The Cost of Being LGBT+ in Canada: Have We Closed the Gap?
But like everybody else, LGBT+ Canadians want financial stability and equality along with social and legal equality. Is there a correlation between the advances we’ve seen in social activism and policy with improvements to our bottom lines? As one of the most progressive countries in the world with respect to LGBT+ human rights, has Canada closed the financial gap between our community and our straight allies?
Let’s take a look at some key components that influence financial parity, and figure out how far we’ve come and how much further we still have to go.
Universal Health Care
In a display of uber-Canadian-ness, in 2004 the Canadian Broadcasting Corporation aired The Greatest Canadian, a (really very Canadian) sort of reality show that presented our national heroes in a series of documentaries and encouraged citizens to vote. Though the finalists included heavyweights like our first Prime Minister John A. MacDonald, hockey star Wayne Gretzky, and environmentalist David Suzuki, we ultimately selected Tommy Douglas, former Premier of Saskatchewan and the person who brought universal health care (commonly known as Medicare) to the nation. With this choice, the voters added universal health care to maple syrup, doeskins, and the suffix “Eh” on a list of things indisputably Canuck.
In the 52 years since the Medical Care Act passed, the system has evolved and currently, instead of a single national plan, there are 13 provincial and territorial plans that are administered on a non-profit basis to provide medically necessary health services to all citizens. In addition, almost two-thirds of Canadians have private or employer insurance as a supplement to cover “non-necessary” services, which usually include dentistry, home health care, and prescription drugs. Quality of health care varies from province to province for all Canadians, regardless of their sexual orientation or gender identity. But there are two general categories of health care where LGBT+ people may shoulder a far heavier burden than their heterosexual or cisgender counterparts.
Transgender Health Care
Gender confirmation surgeries (formerly known as sex or gender reassignment surgeries) were not recognized as medically necessary by Medicare until 2014. Coverage today is determined on an individual basis, and typically requires visits to doctors, mental health professionals, and other health care providers.
According to the Canadian Professional Association for Transgender Health (CPATH), insurance coverage for gender and transition-related care or surgical procedures vary across the country, with some regions—like the Northwest Territories and Nunavut—offering none. In this case, patients seeking medical intervention will have to travel for help, often at their own expense.
Even in areas with services, though, patients experience long wait times and incomplete coverage for some elements of a transition (like chest contouring or electrolysis, for example). For those wanting genital surgeries—like vaginoplasty or phalloplasty—there are few trained surgeons in the country and only a single private clinic, in Montreal.
Ongoing health care costs, like hormones, are not typically covered by Medicare but are rather treated like other prescription drugs—meaning that costs and coverage will depend on province of residence and the existence of additional employer insurance. Those Canadians on income or disability assistance may also be able to access benefits to cover hormone therapy.
AIDS and HIV Treatment
After 35 years of activism, research, and policy change, the prognosis is excellent for people living with HIV in Canada today. That said, the disease still disproportionately affects the LGBT+ community, as the most recent data still show that 53% of all Canadians living with HIV are gay men and men who have sex with men.
Coverage for HIV management drugs and PrEP, a prophylactic approved by Health Canada in 2016, vary by region and insurance coverage. According to the Canadian Treatment Action Council, certain populations—like the Canadian Armed Forces and veterans, and First Nations and Inuit people—are eligible for federal coverage, but most people rely on their provincial plan or private insurance, sometimes in conjunction with income assistance programs. This may change, though, with the campaign for universal pharmacare by the Canadian Labour Congress. If implemented, it would provide access for all Canadians to prescription drugs.
Marriage equality went nationwide in Canada in July of 2005, making it the first country in the Americas and the third country in the world to enact such legislation (the Netherlands was first, followed by Belgium). According to Statistics Canada, as of 2016, nearly 1% of all Canadian couples (representing more than 72,000 pairs) were same-sex, and a third of these were married. This means that nearly 50,000 Canadians have access to medical benefits, pension and inheritance rules, and tax breaks they previously would not have been able to access. That’s a lot of extra loonies.
Married people with private insurance or employee benefits have the option to cover their spouses, a choice that typically makes great financial sense. Given regional health care differences and the lack of coverage for prescription drugs, vision services, and dentistry, private or employee insurance can contribute significantly to a person’s health, which in turn improves their overall quality of life, including finance-related aspects like general well-being and productivity.
Pensions and Inheritance
In 2000, Parliament passed Bill C-23, which modified 68 federal statutes related to issues such as pension benefits, old age security and taxes, and gave married same-sex couples the same rights as opposite-sex couples. In short, same-sex partners can will their pensions or other assets to each other—and in Canada, there is no inheritance tax.
From a tax perspective, being married can be lucrative! If you’re in a relationship where one spouse makes less than another, you can take advantage of spousal credits, tax credit transfers, and transferring dividends to reap savings. In retirement, you can use spousal RRSPs or split your pension income—both effective ways to pay less tax. And if one spouse passes away, assets willed to the surviving spouse will be tax deferred until the surviving spouse sells the assets or also passes away.
Legal Discrimination Protections
The Canadian Charter of Rights and Freedoms is entrenched in the Constitution of Canada and guarantees civil rights to all Canadian citizens. It is one of the most powerful anti-discrimination tools in the country, covering employment, housing, and disability rights.
In 1995, the Supreme Court handed down a ruling that Section 15, which guarantees equality rights to every individual, includes discrimination on the basis of sexual orientation. The following year, sexual orientation was added as a protected class to the Canadian Human Rights Act. The Charter rights provide LGBT+ Canadians with a legal response in cases of discrimination in employment, housing, or other human rights. This means that Canadians cannot be fired from their jobs, denied housing, or otherwise be discriminated against because they are LGB, though at this time there are not explicit protections for gender identity and expression. AIDS or HIV status is a protected class.
Gender Identity and Gender Expression
In June of 2017, the Yukon added human rights legislation to cover trans Canadians, the last region to do so. Bill C-16, passed two days later, made explicit protections on the grounds of gender expression and gender identity a federal law, mandating changes to the Canadian Human Rights Code and the Criminal Code. These regulations now apply to the federal government and federally regulated industries like banks and airports, and add gender identity and expression to the list of characteristics protected under the hate speech and hate crime sentencing sections of the Criminal Code.
How Does All This Affect the Canadian Economy Overall?
A happy, healthy citizenry is something to aspire to in any case, but it also makes excellent economic sense. In a 2014 study, researchers at USAID and the Williams Institute at UCLA found that “countries that treat LGBT people equally also have better-performing economies.”
The study analyzed 39 countries (29 with “emerging economies”) and found that among the factors hindering LGBT+ peoples’ productivity and earning potential were: unjust arrest, detention, or harassment by police; disproportionate rates of violence; workplace discrimination; barriers to physical or mental health; and discrimination in schools.
By implementing frameworks for equality, Canada has generally done a good job of closing the financial gaps for LGBT+ Canadians, simultaneously boosting the Canadian economy for all. And there are more promising ideas on the horizon.
The implementation of pharmacare would benefit all Canadians, and particularly lend a helping hand to those most burdened, including people living with HIV and AIDS. Resolutions for other important LGBT+ financial issues, however, seem further away. For example, there is currently no end in sight to the enormous financial burdens of artificial insemination or adoption, which disproportionately affect LGBT+ Canadians.
Though there’s room for improvement, all in all the financial situation for our community has improved in tandem with the expansion of our social status and legal rights. As it turns out, the legacy of Canadian activists is the perfect thing to celebrate this Pride Month. It’s through their work that Canada maintains a strong global economy supported by the quality of life of individual Canadians—including those who are LGBT+.