Advancing the case was a 33-year-old non-binary male patient, known as KS, who identified as “female dominant.” KS came to the review board after having been denied public coverage for a “penile preserving vaginoplasty” (a surgery that adds an opening to serve as female genitalia, without removing the penis), which isn’t listed on the slate of sex-reassignment procedures covered by the province.

In fact, this procedure isn’t offered by any doctor in Canada — the standard vaginoplasty here involves the “penile inversion” technique. The “penile preserving” technique must be performed abroad; KS asked to be sent to a specific clinic in Austin, Texas (the clinic told me, over the phone, that gender-affirming genital surgeries can range from US$10,000-US$70,000 (C$13,500-C$94,000), depending on what exactly is being done).

Why this particular surgery? Gender affirmation. Genital surgeries shouldn’t be confined to the man-woman binary, KS argued, because non-binary gender dysphoria deserves equal treatment.

Forcing a binary surgery on a non-binary patient “could be considered an illegal act of conversion therapy as well as a violation of the Ontario Human Rights Code.”

WTF