Good afternoon, everyone.
I want to begin by thanking all the committee members. I am very happy to be here. The fact that we have an opportunity to discuss these issues together and to ask ourselves questions is really important for democracy. Thank you very much for giving us this opportunity. I also want to thank the support staff here today, as well as the interpreters and other language professionals who make it possible for me to express myself in my language. Thank you very much.
My name is Joël Xavier. I am Franco-Ontarian by birth, but a Quebecker by adoption. I am a gay man and a trans individual. Yes, we can in fact represent two letters of the acronym. It is possible. In life, I have had an opportunity to be both trans and gay. Some may say that I am doubly stigmatized, but I think I am doubly lucky. As a Canadian citizen, I am personally, professionally and educationally affected by these issues. Currently, I sit on the board of directors of the Quebec LGBT council. It is in that capacity—as an administrator, a board of directors member—that I will make my presentation today.
You can ask questions afterwards in English or French. It's fine.
The Quebec LGBT council, as a group, represents 35 organizations that defend LGBT+ rights and interests in Quebec in a context of social transformation. We have a consultative approach, which means that we consult our members and report on their projects, interests and priorities. We advocate, on a provincial level, for rights and the defence of interests. We cover all of Quebec and a population consisting of francophones, anglophones and allophones. Our perspective is intersectional. As my colleague said earlier, that means we take into account the way social and health determinants can be crossed and have an impact. That is important because we are not only LGBT. We are also individuals with a life, a certain age, cultural heritage, and so on.
Our consultations and research enable us to see, like you surely do, that the relationship between LGBT+ individuals and the health care system is not doing well. It is difficult for us to access health care. There are a number of structural and interpersonal causes, as well as causes such as regional remoteness. Like my colleagues have said, most services are available only in major urban centres. But we feel that people shouldn't have to move to Montreal or to Quebec City to receive care as LGBTQ individuals. Our community encompasses all layers of society. We should not be considered as exceptions, individuals who are very particular and difficult to understand. We are Canadians like everyone else.
This loss of trust is not new. Although many advances have been made in terms of rights, and people are becoming increasingly informed, there is a lack of research concerning namely the expertise of people who belong to the LGBTQ community themselves and stakeholders on the ground. It is difficult to obtain information to defend our rights. We feel that more money should be dedicated to research. I am also thinking of the men, women and non-binary individuals I know who are in their sixties and carry with them all sorts of traumatic experiences. Difficulty trusting the health care system is an experience we are going through. If we are told that we are strange, that we have something bad in us and our identity is considered pathological—which is still done in Canada—it is certain that we will not trust the health care system. A lot of time and efforts are needed to overcome those difficulties. For trans people, especially, access to health care is still very difficult.
If you read the briefs and testimony concerning bills 35 and 103, in Quebec, you will see that a lot of work remains to be done. Since 2009 in Quebec, certain gender affirming surgeries, for trans individuals, have been paid for by the government through the province's health insurance plan, RAMQ. However, to have access to those surgeries, trans individuals must still provide a psychiatric assessment and pay for it themselves. It can cost up to $1,000 or even more to obtain a psychiatric assessment before having access to gender affirming surgery. That is not the case for someone with cancer who undergoes a mastectomy. That person will not be asked to provide a psychiatric assessment. So inequalities exist in that respect. There also factors that render the system ineffective.
Simply in terms of the general health of trans individuals, we see in an Ontario study—but the same thing is seen in Quebec—that about 30% of trans individuals still do not go to emergency services for a medical emergency because they fear discrimination. As a result, our health problems build up because we are afraid of health care providers. Without access to that care, our health deteriorates. We end up going to the hospital when we are really forced to. That leads to costs for the system. As my colleagues were saying, the lack of prevention leads to long-term costs for the system.
We have a few recommendations to make. How much time do I have left?