Transgender student denied coverage for hormone therapy says policy is ‘rooted in transphobia’

Jiya Chandan is a Memorial University student from India. Chandan is transgender and is taking hormone replacement therapy. (Henrike Wilhelm / CBC)

When Memorial University student Jiya Chandan learned that her insurance provider does not cover the medication she needs as a transgender person, she did not think much about it.

But her perspective changed as her doctor questioned the lack of coverage.

“I realized it’s not true that it’s something I would not have thought about because I’m so used to these barriers, but it’s not okay,” Chandan said.

Chandan enrolled in MUN as an international student from India to study political science and has been taking hormones for almost three years.

The drug is a combination of testosterone blockers and estrogen supplements taken by many transgender people.

While Chandan was enrolled in Green Shield Insurance, which is offered to a majority of MUN students, about 70 percent of medical expenses were covered.

However, only students with a valid MCP can enroll in the Green Shield.

When Chandan’s MCP expired, she was forced to switch to Guard Me, the insurance provider used by many international students at MUN.

Now, Chandan herself has to pay the full cost of the therapy – about $ 70 a month – something she has not always been able to.

“I have had to skip doses, or I have had to make a one-month dose last for two months by taking it every other day,” Chandan said.

“It’s not ideal to do. There may be negative risks to your body, but those are just risks I have to be willing to take because I would rather have partial hormone medication than none.”

Mackenzie Broders is the trans student representative at the Canadian Federation of Students in NL

Broders says it is “shocking” to hear that Chandan does not have adequate access to hormone therapy.

“Gender-confirming health care in all forms should be covered, especially hormone therapy,” Broders said.

“It is often the most accessible and the first available form of health care for transgender people. And then having that coverage of all health insurance … it is absolutely necessary and there is no excuse for why it is not covered.”

Hormone therapy, Broders says, is essential for many transgender people as it relieves gender dysphoria.

“It’s often not only life-changing, but life-saving,” Broders said.

“It’s not something that would be difficult to cover. It’s something that is very accessible, and the barriers that are in place around it are not necessarily necessary.”

According to Planned Parenthood, gender dysphoria is “the distress, unhappiness, and anxiety that transgender people may feel about the mismatch between their body and their gender identity.”

And so Chandan felt as she stretched out her medicine.

“Disagreements in how I feel about my body and how I want to feel about my body,” Chandan said.

“I could see more masculine aspects of my body starting to become visible that I had not seen in the last year and a half when I was on my full dose.”

When it was time for Chandan to repurchase the insurance three months ago, she contacted Guard Me with the help of MUN’s Internationalization Office – and after the insurance provider’s response, she opted out.

Mackenzie Broders is a representative of trans students in the Canadian Federation of Students in Newfoundland and Labrador. Broders says transgender students need better access to appropriate health care. (Henrike Wilhelm / CBC)

In an email to the office, Guard Me said: “The policy covers medically necessary services required to treat eligible medical conditions. Transitional treatments such as hormone therapy do not meet the eligibility criteria as it is considered optional.”

Chandan calls the wording “painful.”

“They call it an optional procedure when for many transgender people, access to hormones can be life-saving,” Chandan said.

“It’s really discouraging to see it, and it seems that politics is to some extent rooted in transphobia.”

The insurance policy, Chandan says, is worrying.

“Why [does] a major insurance provider that acts as an insurance provider for a large majority of international students across Canada does not provide transgender health care to people? ”said Chandan.

According to Guard Me’s website, it is “a leading provider of international student health insurance.” Guard Me did not respond to CBC News interview requests.

But Chandan is also critical of the eligibility criteria for the provincial MCP.

“If you have such eight months [in your studies] back and your MCP expires, there are many times they will outright refuse to renew it, “Chandan said.

“There’s a big gap of students who are without MCP. And more than students, a lot of people going into the job market, international students after graduation … It’s definitely something to worry about.”

Health Minister John Haggie was not available for an interview on the eligibility requirements for MCP. The Ministry of Health told CBC News that it would make a statement on the issue, but after a week it still has not.

Broders agrees with Chandan that transhealth care is an area that needs to be improved on and off campus.

“Here in the province, it’s extremely difficult to access a lot of gender-confirming treatment, and there are only certain doctors who will even prescribe hormone therapy. And of course, you have to have an MCP card to see many of them,” Broders said.

“It is difficult for people of all genders and orientations to access the care they need just across the board.”

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