Gender-affirming care in Alberta is accessible through primary care providers, as well as several specialty clinics available below. For additional information and supports, check out the Trans Wellness Initiative.
The Calgary Gender Clinic provides assessment and support for people throughout their transition, including connecting people to hormone providers and gender-affirming surgeries. This clinic also offers mental health treatment (e.g. related to anxiety around gender), and support regarding social transition (including support with family, work, and legal document changes).
The Gender Program at the University of Alberta in Edmonton also provides comprehensive assessments, as well as gender-affirming interventions in the areas of psychiatry, endocrinology, pediatric and adolescent medicine, and nursing support.
As for financial coverage, Alberta Health Services covers many options for medical transition such as hormone therapy, and surgeries through their Gender Reaffirming Program. But, some Alberta-funded surgeries must be conducted at Montreal GRS. The waitlist for the Montreal clinic is several years long which leads many patients to seek out-of-pocket options elsewhere.
For those pursuing government-funded medical transition, Alberta Health provides once per lifetime funding for Alberta residents diagnosed with gender dysphoria who meet the established program criteria to receive lower body surgery (phalloplasty, metoidioplasty or vaginoplasty). Application forms for the funding program can be found here.
Alberta also offers coverage for breast augmentation and mastectomy, but you must be pre-approved through a Request for Breast Surgery application. You also have to be assessed by a psychiatrist or other physician and be diagnosed with gender dysphoria, and have little to no breast growth according to the surgeon.
All aspects of gender affirming medical care in BC are integrated into the provincial health system through Trans Care BC. Trans Care BC supports the delivery of equitable and accessible care, surgical planning, and peer support for trans people across the province. They have developed one of Canada’s leading guidance documents on gender-affirming healthcare, Gender-Affirming Care for Trans, Two-Spirit, and Gender Diverse Patients in BC: A Primary Care Toolkit.They also provide healthcare navigation services through their Health Navigation Team.
In BC, trans and gender diverse people can access hormone therapy through a primary care provider, an endocrinologist (provided they are given a hormone readiness assessment by another health care provider), or in some places, trans-specific clinics.
For patients seeking gender-affirming surgeries, the first step is to arrange surgical care planning with a primary care provider. Trans Care BC has a comprehensive guide on How to Get Surgery explaining surgical care planning, eligibility, specific requirements by procedure, funding information, and all the necessary forms. Since 2019, both upper and lower body surgeries have been accessible in-province, minimizing the need to travel out–of-province or out-of-country for care. The Gender Surgery Program BC is the largest program on the West Coast that ensures that patients have access to lower body surgeries. It also serves patients from Yukon. In addition to public coverage for many surgeries and procedures, other financial assistance programs include:
- The Gender Surgery Program BC covers medically-necessary hair removal in preparation for surgery.
- Hope Air provides funding for flights to and from surgery locations.
- The Travel Assistance Program (TAP) can help to cover surgery travel costs.
- First Nations Health Authority may cover meals, accommodation, travel for those who qualify.
For public coverage of gender-affirming care in Manitoba, a diagnosis of gender dysphoria is required. This can be given by a primary care provider or clinic specializing in gender-affirming care. You can find a primary care provider using the province’s Family Doctor Finder.
Hormone therapy can be accessed through a qualified primary care provider or gender-inclusive clinic (listed below). Hormone therapy prescriptions are partially or conditionally covered, and are also accessible through the Manitoba Pharmacare Program, if eligible.
To qualify for surgeries, Manitoba Health requires a referral letter by an approved psychologist as well as a recognized health care provider. Most surgeries also require a patient to be on hormone replacement therapy for at least a year, and many procedures are conducted out of province, at the Centre de Chirurgie in Montreal. Wait times for surgeries can take up to 30 months. For a full list of what procedures are covered, see this resource for Gender Affirming Services in Manitoba, developed by the Canadian Queer Medical Students Association, or reach out to Manitoba Health.
Manitoba has two main trans health clinics providing gender affirming care, (a youth clinic, and an adult clinic) both located in Winnipeg. However, they both have long wait times. Gender Diversity Assessment and Action for Youth (GDAAY) is a program at HSC Winnipeg Children’s Hospital that offers integrated care and support services for youth through their gender affirming journey. This includes both assessment and treatment for young people up to the age of 14. The Trans Health Klinic serves people 16 and older seeking transitioning care (hormone start, procedures, and surgery). They require clients to have a primary care provider as they aim to transfer some aspects of care (such as hormone prescription renewals) to their regular health care provider eventually.
