Latest news with #ScheduleofBenefits
Daily Mail
30-04-2025
- Health
- Daily Mail
Non-binary Canadian wins lawsuit forcing taxpayers to pay for surgery so they can have a penis AND a vagina
A non-binary Canadian's $70,000 gender affirming surgery - that will see her keep her penis and get a vagina constructed - will be fully funded by taxpayers, a top judge ruled. K.S., who was born a male at birth, uses female pronouns but does not identify as either fully male or fully female, according to documents from the Ontario Superior Court of Justice, reviewed by The 34-year-old, who is only identified by her initials in the legal filing, sued the Ontario Health Insurance Plan (OHIP) in 2022 after the company denied her request to pay for the cost of surgery to construct a 'neo-vagina' at a clinic in Texas. She wanted to build a female sex organ in the gap between her scrotum and anus - while also keeping her fully-functioning male sex organ. Now, the brunt of the $70,000 for surgery and flights to the US will fall on Canadian taxpayers after a landmark win in court. Dr. Irena Druce, an endocrinologist at the Ottawa Hospital, submitted a 'Request for Prior Approval for Funding of Sex-Reassignment Surgery' - which cost $10,000 to $70,000 - for K.S. after completing multiple assessments on her along with Yael Sela, a mental health counselor. Together, they determined K.S. has 'persistent gender dysphoria.' They said she was qualified to undergo the surgery because she had undergone hormone therapy for a year and 'lived for 12 continuous months in a gender role congruent with her gender identity,' the appeal said. The procedure, also known as penile-sparing vaginoplasty, is only available in Texas. It is not allowed in Canada, but the money would pay for her to travel to the US to get the surgery, according to Reduxx. The insurer argued the surgery cannot be publicly funded because the vaginoplasty would not be accompanied by a penectomy and is therefore not a procedure listed on its schedule of benefits. The company, which is run by President and CEO Matthew Anderson, also argued that the procedure is considered experimental in Ontario and not eligible for coverage, the appeal, submitted on April 22, said. K.S. then appealed the denial to the Health And Services Appeal and Review Board - who then overturned OHIP's initial decision, arguing that it should be covered even if a penectomy is not performed. OHIP appealed that, but lost again after the panel determined the surgery - which would leave her penis completely functional and create a 'neo-vagina' in the space between her penis and anus - would be fully insured. The province's appeal was heard on November 26, 2024 as three judges - Benjamin Zarnett, Steve Coroza and Lise Favreau - rejected the company's arguments to deny coverage because a penectomy was 'neither recommended by K.S.'s health professionals nor desired by K.S,' the court's decision stated. The appeal's court also said: '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.' They added that 'a vaginoplasty without a penectomy is an insured service because it is still a vaginoplasty, a specifically listed service,' the document read. K.S.'s physician said in a letter that she 'identifies as transfeminine but not completely on the "feminine" end of the spectrum and for this reason it's important for her to have a vagina while maintaining her penis,' documents said. According to Dr. Druce's biography, she is a clinician investigator that focuses on inflammation and chronic disease with an interest 'transgender health.' 'And her hope is to contribute to clinical research in this domain as her career continues,' it continued. In addition to winning the case to get the surgery, K.S. was also awarded $23,250 by the three judges, the filing said. The province of Ontario has until June 23 to appeal the latest decision to the Supreme Court of Canada. Her lawyer, John McIntyre, told National Post his client 'is pleased' with the decision. '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,' McIntyre said. Soon after her first win last April, K.S. took to social media to celebrate her win and posted to a Reddit board for 'bigenital' individuals, per Reduxx. In those posts, K.S. said she suffered from bipolar disorder, was a disability advocate. K.S., who has since deleted her Reddit account, also delved into her sexual fetishes, describing herself as a 'transgender baby' and a 'little' - someone who is attracted to diapers and 'obsessed' with urinary and fecal incontinence, loss of control in the bladder and bowels. There, she also claimed she designed her bedroom to reflect that of an eight-year-old girl, the outlet found. Many of her posts were made to the Adult Baby Diaper Lover (ABDL) on Reddit - a group where people are sexually aroused while acting like babies or children. K.S. has also spoken about her mental health struggles on the platform, detailing her suicidal ideations related to child abuse and little mental health support.
Vancouver Sun
24-04-2025
- Health
- Vancouver Sun
Ontario loses battle to refuse to pay for penis-sparing vaginoplasty for non-binary resident
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' who wishes to have both female and male genitalia. Article content Article content 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. Article content Article content Article content '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. Article content 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. Article content 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. Article content 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. Article content Article content 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. Article content Article content 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. Article content 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.
National Post
24-04-2025
- Health
- National Post
Ontario loses battle to refuse to pay for penis-sparing vaginoplasty for non-binary resident
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' who wishes to have both female and male genitalia. Article content 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. Article content Article content '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. Article content 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. Article content 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. Article content 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. Article content 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. Article content Article content 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. Article content 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. Article content 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. Article content 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.'
