Since Alexe Frédéric Migneault cannot have a health insurance card with an actual gender identifier, he wants to take extreme measures to obtain it. Starting Monday, November 20, this non-binary person promises to camp outside the Régie de l’assurance santé (RAMQ) offices in Quebec and stop eating for as long as necessary.
“I can’t wait for the RAMQ to decide to do its job,” says Alexe Frédéric, 32, originally from Montreal. Last January, the Civil Registration Office changed its gender designation to the letter X, which trans and non-binary people have been legally able to claim in Quebec since 2022.
However, despite this official recognition by the state, government departments and agencies are still considering ways to implement this change as well. Therefore, Alexe Frédéric is unable to obtain a health insurance card that proves his true identity.
It’s time for this to stop. The RAMQ has known this was coming for a long time. They’ve known since 2021. Come on! You should be able to find a temporary solution for us.
Alexe Frédéric still sent all the evidence to the RAMQ, but that organization says it is unable to produce a card with the gender marker X instead of M or F.
This is not the first time that Alexe Frédéric has tried to make his voice heard on this issue. His hunger strike will be his fourth in less than a year. Every time there are small breakthroughs, but the root of the problem is never solved.
“The first real answer I got last May was that the RAMQ needs to assess the importance of recording a person’s biological sex to ensure their health care,” says Alexe Frédéric.
She also said that her computer systems did not allow this and that it was complicated […]. She also told me that her machines couldn’t print it.
It’s like hitting your head against the wall. I don’t see anything in all of this that can’t be undone.
Hundreds of cases
The RAMQ announced via email that at the beginning of the fall, 359 people had applied to receive the gender marker X on their health insurance card.
It should be noted that the health insurance card is not an identity card, but rather an access and clinic ID card. It ensures that diagnoses, treatments, etc. are linked to the right person, writes spokeswoman Caroline Dupont.
To meet the needs of Alexe Frédéric, who had given up using a health insurance card with the wrong gender marking, the RAMQ offered him a temporary document called TT-19, which is in reality a simple confirmation of his registration with the health insurance of Quebec.
However, Alexe Frédéric explains that the TT-19 form only perpetuates the problems with his old card, as his health insurance number is on it and is still linked to his old gender marker.
In other words, as long as Alexe Frédéric uses the TT-19 form, the clinics will see his old gender marker and then everything happens, be it for making appointments, follow-up visits, etc.
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Since 2022, trans and non-binary people in Quebec have been able to obtain the gender marker X from the civil registry office.
Photo: iStock
People who don’t care
After that, it falls on my shoulders to correct people, correct files, make corrections, make statements, present other works, explains Alexe Frédéric, a daily stressful situation that for him involves a lot of transphobic statements.
Most of the time I meet people who don’t care, it’s the first time they’ve seen it.
These are completely unnecessary conversations and have nothing to do with the healthcare I need, the services I request […]. It’s a waste of time and makes me feel like I’m in a hostile environment.
Despite questions from Radio-Canada, RAMQ is not saying when it will be able to incorporate the X-Marker into its maps.
It also does not address the criticism that linking the TT-19 form with the health insurance number – and thus indirectly with the old gender marker – is harmful for trans and non-binary people.
In the meantime, anyone who submits a request to add one can
As long as the number [d’assurance maladie] If you don’t desexualize, it won’t be of any use, answers Alexe Frédéric.
Administrative nonsense
To support his statements, Alexe Frédéric tells of an incident that occurred in the emergency room last May. Upon arrival, the woman allegedly refused to remove her old gender information from the hospital bracelet during registration.
Above all […], the person shouted to me: “I guarantee you that you will not sign this paper for me that says you are a girl?” says Alexe Frederic. I don’t sound like a girl, I had my beard, I don’t look like a girl, where did that come from?
It was humiliating. He was literally the person who stood between me and the doctors I needed to see!
I’m really looking forward to being able to move on and stop talking about it. I know who I am. I don’t have to justify it. “I’m pretty sure the others don’t care either, and that’s the point,” says Alexe Fredéric.
That’s exactly what I want, that I have the documents that allow me to fit in with the crowd, to just be myself, that’s all.
Significant challenges
In government, an interministerial committee has been working for months to create guidelines that will allow ministries and organizations to properly manage the changes associated with the X-marker.
However, the office of the Minister responsible for the fight against homophobia and transphobia, Martine Biron, cannot say when these guidelines will be available.
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Martine Biron is the minister responsible for the fight against homophobia and transphobia.
Photo: Radio-Canada / Sylvain Roy Roussel
Expanding the X marking to all official identification documents poses significant challenges. “We are working to find solutions,” says his press spokeswoman Catherine Boucher.
She recalls that it was the passage of Bill 2 last year that allowed trans and non-binary people to change their gender marker with the registrar.