New Brunswick has made significant progress in gender-affirming care since first offering coverage for surgeries in 2016.
To access hormone therapy, your primary health care provider must complete a hormone readiness assessment. They may refer to a psychologist for support with this process, but it is not required. A similar process is also required to access gender-affirming surgeries. Once the surgical readiness assessment is complete, your healthcare provider needs to submit a Prior Approval Request form to gain funding approval from New Brunswick Medicare. Most surgeries are referred out of province to the Clinique de Chirugie in Montreal, Quebec, in which case travel expenses are also insured.
See this resource on Medical Affirmation by Two-Spirit, Queer and Trans Pathways New Brunswick for all details regarding accessing care, including a contact list for gender-inclusive care providers, detailed coverage information, and required government forms.
Currently being updated.
The Northwest Territories’ gender-affirming care services are outlined in this policy: Healthcare for Transgender, Non-binary, and Gender-Non Conforming People: Guidelines for the NWT (2020). This is largely based on BC’s guidelines which are considered one of the most comprehensive in the country.
Hormone therapy can be prescribed in NWT without needing to see an endocrinologist. But, if your primary care practitioner isn’t able to take this on, it’s possible you will be referred to an out-of-province endocrinologist, usually in Alberta. NWT does not have capacity for gender-affirming surgeries, so people are referred to out of province clinics in Alberta, Ontario, or Quebec, depending on the procedure.
Gender Affirming Care is governed by the province’s Gender Affirming Care Policy (2023). All details on assessment, referral and approval can be found there. Nova Scotia also has a specific health program that supports gender diverse people, called prideHealth. Through this program, several healthcare services that support gender affirming care (like psychological services, counseling and hormone treatment) are insured.
Youth (aged 19 and under) can seek out gender affirming care by contacting the IWK Trans Health Team if they are located in Halifax. Youth outside of Halifax can call Nova Scotia Health's Mental Health and Addictions Intake Service toll-free at 1-855-922-1122 and ask to be connected to the child and youth community health clinic nearest them. Adults aged 19+ can contact prideHealth to be put in touch with a Gender Affirming Hormone Prescriber.
Gender affirming surgeries are a publicly funded service through Medical Services Insurance (MSI). Some surgeries are available in Nova Scotia, while others will be referred to Montreal GRS. For those who travel to Montreal for gender affirming surgery, many costs directly associated with the procedure can be covered. These include transportation and accommodation costs as per the Nova Scotia Out-of-Province Travel and Accommodation Assistance Policy.
In March, 2022, Nunavut Health Minister John Main announced that the Government of Nunavut will pay for mental health and transitioning services for transgender and non-binary Nunavummiut. The Health Department will be partnering with the Centre de Chirurgie in Montreal to deliver these services. However, eligibility criteria have not been made public. TransCare+ has created a Surgery Access Info and Coverage by Province/Territory resource that includes details for Nunavut.
Gender affirming healthcare in Ontario is largely supported by Sherbourne Health in Toronto. Sherbourne runs Rainbow Health Ontario (RHO), a program with a mandate to improve queer and trans health outcomes. Trans and gender diverse patients can use their 2SLGBTQ+ Health Service Provider Directory to find qualified care providers in their community.
Hormone replacement therapy (HRT) for trans and non-binary people in Ontario is no longer a specialty area. This means that, in most cases, your current primary care provider (doctor or nurse practitioner) can provide HRT for you. RHO’s Trans Health Guide, can advise providers and patients on HRT, as well as all other aspects of gender-affirming care. For patients covered by the Ontario Drug Benefit, injectable testosterone is covered with the submission of an Exceptional Access form (EAP), while anti-androgens and oral estradiol are covered without the need for EAP approval. People younger than 17 can get transition-related support at SickKids Transgender Youth Clinic.
Ontario covers gender-affirming surgeries with the submission of a Prior Approval Form from a primary care provider. See RHO’s Transition-Related Surgery FAQ for a full list of surgery coverages. Ontario also offers financial assistance towards travel costs for Northern Ontario residents seeking out-of-town medical specialist services through the Northern Travel Grant. Further details on each OHIP covered surgery can also be found in these Transition-Related Surgery Summary Sheets developed by RHO.
