At one time, Lorne Warneke was the only psychiatrist in Alberta who saw transgender patients, many of whom still travel from Saskatchewan, Northern British Columbia, and Northwest Territories, waiting months or years to see him. The affectionately nicknamed "Dr. War" has been a fierce opponent against stigma of gender identity, sexual orientation and mental health throughout his unwavering campaign for equality. Today, Warneke says Alberta is a leader in trans rights legislation.
"If I were a transgender person flying around the world looking for a place to live, I would probably pick Alberta. We have the best legislation in place to protect trans people provincially and nationally, except perhaps in Scandinavian countries," said Warneke.
At the University of Alberta, Warneke has promoted education on human sexuality and gender identity in the psychiatric residency program, created an annual award for a resident interested in human sexuality and gender, and there is an annual teaching award given out in his name. Across campus, there are many sexual diversity initiatives that he has consulted on.
These initiatives are a far cry from Warneke's early career, who earned his medical degree 50 years ago.
As a gay physician he knows how it feels to be marginalized. He is driven to use his social position to represent people without a voice.
"When a friend in medical school came out to me, I remember admiring him for having the guts to do so, while being afraid to say anything to him about myself. And that's just how much stigma there was."
Rural roots and collegiate tradition
On his first day of school in the 1940s, Warneke travelled by horse and buggy from his family farm near Ponoka, Alberta, carrying a Roger's syrup tin that his mother had loaded with food. "There were a lot of tomatoes, and they got squishy by the end of the day. I wasn't happy about the first day of school," he recalled.
"I came from a farm and my parents would have been happier if I had become a teacher as they could relate to this. Becoming a family doctor was okay, but not being a psychiatrist," Warneke says.
Warneke's University of Alberta campus looked different from today's bustling locale. The Physics and Chemistry buildings were brand new, and many of the buildings have since been torn down. He lived in Assiniboia Hall for his first year, next door to the women's-only Pembina Hall, strictly monitored by a glaring chaperone in the lobby.
"Girls and boys ate separately except for on weekends. For dinner every day in the male residence we had to wear a shirt, tie, and jacket. We sat at the same table every night and said the University motto. It was very much in the English style."
In this traditional setting, Warneke had his first encounter with psychiatry. "I was introduced to the subject in third or fourth year of medical school," he said. "We were each assigned a case to work on. My patient happened to be transgender, so I asked the patient how she wanted to be addressed and she told me her name, so I thought, let's go with it. That was my first real exposure to psychiatry."
Several years later Warneke met Pierre Flor-Henry, who had just finished his training at Maudsley Hospital in London, England. Warneke was drawn to the neurological approach Flor-Henry had learned, and eventually took an extra year of psychiatric training at Maudsley hospital. This was where Warneke became fascinated by Obsessive Compulsive Disorder (OCD).
"When I returned to the Edmonton General, a patient with very severe OCD came in, and we had limited drugs in those days and the oral drug didn't work. So I said, let's try intravenous, and we had a wonderful response to it. So all of a sudden I became the expert. Just like that."
Passing the torch
In spite of the advancement in legislation, Warneke says gender dysphoria, the medical term for transgender, is still taboo within the medical community. Now partially retired, he is hopeful that the next generation of physicians will pick up where he leaves off.
Although he is not a child psychiatrist, Warneke meets many trans children and adolescents and believes this will increase. Parents are more supportive and teachers are now trained to help, so he is no longer the only source of information.
"At one point, I started to see a lot of adolescents and I worried that maybe this was just a phase. But I can confidently say that 95 per cent of adolescents I see legitimately have gender dysphoria. There's no doubt about it."
Advocacy milestones
Early 1980s - Warneke sees three transgender patients who fulfilled the criteria for sex reassignment surgery. Alberta Health agrees to pay for the surgeries in Belgium.
Mid-1980s - Lobby group forms with Warneke, Sheila Greckol (now Hon. Madame Justice Greckol), Larry Jewell, and Barry Breau (Director of AIDS Network Edmonton) with a mandate to change the Alberta Human Rights Legislation to include sexual orientation as a protected area.
1991 - Vriend vs Government of Alberta - Delwin Vriend is dismissed by King's College on the basis of sexual orientation. His attempt to sue the college is overturned, stating sexual orientation is not protected under Alberta's Individual's Rights Protection Act (IRPA). Vriend successfully sues the Government of Alberta at the Court of Queen's Bench in 1994, followed by an appeal at the Alberta Court of Appeal. The appeal is overturned.
1996 - Warneke opens a gender clinic at the Grey Nuns Hospital.
1998 - Vriend vs Government of Alberta - Supreme Court of Canada rules that the exclusion of homosexuals from Alberta's IRPA was a violation of the Charter of Rights and Freedoms. Warneke is consulted as physician expert, confirming that sexual orientation is a biological state and not a lifestyle choice.
2009 - Funding for gender reassignment surgery is delisted by the Minister of Health. Warneke and others fight this decision. Funding is restored in 2010.
2009 - Covenant Health Board attempts to restrict Warneke's work with trans patients. Warneke ignores the restrictions and continues seeing individuals with gender dysphoria.
2010 - Alberta Motor Vehicle Act adapts to allow trans people to change the gender marker on their driver's license.
2016 - Bill passes allowing changes to gender marker on Albertan birth certificates without having to have related surgery first.
All are invited to see Lorne B. Warneke accept this honour at the Alumni Awards ceremony on Monday, Sept. 25 at the Northern Alberta Jubilee Auditorium.
Reserve your free ticket:uab.ca/aw2017