Access to gender-affirming care in Newfoundland and Labrador (NL) is improving, with Newfoundland and Labrador having expanded their coverage for gender affirming surgeries in 2019 to include services such as chest and genital surgeries, gender-affirming hormone therapy, and mental health services; coverage is limited for certain procedures such as facial feminization, voice surgery, and hair removal. Transgender surgery assessments were also made available in the province; transgender and non-binary individuals no longer need to be evaluated by the Centre for Addiction and Mental Health in Toronto, Ontario, to be approved for gender affirming surgeries.
There are primary care physicians, both in Newfoundland and Labrador, who are offering and supporting the provision of gender affirming care services. A specialized clinic offering trans healthcare in Newfoundland is the Gender Wellness Clinic (for youth) at the Janeway Children's Health and Rehabilitation Centre in St. John's. A noted challenge in the provision of gender affirming care in the province is the concentration of services in urban areas, like St. John's, which makes it difficult for individuals in rural areas to access care.
Gender-affirming hormone therapy can be accessed through primary care without requiring gender dysphoria diagnosis with hormone prescriptions being partially, if not fully, covered by the Newfoundland and Labrador Medical Care Plan (MCP), depending on which part of the program an individual is covered under. It should be noted that not everyone in the province has access to the provincial drug program. Details on transition-related coverage under MCP can be found here.
Eligibility and coverage for surgeries is outlined in the Department of Health and Community Service’s Trans-Related Surgeries Policy (2019). Before scheduling a surgery, your doctor will need to submit a Request for Prior Approval Form to the NL Department of Health and Community Services. Doctors that are qualified to conduct surgical readiness assessments can be found here. Currently, all gender affirming surgeries are performed out of province.
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