When researching this project, three questions needed to be answered. Firstly, what supplies do people need for post-op care? What surgeries are people in the 2SLGBTQIA+ community having in Quebec, and which surgeries are underrepresented but need to be centred and prioritized?

TOP SURGERY

One of the first surgeries included in this project was top surgery. These are the top three types of top surgery that people in the 2SLGBTQIA+ community may seek.

Breast augmentation is a procedure that trans, non-binary, and cisgender people undergo for various reasons, including the desire for a larger chest.

Breast reduction: For some individuals, undergoing surgery to decrease the size of their breasts can help affirm their gender identity. Additionally, individuals with larger breasts may experience back pain, shoulder discomfort, difficulty exercising and limited clothing options, among other issues. Breast reduction surgery is sometimes covered by the RAMQ, but can also be paid for privately.

Top surgery, also known as a mastectomy, is a procedure that involves removing the breast tissue. There are various motivations behind this decision. Some people find their breasts or nipples unappealing, which can lead to distressing feelings of gender dysphoria. Removing breast tissue can help affirm gender identity and/or alleviate gender dysphoria. Furthermore, individuals carrying the BRCA gene may choose this surgical option. Members of the transgender community may undergo chest reconstruction, also known as 'top surgery', to align with their sense of self. People of various gender identities — cisgender, transgender and/or non-binary — opt for this procedure.

Bottom surgery

Uterine surgery

Why is uterine surgery necessary?

Racialized people, especially Black, Indigenous, and Brown individuals, are more likely to experience delays in diagnosing conditions such as fibroids, endometriosis, or ovarian cysts, or to have their pain dismissed. As a result, by the time care is offered, surgery may be the only option.

The Impact of Uterine Fibroids on Black Communities

Uterine fibroids occur at a higher rate, cause more intense symptoms, and tend to appear earlier in people of African descent. Surgery, like myomectomy or hysterectomy, is often necessary to relieve pain, bleeding, and fertility issues.

Reproductive Freedom & Personal Sovereignty

For some, choosing surgery is an act of reclaiming bodily autonomy, especially in communities that have faced medical racism, forced sterilization, or lack of informed consent in reproductive care. The communities that are most affected are those with a high proportion of people who are Black, Indigenous, Brown, and low-income, as well as those with a history of incarceration.

Systemic inequities mean that people in some communities do not have access to consistent, culturally competent health care. This increases their chances of needing surgery due to a late-stage diagnosis or lack of preventive measures. This can result from being ignored by the medical system because of your weight, race, gender identity, sexual orientation, or other factors. This particularly impacts Black, Indigenous, racialized women, trans men, trans masculine people and intersex people whose medical experiences are often under-researched and questioned. These community members are also more likely to experience body shaming and fatphobia under the guise of care. Other factors include: language barriers for immigrants, not being able to take time off of work or school and more.

Some individuals who identify as part of the 2SLGBTQIA+ community, such as lesbians, transmasculine people, non-binary individuals, or intersex people, may undergo gender-affirming surgeries such as hysterectomy or oophorectomy (removal of the ovaries) to reduce gender dysphoria or align their bodies with their gender identity. Access to these surgeries is often limited or delayed for BIPOC 2SLGBTQIA+ individuals due to systemic barriers in healthcare.

About each surgery

Hysterectomy (removal of the uterus):

• Chronic pain or bleeding

• Uterine fibroids

• Endometriosis

• Uterine or cervical cancer

• Gender-affirming surgery

Fibroid Removal (Myomectomy):

• To treat non-cancerous growths (fibroids) causing pain, heavy bleeding, or fertility issues

Cyst Removal (often ovarian):

• When cysts are painful, large, persistent, or possibly cancerous

Laparoscopy (minimally invasive procedure):

• For diagnosing and treating conditions like endometriosis, ovarian cysts, or ectopic pregnancy

Laparotomy refers to surgical procedures that involve opening the abdomen.

• For larger masses, complex conditions, or when more access is needed than laparoscopy allows

Myomectomy (fibroid removal without removing the uterus):

—For those who desire to maintain their uterus, sometimes for fertility-related purposes

Each patient's surgery is chosen based on their symptoms, diagnosis, health goals (including reproductive and gender-affirming care), and doctor’s recommendations.

Information about Vaginalplasty is coming soon