RN/MSW/
Psychologist)
If you would like more information on how to become a provider qualified to make referrals for Trans Related Surgery please see the RHO website for trainings and information
For information on the referral process for surgery in Ontario see Rainbow Health Ontario’s Frequently Asked Questions.
For information about specific transition related surgeries, please see these surgical info summary sheets.
RHO provides a weekly mentorship call from Wednesday from 12-1. Providers are encouraged to call in to ask any trans related health care questions. Register at the bottom of the page on their website.
If you are looking for a primary or secondary provider to support trans pre-surgical planning visits you can make a referral to CAMH .
Visit the RHO Newsroom to be kept up-to-date as our program and website expands to include helpful resources and ensure access to care.
If you wish to access Ontario Health Insurance Plan (OHIP) funded TRS, please make an appointment with your physician or nurse practitioner. TRS planning visits can occur in a primary care setting, with a specialist or at the CAMH Gender Identity Clinic (or in combination depending on your needs and local resources). TRS planning visits will take place with your health care team. You may be asked to see one or two providers depending on the surgery you are requesting. In addition to a physician or nurse practitioner, this might include a social worker, a registered nurse or a psychologist
Your health care provider will arrange or provide the necessary surgery planning visits prior to referral for surgery. In these appointments the provider will ensure that you have met all the OHIP funded surgery criteria in addition to having an in depth conversation with you about your goals, different surgical and non-surgical options, risks and benefits of surgery and other relevant medical and mental health issues.
Once you have completed your TRS planning visit(s), your health care providers will complete a special medical form seeking OHIP funding for transition- related surgeries. Once this is approved, a referral will be made to your chosen surgeon. If the referral is complete and accepted, you will receive a call to set up an initial appointment with the surgeon. The TRS Frequently Asked Questions (.pdf) is a guide to the assessment and referral process for Ministry of Health and Long-Term Care Approval for OHIP funding. The resource is intended for persons considering transition-related surgery in Ontario, and the people supporting them.
The first appointment is a surgical consultation. At this visit you will meet with your surgeon and possibly the Nurse Practitioner or Social Worker. During this visit, we will take a comprehensive history, there will be a detailed discussion about surgery, a physical exam will take place, photos may or may not be taken and consent to communicate with your primary care team will be sought. A pre-op medical questionnaire will be completed.
After this consult visit, if surgery is the next step, the surgeons secretary will follow up with you in order to book surgery. Once surgery is booked, you will get another appointment for pre-admission clinic. This visit typically occurs in the week or two before surgery.
At the pre-admission visit you will be given more details about your surgery, pre-operative instructions, review an after-care plan and you may be given information to take home. You may also meet with anesthesia and possibly pharmacy or internal medicine at this visit.
You are expected to have someone to pick you up from surgery and stay with you for 24 hours afterwards. If you do not have such a person, we will discuss options available to you including the ARC program at SHC.
As a primary care provider it is important to be an advocate for your patient and support them to actualizing their gender in all all areas of their life. Below are resources that help you and your patient in navigating systemic barriers in health and legal and policy.
Template letter in support of an application for change of sex designation on an ontario birth registration, template letter in support of an application for change of sex designation on an ontario driver’s license, support letters.
Inquiring around how transitioning may influence the vocational or educational situation of the patient is important, as providers can help the patient develop strategies for dealing with gender transition in school or the workplace. Unfortunately it is not uncommon for transition to result in the loss of a job or struggle in academic setting.
Submit exceptional access program (eap) form for patients on ontario drug benefit (odb).
Patients covered by the Ontario Drug Benefit (ODB) program include those on Ontario Works (OW), the Ontario Disability Support Program (ODSP), seniors ≥65 years of age, youth ≤24 years of age without private insurance (via OHIP+) and those on the Trillium Drug Program. For patients on ODB, injectable testosterone is covered with the submission of an Exceptional Access Form (EAP), while anti-androgens and estradiol are covered without the need for EAP approval.
