After about two years of what felt like hopeless dead ends and redirections, I have finally received my prescription for HRT.

It feels a bit surreal to process even now. I received my prescription Monday, July 27th, 2015 following my second appointment through the Ontario Telemedicine Network (essentially a Skype-esque service through hospitals and clinics in Northern Ontario so patients can connect with doctors outside of the region)- at the same clinic that was my previous stop in trying to seek HRT fruitlessly.

Living in Northwestern Ontario was one of the trickiest things to navigate, alongside identifying as non-binary and trying to articulate this to doctors opposed to the fake-it-till-you-make-it approach. I didn’t want to sound unauthentic in why I was seeking HRT, as I thought that might work against me in the eyes of the medical field more than not having the desire to identify solely as male. Any searching for clinics providing trans healthcare in Ontario lead mostly to the Toronto region – just shy of 1,500km from my hometown of Thunder Bay. Any personal recommendations were from folks currently living in Southern Ontario who can source a number of clinics, or access CAMH if that route is chosen, by mere transit or a relatively short train ride – not a four-hundred dollar plane ticket or two days of driving for each appointment.

I first spoke with my family doctor, Dr. R. Klassen, about wanting to begin HRT in the form of low-dose testosterone. She was very supportive, but was honest with me in saying she had no experience with prescribing hormone therapy. She referred me to the only endocrinologist (out of the two that are in the city) who would see trans patients  – but he refused to without the prior approval of a psychiatrist and subsequent documentation. After this lead nowhere, I gave the name of a doctor a friend had recommended in Toronto (their name escapes me now, as does the clinic they work out of) for Dr. Klassen to get in contact with. A few weeks later, I was told I couldn’t access treatment or prescriptions without living in the area. I then had my doctor refer me to Dr. Balek at NorWest Community Health Centre – the only local clinic that specifies queer healthcare within their practice. I met with Dr. Balek a month or so later. He was supportive, though stated they required the approval of a psychiatrist. With only one psychologist available, I had to wait eight months for an appointment.

Eight months felt completely wasted after the appointment turned out to be a train wreck of misgendering, insensitivity, stating readiness couldn’t be possible with past abuse – I can’t really summarize it all, but he suggested I see a counselor at the clinic before seeing him again. I wasn’t interested in this as I had accessed their counselling services prior and found it to be more harmful to me at the time and difficult for me to experience benefit. This felt like the heaviest dead end – a doctor willing to support a trans patient but not knowing how to medically, inaccessible exclusive endocrinologist, doctors in Southern Ontario not able to provide distance care, being denied by the only available local clinic. I felt like there weren’t any other real options other than waiting the two years for an appointment at CAMH, and spending hundreds upon hundreds of dollars in travel to attend the multiple appointments without any real guarantee (I didn’t feel confident in accessing HRT through CAMH due to identifying as non-binary, and sourcing experiences of those who identify similarly trying to navigate CAMH, they were not that of obtaining a prescription).

A few months passed, and the Canadian Universities Queer Services Conference had suddenly appeared again. I had attended the year before in Ottawa, and as an alumni requested subsidy from my campus’ Gender Issues Centre at Lakehead University to attend. Thankfully, I found myself in Toronto a few weeks later sharing a room with a good friend I had not seen since the last conference and in a state of more solidified self-understanding than my last attendance. Discussions were heavy, important, exhausting, relieving, providing of solidarity, difficult, frustrating, positive, negative, powerful, soothing, and everything else in between. In a group discussion, I had briefly mentioned the struggle of obtaining HRT in the North while leading into other topics, and a very kind individual in the room apparently took note.

This individual, who I’ll call V, sat down next to me during an outdoor lunch for the conference later that day, and simply asked and confirmed that I was seeking HRT but having a lot of difficulty. They gave me an email, written on a piece of torn graph paper, of a Toronto doctor they had seen through the Ontario Telemedicine Network from their hometown to obtain a prescription and care. This doctor was trans positive, non-binary positive, and committed to providing care for trans patients. I really couldn’t believe that this doctor existed, and could also be sourced from a distance. As per V’s suggestion, I returned home from the conference and immediately sent an email to Dr. Blair Voyvodic. I quickly had an appointment at the Thunder Bay Regional Health Sciences Centre through the OTN.

Our initial appointment was quite possibly the most affirming experience of my life. He asked many questions, a lot that could feel cumbersome and emotionally complex, but in a way that felt genuine, sincere, and compassionate. The appointment was one hour, and in that time Blair took the time to hear what I was seeking, understand as much as he could about my identity to gain some ground about myself, etc. But at the start of the appointment and throughout, he made it incredibly clear that I was not there to “prove myself” or “prove my gender” to him. He made it clear he understood that non-binary trans folks often have difficulty accessing trans health care, and that he was there to support and assist.

He provided a referral for blood work and requested I get in touch with my family doctor so they could communicate prior to and during HRT. I signed a consent form at my family doctor’s office to permit the exchange of information between her and Blair, completed the blood work the day I received the referral via email, and waited for the second OTN meeting that I had booked with Blair during the first appointment. This waiting felt incredibly different than waiting for past appointments – it felt hopeful, optimistic, warm; I was looking forward to it. To put a time frame to this: I initially emailed Blair on June 1st, had connected with his office and had an appointment booked by June 15th, had the first OTN appointment on July 9th, and had my second appointment on July 27th where I was written a prescription for low-dose testosterone. From June 1st to July 27th was the length of the entire process – nine weeks to progress and surpass what could not be done in two years prior.

It’s now 4:58AM on July 30th, and I guess that makes me approaching three days on LD testosterone.

Trans folks don’t merely exist – we survive. Survival was given to me on a torn piece of graph paper.

Thank you, V.

Survive and thrive,
B