GENDER DYSPHORIA

Appropriate training required to assess patients who want sex reassignment surgery

PHOTO : iSTOCKPHOTO . COM

Physicians are reminded of their responsibilities and the training requirements needed when completing prior approval forms and assessments in support of a patient ' s request for OHIP insured sex reassignment surgery ( SRS ). The Ministry of Health and Long-Term Care has told the College that it has encountered instances where physicians have completed the form and assessed patients without having the necessary training in this area of expertise . A provider must be trained in the assessment , diagnosis , and treatment of gender dysphoria in accordance with the World Professional Association for Transgendered Health ( WPATH ) Standards of Care that are in place at the time of the recommendation for Sex Reassignment Surgery ( SRS ). In light of this , the College is reminding physicians that they must have training in the WPATH standards of care to accurately assess their patients for sex reassignment surgery . In 2016 , Ontario expanded access to medically necessary sex reassignment surgery by allowing qualified providers throughout the province to assess patients and recommend them for surgery . The criteria for OHIP insured SRS are set out in the Schedule of Benefits for Physician Services , Appendix D , under Regulation 552 of the Health Insurance Act . Prior approval from the Ministry of Health and Long-Term Care is required in order for the service to be insured . Depending on the type of surgery sought , a prior authorization request completed by a physician or nurse practitioner must include either one or two supporting assessment ( s ) from appropriately trained providers confirming that OHIP ' s funding criteria are met . The second or supporting assessment must come from a different , appropriately trained Ontario physician , nurse practitioner or a registered nurse , registered psychologist , or registered social worker . The Ministry has developed a website dedicated to providing health-care professionals with information about SRS and OHIP . This website can be accessed at : http :// www . health . gov . on . ca . Physicians seeking training in transgendered health care and WPATH standards of care can contact Rainbow Health Ontario . MD

ISSUE 2 , 2018 DIALOGUE 35