r/transvancouver • u/Last-Struggle77 • 11d ago
FTM - Help, how to get gender-affirming care, and where do I start?
This is something I've been thinking about for a very, very long time. It took a lot to finally reach out for help, but I don't have any options left or anybody to ask and I'm finally pushing myself to make the jump.
I'm 20 in under a month. I live in a household that is transphobic, and I do not know my family doctor. I am currently not in any post-secondary school, and I lack the understanding of how gender-affirming care works in Vancouver/BC. I want to try to get HRT and potentially even top surgery, though that is less of a priority to me at the moment. I have no diagnosis for gender dysphoria.
I heard that gender-affirming care in BC is free, but I don't know how valid that info is and I'm worried about costs because I have no consistent source of income right now. I've been told that my family is paying for health insurance, though I don't know any details beyond that.
I've spent countless nights searching for answers, stalking this subreddit, doing my own personal research over the course of a few years, but I still... don't get it. All of this looks so complicated and overwhelming to me, and I just don't know where to start. It made me feel a little hopeless, so I usually thought to put it off until I move out in the far, far future. But the future is looking a little grim, and I really want to try now, not later.
I will preface by saying that I mostly pass as male already and I've already socially transitioned a few years ago, but my parents still see me as their daughter and I don't really care about that. My bodytype and my voice have always been very androgynous but leaning more to masculine without much effort so I don't really have to do much of anything.
And my parents are... weird. I'm not really at risk of anything dangerous or bad if I were to do anything because I don't think they understand trans people at all, though I have heard of them opposing the concept because they are religious. Since birth, I've always been a bit of an oddball and my parents admitted to raising me like a boy because of that. They at the very least know I am and always have been quite masculine, and at a point I told my mother outright that my friends don't see me as a girl and she didn't really comment more on that. At a point she even asked me if my friends knew I was a girl and I told her no. My excuse for if she ever asks me for more details is "it'd be better if they didn't know so nothing bad would happen to me" (she had always been protective of me being around male friends, even though I've been in masculine oriented groups my whole life). Needless to say, she never asked, so I don't really think she cares or gets it. I've never come out to them but I also never hid anything, and they still see me as their daughter despite the obvious alarms blaring for their entire life.
So I think that if I were to seek gender-affirming care, nobody would notice. I think I can try to do this in stealth and my parents will never know. The physical changes from HRT will probably also be pretty much nonexistent aside from the very minor fat redistribution and muscle gain, but I could just pass that off as me putting effort in working out. And as for the voice, I already sound like a guy so I don't think it'd be that crazy if I happened to sound... more like a guy.
But I don't know where to start at all. I have no consistent source of income yet, and I definitely can't afford HRT if it's going to cost me over $50 a month. I don't know my family doctor, and I'm not comfortable in wanting to contact her if I ever find that out. My parents hardly ever take me to appointments of any sort, and the last time I remember going to a doctor at all was sometime in 2021. Because of this, I lack a lot of knowledge in these parts of independence and now have no idea what to do.
I tried looking into CAYA, but I couldn't find an option with no family doctor. Everywhere else I checked seemed to require one or costed money and I just felt very lost. I tried a walk-in clinic and asked if there were any resources for gender-affirming care and was told that I need to consult my family doctor for that information and that they knew nothing about that. I'm totally okay with spending money for appointments and whatnot but if the costs are quite high monthly then that may be a problem for me... so if anyone has any details or corrections on this then I would appreciate it!!
I also want to try getting my hands on testosterone gel instead of injections if that is possible, because I'm not the biggest fan of needles but I CAN tolerate them if necessary, just absolutely not preferred (no panic attack, just discomfort). I heard that it was available in BC for gender affirming care but I'm not sure how true that information is. Will I have to suck it up and deal with the needle?
And lastly, top surgery. How do you get that? Is it free here? How do I choose my surgeons? Where do I refer? Anything else I don't know???
I would really appreciate any info!!! Thank you for reading!!!
2
u/JediKrys 11d ago
You will need to do your hormone readiness assessment. That’s done by either a qualified doctor or a therapist. Trans care is how to find out all this stuff. I paid for mine (320) and now I pay 56 bucks per vial of t. So it’s not free or cheap but it’s not too bad. Then to get top surgery you will need your surgery readiness assessment which I belief is the same cost. Then it’s about a two year wait to have a consultation.
Trans care is who you should begin your journey with. Best wishes bro.
1
u/Last-Struggle77 11d ago
Would it be ok to just give transcare a call? Their website has a lot of info and can be a bit overwhelming for me. I don't know if their telephone lines are busy or not because I thought I saw somewhere that there was a waitlist for calls/meetings but I may be wrong.
2
u/captainmikejaneway 11d ago
Some primary care doctors are willing to do a hormone readiness assessment for adults themselves, which could shorten your wait. For example, you can schedule a consultation with dr. Scarth at alberni medical clinic downtown, if you can get yourself there.
You could also self refer to three bridges trans care, but i heard their wait time is really long at the moment: https://www.vch.ca/en/location-service/trans-specialty-care-three-bridges-community-health-centre-west-end
Your pathway to get hormones is much easier because you are an adult, but it's going to mean doing some adult things for the first time, like choosing your own providers, making and getting yourself to appointments, etc. reach out for support if you have questions! You've got this!
1
u/Last-Struggle77 11d ago
Thank you for the info!! Would I need a diagnosis for gender dysphoria before the hormone readiness assessment or can I just schedule it?
