The public's understanding about transgender issues has grown in recent years, thanks in part to people like former U.S. Olympian Bruce Jenner coming forward. But while awareness is growing in Canada, so are the waiting lists for surgery.

There is currently only one clinic in Canada where transgender people can seek transition surgery and the wait times can stretch to two years.

James Gardner would like to see that changed.

Three years ago, the 56-year-old Victoria, B.C., radio announcer with CFAX transitioned from being "Sheila" to being "James." While Gardner is glad to have finally made his transition public, what he wants now is genital surgery to complete the change.

Gardner says he knew he was different from an early age. He hated wearing dresses, didn't like playing with dolls and realized he was attracted to girls.

Growing up, he says he felt uncomfortable in his body, feeling like who he was inside didn't match his outside, but didn't understand why.

"For me, it was just not being comfortable in my body. I would feel like I was an imposter," he recently told CTV News.

Gardner lived most of his adult life as a lesbian and says while he didn't dislike being a woman, he says he never felt right about his body. Then, a few years ago, after doing some research, Gardner says he realized he was transgender.

"I actually had the epiphany where I was like, 'Oh, that's what it is,'" he says.

From there, it was an easy decision to start making the transition into a man. He began taking testosterone injections, which helped him grow facial hair and deepen his voice. Then he had a double mastectomy to remove his breasts, which he describes as a total relief.

"It just felt natural. It felt good," he says, adding he's had a lot of support from his friends and family, including his 90-year-old mother who he says accepts him for who he is.

Now, Gardner wants to have surgery to build male genitals, a procedure called a phalloplasty. But, as he's documented on his blog, he's hit a roadblock and can't even start the process for a year and a half.

That's because there is only one clinic in Canada that performs complex genital reconstruction surgery, the GRS clinic in Montreal.

Men transitioning to women typically need to wait six to eight months to begin surgery at the clinic, while the wait time for the more complex female-to-male surgery is between 18 months and two years.

Head surgeon Dr. Pierre Brassard says there has always been a long wait for gender reassignment surgery.

"I have been doing this since 1994 and the demand has always been there, although the access to care wasn’t," he says.

Brassard is glad to see that there has been more acceptance in recent years of the need for psychological care for those who are transgender, but it's still not something that's discussed much in medical school, he says.

"Most doctors don’t learn this at all. And in surgery, most plastic surgeons would be exposed to only one sex change in their training. So that is the problem: it is not taught," he says.

Brassard knows his work is important because his patients often tell him they had struggled with depression and thoughts of suicide before their surgery.

"Just today, an hour ago, I was with a patient and her mom was there and she said 'You saved my daughter’s life.' And she hugged me so much. This is something I hear every week," he says.

"… I feel very good about this work because it really helps patients."

One recent study found that 77 per cent of people undergoing gender transition had considered suicide and 45 per cent had attempted it. But rates of suicide ideation plummet after transgender people complete transition with surgery.

Whileno one should rush into surgery, as it's irreversible, Brassard says thinks the wait time could improve, but he doesn't expect that to happen any time soon.



Gardner admits that knowing that he still has many more months to wait for his surgery often leaves him in despair.

"I have gone through periods when I have been in bed for three or four days, over a weekend. I don't want to face the day," he says.

Not everyone transgender chooses surgery and Gardner doesn't believe it will "make him a man." But he says the surgery would allow him to feel whole, and a normal part of society.

"What is it to be a man? Nobody really has the answer to that. But I think for me… to have the inside match the outside for me is really important," he says.

With a report from CTV medical specialist Avis Favaro and producer Elizabeth St. Philip