Some Ontario doctors are concerned about a change in the Ontario health system that could limit how many patients get access to gender-affirming virtual health care.
Several of the doctors have signed up to a Change.Org petition because they're not happy with a new fee schedule between physicians and the Ontario government, for virtual medical appointments involving people who are transgender and seeking specialized care.
The new OHIP schedule will pay $20 for a video appointment and $15 for a telephone appointment, which is part of the Physician Services Agreement ratified by the province and the Ontario Medical Association earlier this year. One Toronto media report said the OHIP billing fee for a regular in-office visit is $63.
The new deal comes into effect on December 1, 2022.
One of the key treatment facilities is the Connect-Clinic in Toronto. It's where patients across Ontario can call in or do a video consultation with health-care providers — which provides virtual gender-affirming care to patients across Ontario — have launched a petition urging the Ministry of Health to protect access to virtual care.
The Connect-Clinic was established in 2019, before COVID happened and before virtual care became so widely accepted. The clinic said it currently has about 1,500 registered patients and roughly 2,000 more on the waitlist.
The clinic said virtual care is a preferred method to access care for many trans and gender diverse people since it is a safe way to connect with competent and inclusive physicians, especially for those who do not live in large cities.
In Sudbury, there is gender-affirming care available through the Réseau ACCESS Network, which is a non-profit, community-based charitable health promotion organization.
Aspen Groom (pronouns They, Them) is the Sexual Health coordinator at Réseau. Groom said accessing any sort of gender-affirming care is difficult and added virtuial care it is not always the best solution.
"Gaining access to gender-affirming health care in Ontario is challenging. Virtual care for transgender folks has really acted as a Band-Aid solution that has allowed transgender folks to get the care they need. I say “Band-Aid" because it meets the immediate needs of patients by providing them access to hormones or gender-affirming surgery, which is life-saving care, but often does not offer the best long-term care options for patients," said Groom.
They added that changing access to a health service in high demand and without alternative options is leaving people to their own devices. Groom added that the onus is on the government to step up and provide better health care.
"If the government is indicating by this decision that in-person appointments are better for patients, then they need to be providing more funding for gender-affirming care clinics, and to train more family doctors so that they feel empowered to offer these services," said Groom.
To provide some context on the Sudbury situation, the Gender Affirming Service Clinic out of Réseau ACCESS Network operates completely on fundraised dollars, Groom continued.
“We offer this service because of an extensive community need and after only being open since July 2022 we have a two-to-three month wait for appointments.” they added.
“Our services are by self-referral, and we are finding that is connecting us with folks who have struggled to gain access to care in the past, which is great, but if we want to continue or expand this service, we will need more funding and from avenues that will be more reliable year over year.”
