Jesiah MacDonald wants a human chest.
Without chest contouring after a mastectomy for his surgical transition from female to male, he won’t have one, he says.
Last month, the province announced it would begin funding eight surgeries associated with sex reassignment, one of which is a mastectomy.
However, they’re not funding chest masculinization, a decision MacDonald believes is ill advised.
“I think that they’re on the right page, but they haven’t figured out how to help the most people. And I think it’s because they’re looking at it wrong. They’re looking at it like, ‘there’s an excess on this body that we need to get rid of,’ rather than, ‘we need to reconfigure this part of the body,’ the 26-year-old transgender Trenton man says.
The province will be funding nipple-sparring mastectomies, a procedure that saves the nipple while breast tissue is removed.
Although this provides the result MacDonald would be looking for, he says it’s only an option for those starting with a B cup or less.
Christine Gibbons, acting director of policy and planning with the Department of Health and Wellness, says the decision on what to fund comes from examining the needs of the community and what other provinces fund.
“We did a comprehensive assessment of what other jurisdictions are covering. We spoke with members of the community; we spoke with medical professionals. We determined what we thought were the major surgeries that community members would need in order to transition.”
MacDonald began transitioning when he was 18, starting hormone injections and coming out as transgender to his family.
“It was a few months after I started doing research and accepted it for myself that I talked to my mother. And it made sense to her. Even at that point, I had come out to her as a lesbian and she wasn’t comfortable with that … It almost seemed to comfort her because it made sense to her,” he says.
He hadn’t known much about trans sexuality before that point, and as he researched it, he said his life made more sense.
His physical transition began shortly before he turned 19, taking a few months to kick in before he seemed like a prepubescent boy, complete with a cracking voice and little concentration.
His muscle tone changed, grew facial hair, developed a different smell and went up a shoe size.
His group of friends stayed the same, as did his behavior.
“I never did stereotypical girl things. So I guess what made it easier for me is I didn’t have to learn how to be a boy. I just do the same things, wear the same clothes. Maybe that’s what makes it so hard for some people to understand - the ones who would think it’s a choice; they would assume that a person would change their whole life, activities to do that.”
Although he hasn’t had much of a social struggle, staying in the same body has been more than he could handle at times, he says, pushing him to dire straits such as growing marijuana in order to fund his surgery.
He pleaded guilty to producing the drug in 2013, avoiding jail time because of his unique circumstances.
“It was an act of desperation. I wouldn’t have ended up trying to grow marijuana, if I hadn’t tried to kill myself the summer before because I was tired of waiting.”
During his transition, MacDonald has also been in the middle of an ongoing legal battle with the province’s Medical Services Insurance after receiving a bill for a hysterectomy in 2010 he says was medically necessary due to a family history of ovarian cysts.
Now, he’s keeping himself busy with a non-profit organization he created, Nova Scotia Trans Justice.
Through the group, he wants to support the trans community in the province and provide information services.
“We’re developing our own parental resource. If your kid comes out to you, there are a lot of questions. I just knew that my mother wasn’t comfortable going on Google and trying to find out things for herself, and I would imagine there’s a lot that are like that.”
He’s still trying to fund his chest surgery, but in legal ways.
MacDonald set up a crowd funding campaign on Indiegogo so he could get the procedure done in Nova Scotia.
“Some of my trans friends have said you can’t put all your eggs in one basket. What if you don’t feel better after you have your top surgery? But I can’t see that being the case.”
MacDonald could leave the province to have the procedure done all at once, travel costs and the price of a mastectomy covered, and pay for chest contouring out of pocket – an option that’s not ideal for him as he doesn’t fly well and doesn’t want the added stress.
Gibbons notes that only a few provinces cover chest contouring, and they’re major jurisdictions, such as British Columbia and Ontario, that typically have broad coverage in all aspects of health coverage.
On Twitter: @NGNewsAmanda