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Prior to May 2002, services for transgender people in BC were provided by the Gender Dysphoria Program at Vancouver Hospital (also known as the "Gender Clinic"). The Gender Clinic, established in the early 1980s by Dr. Diane Watson, focused on the assessment and treatment of people who met psychiatric criteria for "Gender Identity Disorder". As part of the Centre for Sexual Medicine, the Gender Clinic offered endocrinological, urological/gynecological, psychiatric, psychological, and social services, and was the sole gatekeeper for public health coverage for transition-related surgeries.
In May 2002, as a result of budget constraints, Vancouver Hospital made cuts throughout the Department of Psychiatry, including several staff positions at the Gender Clinic. The remaining staff felt the Clinic could not continue to provide service and announced the closure of the program. The closure of the Gender Clinic left people unsure where to get care, and unable to apply for public health funding for surgery.
When the Gender Clinic's closure was announced, an ad hoc coalition of community organizations contacted staff at the Gender Clinic and health planners at Vancouver Coastal Health (the health region that managed the Gender Clinic) to request that the transgender community be involved in redesigning services.
In July 2002, representatives from the BC FTM Network/FTM Etc, the Cornbury Society, Trans/Action, Trans Alliance Society, Transcend, the Women/Trans Dialogue Planning Committee, and the Zenith Foundation started working with health planners from Vancouver Coastal Health and Vancouver Hospital to obtain community input.
In September 2002, a province-wide survey was launched to get feedback from transgender people and loved ones). Over 180 people participated.
In December, Vancouver Coastal Health announced it had hired a consultant, psychiatrist Dr. Lili Kopala, to create a framework for the implementation of a new transgender service.
In February 2003, a transgender community member completed a review of research on best practices for the delivery of transition/crossdressing services, and compared models from 35 services in other regions. This report was submitted to Dr. Kopala to assist her in the consultation process.
In March 2003, Dr. Kopala met with key people involved in transition/crossdressing services -- including bureaucrats within Vancouver Coastal Health and the Medical Services Plan (MSP), service providers, representatives from transgender community organizations, and staff from the former Gender Clinic.
In April 2003, Dr. Kopala completed a report summarizing the results of the survey, focus groups, and interviews with service users and service providers, as well as the review of literature on transgender health needs, standards of care, and models for service delivery.
In June 2003, Vancouver Coastal Health launched a new program based on Dr. Kopala's Recommendations for a Transgender Health Program. Joshua Goldberg, a transgender community member active in the consultation process, was hired to coordinate the startup of the new program. In November 2003, Dean Brown was hired to provide peer counseling and advocacy services; in April 2004, following Dean's move out-of-province, Lukas Walther was hired to replace him. Physicians were contracted in January and April 2004 to develop best practice guidelines relating to assessment prior to initiation of hormones/surgery and hormone prescription protocols. Wynn Buchwitz was hired in June 2004 to coordinate office administration. In December 2004, following Joshua's move to a trans health education project, Chan Drepaul was hired to coordinate the program.
In the first year of the program's development, the THP:
Priorities for the second year of the program's development included: