Non-binary Montrealer Alexe Frédéric Migneault, shown in Quebec City on Tuesday, Nov.21, 2023, is on day six of a hunger strike to pressure Quebec's public health insurance board to add a third gender option to its health cards.THE CANADIAN PRESS/Jacques Boissinot

MONTREAL - Non-binary Montrealer Alexe Frédéric Migneault entered day six of a hunger strike on Saturday as part of a bid to pressure Quebec's public health insurance board to add a third gender option to its health cards.

"It's getting a little hard in the morning, especially," Migneault, whose pronouns are they/them, said in a phone interview. "That's the time when I have the least sugar in my blood and the least hydration, as well. So it's always difficult."

Migneault says they've only ingested liquids — water, vegetable broth, sports drinks and the occasional hot chocolate — since they began their strike on Monday.

They've also been camping in a public park near the insurance board's Quebec City office, withstanding frigid overnight temperatures by bundling up in blankets inside their car. A friend recently found a room where they could stay for a few nights.

During the day, they've sought temporary shelter from the cold in malls and cafés.

Migneault has been trying for years to get an 'X' gender marker on Quebec health cards, which currently only display the traditional 'M' and 'F' identifiers for male and female.

The provincial health board, known as the RAMQ, says the Quebec Health Department is still studying the impact such an update could have on the health and social services network, which relies on the information on health cards to process patients and manage their care.

But Migneault says they're tired of waiting for the RAMQ to catch up. Quebec made the X gender option available on birth and death certificates last year.

"I believe I am shedding light on something that is urgent and that needs to be addressed as soon as possible," Migneault said Saturday. They rejected arguments that Quebec health cards need to reflect sex assigned at birth, insisting that the X marker would be a boon for the overall health of non-binary people.

"If non-binary people have access to their X, I'm sure — I'm very, very certain that they're going to feel safer accessing health-care services, and so they're going to be less susceptible to having mental health issues, physical health issues even. We're going to be in better health in general."

Despite what Migneault described as the urgency of their cause, they say they haven't heard from any Quebec government or RAMQ officials since they began their hunger strike.

But they have drawn the attention of the provincial minister that oversees the government office dedicated to the fight against homophobia and transphobia.

Speaking to reporters in Quebec City on Friday, Minister Martine Biron asked Migneault to end their protest and be patient. She pointed to an interdepartmental committee under her purview that is studying the gender marker issue. She said the committee is making progress, but didn't say when the X option might become more widespread.

"I can't pull on the flower to make it grow more quickly," Biron said. "There are steps to take, but there is movement."

In response, Migneault has vowed to continue their strike. "I'm going to fight until the end until we get the X," they said. "We deserve the X. The letter that I have on my birth certificate is the one I am entitled to and I will accept nothing else."

This report by The Canadian Press was first published Nov. 25, 2023.

News from © The Canadian Press, 2023