Advocacy & Equity Priorities

Trans Manitoba Human Rights Complaint

Equitable Insured Public Health Benefits

Proposed Resolutions

Living Document

Current Version May 2021

Trans Manitoba calls upon the Manitoba Provincial Government to recognize and provide resources towards the health care priorities listed below. These issues broadly impact Manitobans and are not limited to the Two-Spirit, nonbinary, and transgender communities. All actions must be informed by best current practices and made with active and ongoing input from Two Spirit, nonbinary, and transgender Manitobans.

Trans Manitoba’s suggested resolutions include but are not limited to the following:

1. Establishment of provincially funded healthcare initiatives by and for Two-Spirit, nonbinary, and transgender people including the following:

   1. Centering of Two-Spirit, nonbinary, and transgender identities as primary participants;

   2. Creation of a standard of care that applies to both public and private medical practitioners and contractors, for all Two-Spirit, nonbinary, and transgender Manitobans, including pediatrics and youth, with clear guidelines for care providers and transparency for paths to obtaining care for patients, as well as a meaningful complaint process when these standards are breached;

   3. Creation of a specialized gender care clinic system that is accessible to rural and Northern peoples;

   4. Programming that ensures gender diverse patients understand their rights and how to access insured benefits;

   5. Full coverage of gender confirmation surgery protocols from intake to post-op care, including preparatory procedures (such as electrolysis or laser hair removal), mental health care before and after procedures, and at-home care or follow up as needed (such as that provided by a Public Health Nurse).

2. Recognition of transgender people as eligible for employment equity within the responding organizations.

3. Paid, trans-led, peer support workers available in all places where trans folks interface with the healthcare system.

4. Endorsement of and advocacy for a public school curriculum that is modern, sex-positive, and unambiguously inclusive of, but not limited to, the individual and familial experiences of the following peoples:

   1. Two-Spirit

   2. Indigiqueer

   3. Lesbian

   4. Gay

   5. Bisexual/pansexual

   6. Nonbinary, transgender, and gender non conforming

   7. Queer

   8. Intersex

   9. Asexual/Aromantic/Ace-Spectrum

5. In the administration of gender/sex designations, gendered imagery, and gendered language in all internal and outgoing client and patient-directed paperwork, posted mail, marketing, websites, publications, programming, both digital and physical, we require the province to begin with the process of creating and implementing with expediency:

   1. A nonbinary gender marker or option or removal of sex/gender markers on all forms, records, and identity documents;

   2. A free process for Manitobans to change their markers, of their own will, without medical validation;

   3. An examination of how sex and gender designations are recorded, assigned, and used by the government in order to best serve all Manitobans;

   4. A comprehensive audit and revision to a standardized guideline of body-centric and gender-inclusive language and imagery that does not reveal the patient’s personal information (such as in letters from Cancer Care/Cervix Check).

6. An eldercare strategy that meets the needs of Two-Spirit, nonbinary, and transgender seniors population [this falls under MB Health/ Healthy Living & Seniors].

7. Removal of legal change of name from publication in the Manitoba Gazette.

8. Addictions and mental health care covered by Manitoba Health as insured benefits under primary care.

9. Financial aid that removes barriers for Two-Spirit, nonbinary and transgender Manitobans to obtain educational and professional opportunities in healthcare.

10. An examination of the relationship between social determinants for Two-spirit, nonbinary, and transgender Manitobans and public health outcomes, to be followed by action to removing barriers to care.

11. A transparent, functional, accessible process for complaints to the college of physicians.

12. An actionable commitment to meaningful, ongoing community stakeholder engagement with Two Spirit, nonbinary, and transgender Manitobans.

13. Insured coverage for the following items:

    1. Medically necessary and gender-affirming medications and medical support devices;

    2. All post-surgical care supports and accessories, including those needed in the treatment of complications from gender-confirmation surgery.

14. Gender-inclusive washrooms in all facilities, with appropriate signage that indicates the designation and provides an explanation for the need for an inclusive washroom (see the University of Winnipeg for a positive example).

15. Financial compensation for 2SLGBTTQ+ stakeholders contributing to correcting these historic deficiencies in the health care we are currently offered.

16. Medical benefits for employees of respondents that support gender-affirming care and mental health care, including training for EAP providers.

17. All Manitobans, including incarcerated people, to have access to this care.

18. All services available in-province by [agreed upon timeline]; until then, up-front coverage for travel and complete post-surgical care out-of-province.

19. A strategy for reducing wait times for all gender-related care so that harm and psychological trauma experienced while waiting for care are eliminated or meaningfully reduced.

20. Removal of the psychological evaluation process from gender-confirming care for youth and adults, to be replaced with holistic mental health care as part of primary care.

21. Elimination of an “approved provider list” for gender-related care, under the premise that all care providers will become competent to provide gender-related care in Manitoba.

22. Pre and post natal care that is explicitly gender inclusive.

23. Removal of all document service fees related to sex and gender.

24. Removal of “living as your chosen gender” as a barrier to care.