Transgender people face fewer barriers to gender reassignment surgery than they did in the past, but the steps they need to take to get there are still not clear, a UBC study suggests.

The study, released Tuesday by the Stigma and Resilience Among Vulnerable Youth Centre, surveyed 337 transgender Canadians and held in-depth interviews with 35 people in B.C. who had received a readiness assessment for surgery or had already had the surgery.

Sixty per cent of respondents had to travel two or more hours to have surgery, often leading to increased complications. Most patients also had to pay their own aftercare and travel costs.

Currently, publicly funded chest or breast surgeries are mostly available only in Vancouver and Victoria, while lower body surgeries are only available in Montreal, or outside of Canada.

According to study author Elizabeth Saewyc, a UBC nursing professor, many primary care physicians lack the necessary training to direct patients or provide aftercare.

But even before surgery, patients often face long, confusing delays. Forty per cent of respondents found it difficult to find a doctor who could clear them for surgery. The patients said wait times of five months to a year were common.

Patients with a body mass index of over 35 are not eligible for surgery through Trans Care BC – a barrier the organization has said it is working to fix.

There were positives in the study results. Half of the participants did not have to pay for their assessment appointment and nearly two-thirds of patients had their surgery funded entirely by government healthcare.

The study authors focused their recommendations on a clearer, more streamlined path to surgery. To reduce travel and wait times, the study recommended training more assessors and surgeons in different regions of the province, as well as providing assessments by video.

It also recommended that the province educate primary care physicians on helping patients navigate the system both before and after surgery.