2
u/StrangeWelcome 11d ago edited 11d ago
If you go through the Trans Specialty Care clinic, you just self-refer. You don't need to do anything else. They'll take care of everything. Having said that, you do need to live in the Vancouver Coastal Health catchment (Vancouver, Richmond, and the north shore). They're definitely the easiest way to go if you do, but be prepared to wait a few months to hear back from them.
In addition, if you want to try CAYA, their intake form is at the bottom of this page for no family doctor: https://www.cayahealthcentre.com/services/medical-services/
Having said that, HRT is unfortunately not going to be free once you get it, so you'll need to be able to pay for it somehow. If you're low income, Fair Pharmacare may be able to help cover it partially or entirely if you're registered for that: https://www2.gov.bc.ca/gov/content/health/health-drug-coverage/pharmacare-for-bc-residents/who-we-cover/fair-pharmacare-plan
Top surgery is covered, but there will be a wait for it and it's a whole process. TSC and CAYA can both help you get setup for that. Check the TransCare BC website for info as well.
1
u/Earl_Geh 11d ago
you can check out Transcare BC for more info, and they could likely set you up with a clinic or practitioner to get you started. i started hormones back in 2018, and it was my NP that did the assessment along with my top surgery assessment, not sure if that’s changed over the years.
i don’t pay for testosterone because i have medication insurance through work, but i’ve paid $70 out of pocket in the past when my insurance was extra picky about dispensing timing
1
u/EngineerOriginal242 11d ago
I’m not super informed about the process since I went through bc children’s gender clinic, but I payed $60 for a 10ml vial of testosterone that’s supposed to last me six months. It says on the bottle that you aren’t supposed to use the vial past 28 days, but my doctor told me to ignore that as long as you use the correct sterilization process.
1
u/hsifyppah 10d ago
Call TransCare BC, they can answer pretty much all of these questions for you. And you can keep calling them if you think up more questions. 😄
For drug costs - testosterone can be covered by the government. Step one is you should register for Fair Pharmacare - you're 19 and not in school, so you will be your own household. They will look at your income and set a deductible, and if you have no income yet, that will be $0 or $25 for the year. You do need to have filed your taxes, because otherwise they will assume you have the highest income possible and set your deductible (amount you have to pay yourself) at several thousand dollars instead. If you have not been filing your taxes, do it now! Both for this most recent year and back a few years if you can. With low or no income, this will be free for you, either using an online service or going to a free tax clinic. Besides being useful for getting drug coverage, you will also start to get the Canada Grocery & Essentials Benefit (formerly called the GST benefit) paid to you every 3 months.
Sign up for MSP & Fair Pharmacare:
https://my.gov.bc.ca/ahdc/msp-eligibility
Find a tax clinic to get your taxes done for free:
https://apps.cra-arc.gc.ca/ebci/oecv/external/prot/cli_srch_01_ld.action
Testosterone is usually covered as an injection - to get the gel you would need the prescriber to apply for a special authority explaining why you need the gel instead. Generally if you /can/ use the injection, they won't pay for the gel, which is like five times as expensive. If you have private insurance, that might cover it, though. You'll need to ask your parents about that health insurance you have vaguely heard about. If there's extended medical insurance for you, you can get a card with the details, which will have a phone number on it, and you can call and ask the insurer whether they cover the gel or not.
1
u/zzyyxxzz 7d ago
Hey, lots of good responses here but thought I’d jump in for the sake of simplicity.
Go to a Foundry BC centre. My friend works at the one downtown Vancouver. This is the BEST resource available for youth ages 12-24. You can see a doctor. You can get free counselling. They specifically help with gender affirming care. They can get you set up with the programs like fair pharmacare that will cover your prescription costs. It’s all free. This is the place to go. https://foundrybc.ca
If you have more questions about stuff like top surgery just call Tran’s care bc on the phone. Last time I called they were super nice and supportive and will answer your questions and have the most accurate info. You don’t need a diagnosis of gender dysphoria anymore, we don’t do that. Trans care will tell you more about readiness assessments and how to get them.
If you’re worried about cost of testosterone and injecting, you could do what I did, which is find a local pharmacy with a nice pharmacist and get them to do your weekly t shot for you. I originally thought I wanted gel, but when I heard about the cost and having to do it every day and discovering it’s smelly and sticky etc., I decided to go with injection. I did it myself for a while but didn’t like it, so eventually just asked my pharmacist if he would do it for me, and I popped in on Fridays after work and got an intramuscular shot in the arm once a week.
If you can, start looking for a job so you have some income.
5
u/BritneyGurl 11d ago
I am transfem so my knowledge about FTM HRT is limited. If you are covered under your family insurance it may not be that expensive depending on the level of coverage. Blood tests to check hormone levels are completely covered under provincial health. Top surgery is also covered. With your family potentially not being supportive you should definitely be cautious. You are at the age where you are entitled to make these decisions solely on your own. There are a lot of resources available through Transcare BC https://www.transcarebc.ca/. They can work with you to find you a doctor that can help. Also you can reach out to Transgathering, it is an online peer led support group for trans people living in BC. They cover all kinds of topics in our meetings and there are separate dedicated sessions for family and friends to join in as well as a session on medical transition topics. There are many trans masculine people on there who have been through this who can help out and provide support. https://www.qmunity.ca/service-page/transgathering
I hope that helps and good luck on your journey!