Nova Scotia will now cover the cost of top surgery for non-binary folk in landmark move for inclusive healthcare

Non-binary legal recognition too 'complex' to introduce, government says

The Canadian province of Nova Scotia has announced that it will cover the cost of top surgery for non-binary people through its Medical Services Insurance (MSI).

Nova Scotia’s insurance programme is “designed to provide eligible residents with coverage for medically required hospital, medical, dental and optometric services”.

In June, 2019, the Nova Scotia government announced it would begin covering top surgery for trans women, having previously only provided it for trans men.

But now, effective 2 November 2, non-binary residents will also be able to access surgery for free.

According to CBC, the change came after Sebastian Gaskarth, who is non-binary, filed a complaint with the Nova Scotia Human Rights Commission in 2019 after they were denied surgery.

Gaskarth said they feel “relieved” and “really happy” about the change, and added: “It just affirms who I am as a person and for [whoever] else needs the surgery as well.”

They said that the decision was not just about surgery, but also about MSI publicly acknowledging that gender is not binary.

“Which is huge,” they said, “which will hopefully propel MSI and other organisations to start to be more inclusive and to see things beyond the binary.”

However, they told local radio station NEWS 95.7: “I’m happy that I’m able to share my story, but I would hope that MSI, moving forward, would be more proactive in changing and supporting trans individuals so it’s not a matter of people having to go through this process to human rights complaints to make sure that they are getting the support that they need.”

Community legal worker Mark Culligan told CBC that the change was a “real milestone”, and said: “The previous coverage was based on the understanding that transitioning happens from male to female, from female to male, and what was unique about Sebastian’s case was that they were asking for a surgery that more accurately reflected their identity as a non-binary individual.”

In July last year, Nova Scotia rolled out non-binary and gender-free options on ID documents, allowing residents to choose X as a gender, or choose not to display a gender, on their provincial driver’s licenses, birth certificates and photo ID cards.

At the time, Patricia Arab, the minister of internal services, said: “A priority for our government is making sure we are as inclusive and diverse as possible, and making sure all our residents feel safe and that they have a place here.

“This isn’t the last step in the conversation but it’s certainly a significant move to make sure that we have a safe and inclusive community here in our province.”