Nova Scotia facilitates sex changes with free 'readiness letters' from health service

There is a nurse available to teach female patients how to inject themselves with testosterone, and the service also helps make arrangements for sex change surgeries that take place in Montreal.

Mia Ashton Montreal QC

A health service in Halifax, Nova Scotia has announced that a social worker will be available for the next several months to provide free “readiness letters” for people seeking experimental sex changes in the province.

The Halifax Sexual Health Centre (HSHC) shared a “new service alert” on its Instagram account Tuesday stating that thanks to the Mental Health Foundation, the service will be offering “psychosocial assessments” which it defines as “readiness letters” for hormone therapy and gender-affirming surgeries.

No referral is necessary to access this new service, and appointments are offered both in-person and online.

On their website, the HSHC states it “can help with any aspect of a person’s transition, including the MSI (Medical Services Insurance) approval process and surgical arrangements.”

The HSHC dishes out experimental cross-sex hormones to those 18 and over who believe themselves to be members of the opposite sex, and all it takes is two visits before a patient can embark upon a life-altering and irreversible medical pathway.

The first visit is a “meet and greet” that involves a discussion of “transition goals,” a review of health history and a physical exam. If all is well, consent forms are signed on the second visit and the patient walks out with a prescription for hormones.

There is a nurse available to teach female patients how to inject themselves with testosterone, and the service also helps make arrangements for sex change surgeries that take place in Montreal.

Under-18s are told they can access gender-affirming care through the IWK Trans Health Care Team. A “Navigating Trans and Gender-diverse Health Care” information guide put together by prideHealth and the IWK team gives gender-confused youth advice on tucking their penises and binding their breasts, and provides links for websites that supply “packers,” “breast forms,” and “binders.” 

Boys who identify as girls are advised to wear a “gaff,” which is described as “a garment similar to underwear that gives the wearer the appearance of a flat crotch.” The recommendation comes with “important safety considerations: Tucking for long periods of time can cut off blood circulation and can also cause skin issues, irritation from friction, and/or fungal infection.” 

“There’s not a lot of research on the safety and practice of tucking,” says the guide, but this doesn’t stop them from recommending the practice to minors.

Girls who believe themselves to be boys are advised to bind their breasts and dye their sparse facial hair to give it a thicker appearance. There is also information about “packers,” which are prosthetic penises that can be placed in underwear. Some even make it possible to pee standing up, called Stand To Pee, and others “double as a flaccid penis and as an item that allows the wearer to engage in penetrative sex, known as a Pack and Play Packer.”

There’s advice on how to obtain “gender-affirming hormones,” without a “psychosocial assessment” beforehand under what is known as the “informed consent model.” This model views psychological assessments as unnecessary barriers to care and instead simply requires that young people sign a consent form saying they understand the side effects and risks of cross-sex hormones before treatment commences. The consent forms typically mention nothing about the rising rates of detransition or the effectiveness of psychotherapy as an alternative treatment.

“The informed consent model respects a trans person's right to self-determination. It does not rely on a diagnosis of gender dysphoria as a prerequisite to prescribing hormone therapy,” the website informs young people seeking sex changes.

If for any reason a young person cannot obtain hormones via this model, the service offers an assessment by a “WPATH-SoC trained clinician.” The World Professional Association for Transgender Health (WPATH), the group that recently added eunuch as a valid gender identity even children can possess, advocates for adolescents to have access to experimental sex changes despite its president recently acknowledging that social contagion is driving the huge surge in young people identifying as transgender.

A shopping list of sex change surgeries is available for gender-distressed minors to peruse, although aside from medically unnecessary bilateral mastectomies that are offered to 16-year-olds, all others require a young person to be at least 18 years of age.

Once at the age of majority though, the service will help with arrangements for phalloplasty surgery, which is an extreme, radical procedure involving stripping the forearm or thigh of skin and flesh and constructing a non-functional appendage resembling a penis. This surgery comes with an extremely high risk of serious complications.

Also on the list is vaginoplasty, which is where surgeons amputate the penis and use the penile tissue, or sometimes sections of the patient’s intestines, to construct a cavity that is supposed to resemble a vagina. Like phalloplasty, this too comes with a high risk of complications.

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