Recommendation: Injectable testosterone is funded by the Ontario Drug Benefit (ODB) program for gender affirmation with an Exceptional Access Program (EAP) request. We suggest that providers submit EAP requests for both testosterone cypionate and testosterone enanthate, so that delays in access do not result when one formulation is on back order or not locally available. (See Appendices N and O in the Guidelines for samples).
Sample request for an unlisted drug product, testosterone cypionate (depo-testosterone), overview of ontario process for transition-related surgery (trs).
This section provides a brief overview of the Ontario system for TRS planning visit(s) and referral. It is not exhaustive nor intended as training for conducting TRS planning visits.
Since TRS was relisted under OHIP coverage in 2008, surgical referral was delegated solely to the CAMH Adult Gender Identity Clinic. However in March 2016, the Ministry of Health and Long Term Care (MOHLTC) announced a regulatory change that allowed qualified providers outside of CAMH to conduct TRS Planning Visits and TRS referrals. This positive change has increased access to TRS for trans Ontarians and has encouraged a shift towards the provision of trans-related health care in the primary care setting.
For patients assigned male at birth | For patients assigned female at birth | ||
---|---|---|---|
Upper body | Augmentation Mammoplasty | Mastectomy | |
Gonadal | Orchiectomy | Hysterectomy Salpingo-oophorectomy | |
External Genital | Vaginoplasty | Clitoral Release with vaginectomy Metoidioplasty Phalloplasty Testicular Implants with scrotoplasty Penile Implant | |
For more detailed information on individual transition-related surgeries, please download the RHO TRS Summary Sheets
Overview of the trs planning and referral process.
1 connecting with qualified provider(s).
Decide which Qualified Provider(s)will conduct the TRS planning visit(s) and hence complete the MOHLTC Prior Approval from.
The MOHLTC requires the Prior Approval form to be completed by “a provider trained in the assessment, diagnosis and treatment of gender dysphoria in accordance with the World Professional Association for Transgender Health (WPATH) Standards of Care…” , and it is expected that the Qualified Provider who signs the Prior Approval form has conducted a complete TRS planning visit. Patients and their providers may choose what works best given individual patient needs and local resources.
A TRS planning visit is a collaborative visit between patient and a qualified provider to discuss TRS and how to optimize the patient’s experience and outcome. Topics discussed include WPATH and MOHLTC criteria, confirming the diagnosis of gender dysphoria, reviewing the stability of medical and mental health conditions, a surgery-specific informed consent discussion and aftercare planning.
Whether a patient has TRS planning visits in Primary Care or with CAMH or another Qualified Provider , there are many ways that a primary care provider can support a patient throughout the TRS process. Providers can help prepare patients for surgery by assisting in the optimization of medical and mental health conditions, supporting smoking cessation, discussing the aftercare plan, preparing for travel, finances and supplies, and providing emotional support. Some patients may benefit from peer support and information such as that provided by Sherbourne Health’s Surgical Support Groups for Community Members .
3 complete the mohltc prior approval form.
Complete, sign, and submit the “Request for Prior Approval for Funding of Sex-Reassignment Surgery” (also known as the “Prior Approval” form) to the MOHLTC.
The number of qualified providers who must complete independent TRS surgery planning visits and sign a Prior Approval from is based on the type of surgery requested. Upper body surgery requires a TRS planning visit(s) by one qualified provider (either a physician or NP). Gonadal or external genital surgery requires independent TRS planning visits with two qualified providers, one of whom must be a physician or NP, while the second can be a physician, NP, registered nurse, psychologist, or a registered social worker with a Masters of Social Work. Only the Prior Approval form should be sent to the MOHLTC; TRS clinical notes and referral letters should not be sent. The MOHLTC will then send a response letter with the outcome of the funding application.
Once an Approved Funding Letter is received, the qualified provider(s) can then send TRS referral letters to the TRS surgeon. TRS referral letters are different from typical referral letters; they include a large amount of information regarding the topics covered in the TRS planning visits. Providers should be familiar with the WPATH recommendations for TRS referral letters. Most surgeons will require complete documentation of thorough TRS planning visit(s). Additional materials such as medication lists, lab results, ECG, and/or photographs may be required by some surgeons before an appointment is booked.
