimbursement limited to a lifetime maximum of $10000 CAD.
What are the GAC’s limitations?
To Adrian Neulander, a representative from the Trans Patient Union (TPU), the GAC Plan has two important shortcomings. First, they explained the GAC’s maximum offered coverage is not enough to take care of most procedures not already covered by provincial or international insurance that students are likely to need. Neulander explained that both the maximum coverage per procedure and lifetime maximum amounts are insufficient.
“For a lot of procedures that patients are going to want to get, this coverage is just wildly inadequate. For example, when you’re talking about facial feminization surgery, those costs are measured in multiple tens of thousands of dollars,” Neulander said. “This plan is good for these smaller procedures like hair removal, [but] if you want to get a surgery covered under [GreenShield], they are probably not going to make a huge difference.”
Second, Neulander noted that Greenshield requires students to receive a gender dysphoria diagnosis from a doctor or nurse practitioner before accessing care, despite the fact that it is not a requirement for receiving gender-affirming care via Quebec health insurance.
To be diagnosed with gender dysphoria, patients typically have to experience symptoms for six months. While this creates a barrier to accessing care, Neulander noted that practitioners at the Student Wellness Hub have been willing to work with students and provide diagnoses without waiting for six months.
How can students pursue care?
Neulander stated that the Wellness Hub is a good place to start for students looking to begin receiving gender-affirming care as it provides quicker access to treatments like Hormone Replacement Therapy, since wait times are faster than many other clinics in Montreal.
Neulander also suggested that students looking to receive gender-affirming care get in touch with the TPU, which has a number of resources for students and provides one-on-one support to people who need help with their transition.
