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Newfoundland transgender woman has learned transition comes with a cost

Sarah-Dena Harnum
Sarah-Dena Harnum - Contributed

For those in the LGBTQ community, the price of reaffirming who they are can take a toll on their bank accounts

In the tiny community of New Harbour about an hour’s drive west of St. John’s, N.L., a 51-year-old who identified as a man for decades publicly came out six weeks ago as a woman.

Meet Sarah-Dena Harnum.

There are still a few photographs on Facebook of Sarah-Dena – who now prefers to be addressed with the traditionally feminine pronouns of her and she – from before her transition. In one of those photographs, then-Dean Harnum smiles at the camera, sporting a coarse, greying stubble and dark sunglasses.

That facial hair is now gone.

A newer profile pic on Facebook shows the New Harbour single mom with shoulder-length brown hair, a floral print blouse, lightly applied make-up and lipstick.

Outwardly, it’s a strikingly noticeable change.

There are times when it garners unwanted attention, like during a quick stop at a local A&W restaurant for a bite to eat.

“I was at (the) A&W in Carbonear for lunch and some woman kept staring at me,” Harnum wrote on Facebook earlier this month. “I'd stare back at her and make eye contact with her and she'd look away and when she thought I wouldn't notice she was staring again.”

But Harnum's work colleagues and supervisors with the Province of Newfoundland and Labrador, her son, relatives and friends in New Harbour have almost all been supportive of her transition.

Nineteen-year-old son, Ben Harnum, who hugged and showed unconditional acceptance when Sarah-Dena Harnum first announced a queer sexual orientation a few years ago, made her a birthday cake last year. On it, the greeting read, “Happy birthday, Mom!”

“He has been my biggest cheerleader and biggest supporter,” Harnum said.

And while this support is critical for those who come out to friends, family and their community, this isn’t the only struggle they face. The high financial costs, especially for someone transitioning from one gender identity to another, is often more a footnote in conversations.

“My expenses are probably up about 50 per cent.” — Sara-Dena Harnum

Buying a whole new wardrobe, picking up make-up, getting needed drugs and hormone therapy, in some cases undergoing surgery, and travelling to meet with doctors, counsellors, speech therapists and support groups can drain a bank account.

And then, to top it all off, there are the fees to be paid to get official government documents changed to reflect the transgender person’s new public gender identity.

“That cost me a total of $175 to get a new driver’s licence, a new birth certificate, and to have my name officially changed,” said Harnum.

Her job as an administrative assistant brings in about $30,000 after taxes and other deductions, making it a challenge to make ends meet.

“As a single parent, your life revolves around your budget so I built up my wardrobe one piece at a time at thrift stores and clearance racks and got great deals,” she said. “My most expensive purchase has been my hairpieces.”

Under that wig of long brown hair, Harnum is balding. It’s not a look she wanted as a woman.

“It’s socially acceptable to see a bald man,” she said. “It’s not socially acceptable to see a woman who is bald.”

Each of Harnum’s wigs of synthetic hair cost $200, a steal considering many such wigs start at $400.

“My friend has a human hair wig and it’s cost her $900 because it’s a specialty item and they’ve got you over a barrel,” said Harnum. “I took money from my tax returns for over two years to buy my wigs.”

According to her, women’s clothing can cost anywhere from 50 per cent more to roughly twice as much as comparable men’s attire.

“For work, I used to wear a button-down shirt and khakis and that would cost me about $40,” she said. “I bought a black dress for my niece’s wedding last summer and the best price I could get was $70.”

“Quebec will pay for everything. Nova Scotia does more than Newfoundland but not as much as Quebec.” — Sara-Dena Harnum

Prior to publicly coming out as a woman in April, Harnum spent about $450 just to get a new wardrobe, much of it in thrift stores or on sale.

Gasoline and wear-and-tear on Harnum’s 2011 Grand Caravan to drive into St. John’s for doctors and speech pathologists’ appointments, counselling and other needs related to her transition also add up. At $30 for gas and another $10 per trip for a quick meal, Harnum figures travel costs soak up another $2,000 per year.

Prescription medication and hormone replacement therapy is another expense.

“I take two testosterone blockers because my testosterone levels are quite high,” said Harnum.

Those two drugs cost her $85 for a three-month supply. It would be quite a bit more but Harnum enjoys the benefits of a provincial government employee health care plan. Without those benefits, she would be paying more than twice as much for that medication, roughly $185 every three months.

The cost of the estrogen she also takes as part of her hormone replacement therapy is covered under Newfoundland and Labrador prescription drug plan.

Although candid about many aspects of her transition, Harnum shies away from any discussion of any possible plans for sex-affirmation surgery. It’s a subject that’s just too personal.

But she is willing to share the experiences of friends – provided they remain anonymous – who have had to travel to the Greater Toronto area – one of two major centres for these surgeries, the other being Montreal –  to be assessed ahead of being approved for sex reassignment surgeries, now referred to as sex-affirmation surgery, and for the procedures themselves.

It can take as little as a single trip or as many as four for people to be assessed before they are given the green light for surgeries such as phalloplasty, vaginoplasty, breast removal and chest sculpting, facial feminization and breast augmentation, said Harnum.

The procedures which are approved and those which are publicly funded vary from province to province. According to Harnum, Quebec seems to cover the most.

“Quebec will pay for everything,” she said. “They’ll pay for breast augmentation, facial feminization surgery and chest sculpting,” she said. “Nova Scotia does more than Newfoundland but not as much as Quebec.”

Gemma Hickey
Gemma Hickey

These surgeries can be expensive. A vaginoplasty can cost about $23,000, not including the travel costs and weeks people sometimes have to stay near the medical facility.

Certainly, not all transgender people opt for these surgeries but there still is a waiting list. Those who can't wait sometimes choose to leave Canada and get the surgeries done elsewhere.

“A friend of mine went to Thailand,” said Harnum. “It cost her $40,000 for a vaginoplasty.”

These big surgeries are also not the only procedures many transgender people seek out. Laser removal of facial hair has already cost Harnum $1,200 and she’s not done quite yet.

The total bill for a person to get all the surgeries through the private sector can add up to about $100,000 plus, she estimated. That number might vary up or down depending on the transition from male to female or female to male. 

“Some people are putting it on their credit cards,” she said. “They’re taking second mortgages on their homes … or their friends lend them money if they’re able.”

Gemma Hickey, another transgender person in Newfoundland, is one of the lucky ones able to count on financial support from the community.

Although presenting as trans-masculine, looking physically like a man, Gemma identifies as non-binary, neither male nor female, and has asked to be referred to by the pronouns they, them, and their.

They lived their life as a girl and woman for decades prior to transitioning and have also chosen to keep the traditionally female name of Gemma.

In January last year, though, Hickey travelled to The McLean Clinic in the Greater Toronto Area for what is commonly called a top surgery, a procedure that involves the removal of both breasts. That surgery alone cost $9,000, not including tax and the need for plane tickets for Hickey, her mother and a friend, meals and two hotel rooms for four days.

Hickey, though, had help with those costs. A community group called Raise Up Fundraising held a bingo event and put together $5,000.

“I charged the rest to my Visa and … it took a few months to pay off,” said Hickey. 

The financial burden on transgender people to get the procedures they want can be sometimes simply prohibitive. Harnum, for example, is holding off on two hair transplant procedures, each of which would cost $6,000 and require a trip to Nova Scotia.

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