Decision for TRS and TRS Planning Visit Options | TRS Planning Visit(s) & Prior Approval | Post-op Support |
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RHO's FAQs on Transition-related surgery (TRS)
Home » GET INFORMED » Talk Rights » Frequently Asked Questions Regarding Change of Sex Designation For Trans Persons
May 19, 2015
Like all content on this website, this document is not legal advice and is provided solely for the purpose of public information and education. If you are facing a legal issue or have a question about your specific situation, you should consider seeking independent legal advice. You can find a list of legal clinics and other resources to help you here.
The CCLA is a national organization that works to protect and promote fundamental human rights and civil liberties. To fulfill this mandate, the CCLA focuses on litigation, law reform, advocacy and public education. Our organization is not a legal clinic. As such, we are typically not in a position to provide members of the public with legal advice or direct legal representation. However, we do try to provide general legal information and appropriate referrals where possible. For questions about this document, email publicenquiries [at] ccla [dot] org.
This guide is focused on issues relating to how trans persons can change the sex designation on their birth certificates. For information on how trans persons can legally change the name used on their identification documents, see this guide .
This page is intended to help trans persons with issues related to changing the sex designation on their birth certificates. As such, some of this information may not be helpful to those seeking to change their birth certificates for another reason.
Note: Every effort has been made to ensure comprehensiveness and accuracy (as of May 2015). However, this FAQ may not fully reflect the current state of the law.
We use the term “trans” to include anyone who does not identify with the sex designation they were assigned at birth.
Questions addressed in this FAQ:
Should i have to have surgery in order to change the sex designation on my birth certificate, are sex designations on birth certificates even necessary, how can i change the sex designation on my birth certificate, where do i apply to change the sex designation on my birth certificate, what proof do i need to show in order to change the sex designation on my birth certificate do i need to show proof of surgery, can i apply if i am younger than 18 or 19, can i apply even if i was born outside of my current province/territory.
You can download a PDF of this document here: CCLA Change of Sex Designation FAQ .
Many trans persons consider the sex they were assigned at birth to be inaccurate. If this is you, changing the sex designation on your birth certificate may be important for your well-being. It is also important for legal reasons as well.
In order to enjoy a greater degree of safety and freedom from discrimination, you may want to have identification documents that match the gender with which you identify and present yourself. The information on most identification documents is drawn from birth certificates, so changing your birth certificate is often a necessary first step. “Sex” is a category on most driver’s licenses, passports and health cards, and so you may find yourself being forced to discuss your gender identity – sometimes even your genitals – with a stranger. This is even worse when that stranger is empowered to make decisions that greatly affect you, such as whether to write you a traffic ticket, offer you a job, refer you for medical treatment, or let you enter the country.
Trans persons face widespread discrimination and high rates of violence. Of trans Ontarians surveyed by the Trans PULSE Project, 26% reported being hit or beaten up because they were trans, 73% reported being made fun of, and 39% reported being turned down for a job. In 2010, Trans PULSE estimated that 50% of trans Ontarians had seriously considered suicide at some point in their lives because of the discrimination they faced. Involuntary outing on a regular basis, such as by having an inaccurate gender specified on your identification documents, eliminates one of the few mechanisms you may have to protect yourself from transphobia.
In 2014, a judge in Alberta considered the constitutionality of the provincial law that regulated gender markers on birth certificates. The judge struck down that law, because it was contrary to the Canadian Charter of Rights and Freedoms . In doing so, the judge cited a prior decision of the Ontario Human Rights Tribunal. That decision detailed some of the discrimination faced by trans persons (referred to here as “transgendered” [sic]):
“[T]ransgendered persons as a group tend to face very high rates of verbal harassment and physical assault and are sometimes even murdered because of their transgendered status. […] [I]t is very difficult for a transgendered person to find employment, […] there are very high rates of unemployment among transgendered people generally, and […] many transgendered people are fired once they are exposed in the workplace as being transgendered.”
