The Northwest Territories gender-affirming care guidelines are outlined in this document: Healthcare for Transgender, Non-binary, and Gender-Non Conforming People: Guidelines for the NWT (2020). The intended audience of this document is healthcare providers, and it aims to establish a clear referral process for gender-affirming healthcare services. However, the guidelines do not provide comprehensive clinical directions for providers. Instead they direct to resources from Trans Care BC, Rainbow Health Ontario, and the Alberta Medical Association for specific guidelines and protocols for assessments.
In the NWT, gender affirming care is accessed through your primary care practitioner and a diagnosis of gender dysphoria is often required. Generally, gender-affirming hormone therapy can be prescribed in the NWT by a clinical expert, however youth may be referred to paediatric specialists out of territory. The NWT does not have the capacity to perform gender-affirming surgeries, so people are assessed by a clinical expert and then referred to out of territory surgical providers, mostly in Quebec, Alberta, and Ontario. Wait times for surgeries can often be several years.
Clinical experts, as defined in the guidelines, may be doctors, NPs, RNs, psychologists, or RSWs. However, the reality is that there are very few designated clinical experts in the NWT. This can be a barrier to accessing gender affirming care, because an assessment by a clinical expert is often required to access care. The NWT Health Care Plan covers vaginoplasty, metoidioplasty, phalloplasty, mastectomy, and, in some cases, breast augmentation. Most other procedures are not covered.
If you would like help navigating gender affirming care in the NWT, you can reach out to Northern Mosaic Network’s Peer Support Program: https://www.northernmosaic.net/peer-support
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