How to Change the Sex Designation Marker
I've written a post (or two) about changing one's sex/gender marker on one's Canadian Passport. (For this post, I'm just going to use "sex" instead of sex/gender or any alternative.) This post is about changing one's sex designation on a British Columbia birth certificate. That's my province of birth, and it's the one with which I have the most experience. Others have been writing about the Ontario process (which, by the way, doesn't require genital surgery -- although how the bureaucracy is handling the cases is pretty poor). I'm including some files that aren't available elsewhere (that I'm aware of) on the web. I had to obtain them through email from the BC Vital Statistics Agency. [...]
This will be a rather short, to the business post. Here are the three forms you need to fill out:
In a previous post, I wrote a bit about how much better Ontario's new rules are (even if the implementation is turning out to be horrible), but BC still requires genital surgery in order for trans* people to have the basic (Canadian) human right of gender-congruent identification.
You may notice that I say "genital surgery" and never use terms like "sex change" (this is the worst of them all: never use it), "sex reassignment surgery," "gender confirmation surgery," "gender reassignment surgery," and so on. Why? Because neither sex nor gender are determined by one's genitals. So let's call it what it is: genital surgery (for trans* women, at least. Trans* men would call it "bottom" surgery to separate it from "top" surgeries such as mastectomies and chest sculpting, and to allow for non-genital "bottom" surgeries). Language is important.
What genital surgery BC requires is never, of course, specified. But they seem to need, at a minimum, bilateral orchidectomy (removal of testicals), and very likely penectomy and labiaplasty. If one goes for a standard genital surgery package from a surgeon (almost everyone goes to a specialist in these procedures), trans* women typically receive: bilateral orchidectomy, penectomy, urethral opening reconstruction, labiaplasty, and vaginaplasty (and some ancillary procedures).
Good surgeons will be prepared to fill out the form required of them (the 2nd form), and will have their own supporting documentation to provide the patient. The form requires a signed photocopy of the surgeon's medical license. Some surgeons actually give you a certificate (used for these legal purposes), which is a little funny: it certifies the patient as an infertile woman, and it's printed on heavy card stock...like an actual certificate. I found that really funny, but I have an odd sense of humour sometimes.
Most patients travel quite a long way for the best surgeons. There's one in Montreal, Canada, a couple in the USA, and most of the top surgeons (usually only the top two are referred to, though) are in Thailand. The latter pioneered the next generation technique, while the former typically use a technique used for decades. It's also expensive. When one accounts for travel, hotel, food, extra medical supplies, and the surgical fees, we're talking $18,000 for a good Thai surgeon, and even more for a Canadian or American one. (Even though the Thai surgeons are often considered superior, the cost of living is cheaper, which explains the cheaper cost. But one has to travel a much further distance, to -- for a North American -- a country much more foreign than, for a Canadian, the USA. But hey, some of us are adventurous, and the travel is a benefit, not a cost...except for the ~22hrs of travel, each way. If you can spring for business class on the return trip, I very highly recommend it: the lie down seats make a big difference to comfort). Oh yeah, and you're there for a month: minimum 3-4 days pre-surgery, and 3 weeks post-surgery.
The great indignity of the process for changing one's birth certificate, under the BC procedure, is that one not only needs the paperwork from the surgeon, but one also needs a Canadian physician to inspect the patient to confirm that the surgeries were in fact performed.
I'm not kidding: you make an appointment. They inspect you. And then they sign off on the 3rd form that I linked. I think that the physician should at least give the patient one of those "Inspected by ___" stickers you sometimes find in clothes. (I know, there's that goofy sense of humour again!)
But there you go. Those are the forms one needs, and the procedure is pretty straightforward, even though it's (more than) a little demeaning, and it's certainly a form of adverse affect discrimination, and I really hope that other provinces will follow Ontario's lead (though not their example in a better policy's implementation).