Prince Edward Island publicly funds various gender affirming procedures and surgeries, as outlined in their Gender Affirming Care Coverage Policy. The Policy was updated in July 2023, adding chest masculinization and voice therapy to the covered services.
Doctors and Nurse Practitioners with the right qualifications can offer hormone therapy treatments. If a patient doesn’t have access to a qualified doctor or nurse, they can seek out a readiness assessment through the Patient Navigator. Those who don’t have a family physician or nurse practitioner (or don’t feel comfortable discussing this with them), can self-refer to the Gender Affirming Clinic that is held twice a month at the Sherwood Medical Centre, 2nd floor, 15 Brackley Point Rd., Charlottetown. You can call 902-569-7772 or email [email protected].
Some gender-affirming surgeries are performed in PEI, however most will be referred out-of-province. In general, travel and accommodation costs are not covered. All procedures must be pre-approved to be covered by Health PEI. Approval for non-surgical procedures can be obtained by having a primary care provider complete and submit the Gender Confirming Procedure Prior Approval Request Form and submit it to the Health PEI Gender-Affirming Clinic, or Health PEI’s Out of Province Coordinator, if the surgery will be completed out-of-province. Financial Assistance for Out-of-Province Medical Travelis also available.
Quebec follows the WPATH standards of care when determining eligibility for access to medical transition. Transitionner.info is an online resource website which explains various aspects of Quebec gender-affirming care in more detail.
There is no standardized route for hormone therapy in Quebec. Some doctors will require a referral from a mental health professional, while others will act independently, using principles of informed consent to prescribe hormone therapy. In some cases, people are referred to endocrinologists. If you don’t have a primary care provider, see this list of gender-affirming healthcare providers.
Gender-affirming surgeries are funded via a special program from the Ministry of Health and Social Services managed by the CHUM (Central Hospital at the University of Montreal) and must be done at the private GRS Montreal clinic to be covered. Details on eligibility and access requirements can be found here.
In Saskatchewan, gender-affirming care can be accessed through primary care providers. Individuals without a primary care doctor can seek one out through the Trans Health Navigators - TransSask. The Saskatchewan Trans Health Coalition also created a Medical Transition Guide that provides an overview of options for gender affirming care in Saskatchewan.
Residents who have an active Saskatchewan health card are eligible for coverage of certain hormone replacement therapies. Inquiries about hormone therapy coverage can be directed to the Ministry of Health's Drug Plan and Extended Benefits Branch at 1-800-667-7581 or 306-787-3317.
Some gender-affirming surgeries, such as hysterectomy and mastectomy, are provided in Saskatchewan. More complex procedures will be referred out-of-province. Prior approval is required from the Ministry for coverage of out-of-province procedures. Full details on seeking access to surgeries and approvals are found here: Gender Identity, Gender Diversity, and Transgender Support.
Yukon has the most comprehensive gender-affirming health system in Canada since unveiling new gender affirming healthcare policies in 2021. Policies B.13 (Non-medical procedures) and B.14 (surgical procedures) outline the gender-affirming health service Yukoners have access to through public insurance. This includes procedures such as upper and lower body surgeries, facial surgeries, body contouring, voice feminization surgeries, hair removal, and voice and communication training.
While coverage for certain procedures was initially paused due to required regulatory changes, regulation has now been updated. As such, many gender-affirming procedures are now directly covered under the Yukon Health Care Insurance Plan.
In addition to coverage offered by provinces or territories, the cost of medications related to gender-affirming care, equipment, as well as transportation required for surgeries are covered under the Non-Insured Health Benefit program.
Most medications related to gender-affirming care, such as hormones, are available without prior approval. Equipment such as binders and packers is also covered under the Non-Insured Health Benefits program according to the medical supplies and equipment benefit. More information is available under the Self-care equipment and supplies benefit list. The Non-Insured Health Benefits program doesn’t cover the cost of surgeries, however the program does cover transportation costs for surgeries not available locally. This includes travel out of province for gender-affirming surgeries, as long as they are covered by a provincial or territorial insurance plan. More information is available in a government scenario note on Non-Insured Health Benefits.