If your only interaction with the transgender community was through media coverage, you might well think the biggest problem its members faced in recent months was not being allowed – at least at first – to compete in a beauty pageant.
But despite the well-publicized plight and eventual triumph of Vancouver Pride parade grand marshal Jenna Talackova, advocates say the transgender community's push for equality remains decades behind even the gay rights movement, particularly in British Columbia.
Beyond the daily slights – glares in public bathrooms, being called "sir" when you identify as anything but – there are the long-term problems, most importantly the fact that reassignment surgery is not available in B.C. and the province does not cover the costs for all people.
While such provinces as Alberta and Ontario cover the cost of surgery whether the procedure is a vaginoplasty or phalloplasty, B.C. only picks up the tab for the former. (A vaginoplasty is the creation of a neo-vagina, labia and clitoris. A phalloplasty is the construction of a penis.)
B.C.'s Health Ministry says it is reviewing its coverage, but it's unclear when a decision will be made. The ministry also reviewed phalloplasty coverage in 2006 and 2010, with no change. The province has said complication rates remain high, though it's undercut that point by noting patient satisfaction is also high.
What's more, B.C. has a doctor trained in sex-reassignment surgery but, like other provinces, has its residents fly to Montreal for the procedure instead. Montreal is the only city in Canada in which a vaginoplasty or phalloplasty is performed.
B.C.'s lack of funding for phalloplasties – as well as its reluctance to have sex-reassignment surgeries conducted in the westernmost province, despite the fact Vancouver is something of a hub for transgender people – confounds advocates.
"Transgender is a new game," said Dara Parker, executive director of Qmunity, a resource for the lesbian, gay, trans, bi and queer communities. "Where we're at is about 20 years behind the gay rights movement."
Nanci Blu, who volunteers at Qmunity, plans to fly to Montreal in September for sex-reassignment surgery. Ms. Blu, 61, said she was 14 years old when she first realized she was transsexual. Her moment came after she saw another transsexual person on television. However, it wasn't until several decades later, in 2010, that Ms. Blu started dressing and living as a woman full-time.
"I started slowly. I started wearing a purse. I was still a biker, but then I'd add another piece of this or that. If I decided I'm going to wear this blouse but something made me think it was too risque, then I would go, 'No, don't wear that blouse,' and I took myself up step by step," she said in an interview.
Ms. Blu expressed frustration at having to cross the country to get her surgery.
"I have to fly out there and I have to stay there for awhile as I recuperate, and then I have to come back. I don't know what the percentage of people who've had complications after they got back to Vancouver is. They can no longer see the doctor first-hand," she said.
Marie Little, chair of the Trans Alliance Society, said one of her friends had a complication after getting the surgery and returning to Vancouver, but was able to get to another doctor in time.
Ms. Little said she's also met community members who had phalloplasties performed at their own expense, without any trouble. She scoffed at the B.C. government's reluctance to fund the procedure.
Spencer Chandra Herbert, the New Democratic Party MLA for Vancouver-West End, the riding in which the Pride parade is held, said he wrote to B.C. Health Minister Michael de Jong earlier this year asking why the province does not cover the phalloplasty cost. Nothing changed.
Mr. Chandra Hebert said flying people to Montreal not only takes them away from loved ones and out of their comfort zone, it also makes little sense financially.
While Pride is a great celebration for many, he said that's not the case for all.
"You talk to trans folks and they say it's not really a party for them. Their human rights are still not explicit. The level of discrimination, the level of understanding even of what being trans means, is still very lacking," he said. "There is still a fight there."
A spokesman for Mr. de Jong said the minister was unavailable for an interview.
Cameron Bowman, the Vancouver doctor trained in sex reassignment surgery, was on vacation and could not be reached for comment.