Care & Services for Gender Diverse Individuals
Some of the clients we see are adolescents, and this would be a time when sex characteristics are starting to physically show. The inconsistency of sex assigned at birth and gender identity creates distress and we expedite referrals. We work closely with the Northern Gender Clinic and support the use of puberty-blockers. The goals of hormone therapy are to induce feminizing or masculinizing changes, and each person individualizes the end points of treatment. We take into consideration a variety of factors, such as social and economic issues, medical conditions and the risk/benefit ratios of certain medications.
We involve the client in making informed decisions guiding their healthcare. We recognize the importance of family members as support and welcome their attendance during the consultation. Geographically remote clients who need to have a consult may request a telehealth appointment.
Some of our clients experience nuisance bleeding and need menstrual suppression (in the form of injectable medroxyprogesterone every 12 weeks or the Mirena intrauterine device which is effective for 5 years) that can be utilized in addition to their testosterone injections. In some instances, we have clients who need our help to provide operating room access to have these intrauterine devices inserted with anesthesia support, to lessen the discomfort and dysphoria of this kind of procedure.
For surgery, the pros and cons of hysterectomy +- ovary removal are discussed. If there is a desire to use the ovaries for fertility in IVF, or to support bones against osteoporosis should one stop using testosterone, then one could consider having one or both ovaries left in place.
Routine gynecologic care is hard to define in the gender diverse population. There is an absence of medical evidence in support of different types and frequencies of cancer screening for organ systems associated with sex: for cervical cancer or prostate cancer we do not have guidelines to outline our testing so for now we use best evidence guided practice.
Standards of Care for the Health of Transsexual, Transgender, and Gender-Nonconforming People, WPATH 7th version, 2012. *waiting for SOC version 8 coming out this year
Gender affirming surgery
We have experience with offering gender-affirming surgery for transgender male clients who wish to have pre-surgical consultation for hysterectomies. We work closely with the surgical assessors in Prince George and Northern Health Authority to ensure patients have a multi-disciplinary approach to care. Clients who need gynecologic care are treated sensitively and we have made efforts in making our team knowledgeable and inviting to all.
Sperm & egg banking
We are also able to show to discuss with clients their options for egg and sperm banking in order to preserve their possibilities for having a family in the future if this is important to them.
We use mostly fresh sperm samples when performing intrauterine insemination procedures, but our laboratory does not yet have capability to freeze and store sperm long term. We can give advice and pricing to individuals wishing to freeze their sperm. Clients can produce and have their sperm frozen at our affiliate clinic, Olive Fertility Centre, in Vancouver
Egg banking is used to provide options to preserve eggs at their current age and freeze them for future use. Clients can have their eggs frozen at our affiliate clinic, Olive Fertility Centre in Vancouver. In this process you would go through ovarian stimulation to produce multiple eggs. Blossom can lessen the financial burden of how many days you need to spend in Vancouver by monitoring the stimulation phase with ultrasound in our Prince George clinic. Patients would then go to Vancouver to have the eggs retrieval where the eggs are removed from the ovaries and frozen. Clients can book an appointment to learn more about this option and if it is a suitable option for them. The consultation is covered by MSP if you have a referral.