These concerns also extend to young trans persons, who may be forced to endure bullying by their peers if the sex designation on school records does not match their gender identity.
Many trans persons want the benefits of official documents that correspond to their identity but may not want to undergo surgery. They may be content with the use of hormones or simply by presenting themselves consistently with their gender identity.
Gender reassignment surgery can be expensive, difficult to access, and carries the risks associated with any surgery. In addition, it has been reported to typically cause sterility . Gabrielle Bouchard of the Montreal-based Centre for Gender Advocacy has said the surgical requirement in order for official documents to be changed amounts to mandatory sterilization. The surgery requirement also emphasizes biological sex characteristics rather than gender identity. Even after surgery has been performed, a second doctor must sometimes “confirm” the surgery. C.F., the plaintiff in the Alberta court case mentioned earlier, told the Edmonton Journal :
“What this legislation requires is that you not only submit to dangerous, risky surgery, but then actually attend for a humiliating genital inspection before two separate physicians, both of whom will make a value judgment about whether your genitals are sufficiently female[.] It’s like something from ages gone by. It’s very disturbing stuff.”
Due to these types of concerns, there have been and continue to be legal challenges to the various provincial legislation that require reassignment surgery in order to change sex designation. In the Ontario and Alberta decisions discussed earlier, the requirement for gender reassignment surgery was found to be discriminatory. As a result of these rulings, several provinces, including Alberta, British Columbia, Manitoba, Ontario, and Quebec, have taken steps to amend their laws to remove reassignment surgery from the requirements necessary in order for you to change your sex designation. Nova Scotia has also indicated that it plans to amend its legislation to remove the surgery requirement.
Some activists have argued for the removal of sex designations from identification documents altogether, on the basis that gender identity is not a binary classification. The binary does not accommodate people who do not identify with a binary gender classification.
Ongoing cases challenging legislation in British Columbia , Saskatchewan and Quebec are seeking the removal of sex designations from birth certificates. So far, although several provinces have removed the surgery requirement, no province has taken the step of removing sex designations altogether or providing for a third non-binary option.
In contrast, several countries, including Australia and Germany , now allow persons to designate their sex on their passport with an “X”. However, some trans rights advocates argue that the “X” continues to out trans persons, and is used as an excuse for not eliminating the surgery requirement. An Australian court has ordered the government to register a third category of sex designations on birth certificates and name change certificates.
For more on the possibility of non-binary gender designations, see the BC Law Institute’s report , where the Institute highlights the implications and consequences of different solutions to providing a non-binary sex designation in Canada.
All provinces and territories except Nunavut have procedures for changing sex designations when a person has undergone gender reassignment surgery.
The rules for changing the sex designation on a birth certificate vary from province to province. They are also changing rapidly. In all provinces except Quebec, where the Civil Code governs these issues, the law concerning birth registration is found in the provincial Vital Statistics Act and associated regulations. These laws and regulations can be consulted for free on http://canlii.org . Note that a province may have policies that are not in the legislation. For more information about requirements, check with the government agency responsible for birth certificates in your province or territory (listed below), or with a trans advocacy organization, such as Egale Canada .
Many provinces require letters from a mental health professional in order to change a person’s gender marker or name. Such a letter may also be required to access sex reassignment surgery.
Online government information is limited outside British Columbia, Manitoba and Ontario. Where specific information regarding change of sex designation is unavailable on a province’s website, the links below provide contact information for the appropriate agency.
Alberta | |
British Columbia | |
Manitoba | |
New Brunswick | |
Newfoundland and Labrador | |
Nova Scotia | |
Ontario | |
Prince Edward Island | |
Quebec | (in English, see bottom of the webpage) |
Saskatchewan | |
Northwest Territories | |
Nunavut | (only general information is available; Nunavut does not have a law that allows for changing the sex designation on your birth certificate) |
Yukon |
Until recently, all provinces and territories required you to have gender reassignment surgery if you wanted to change the sex designation on your birth certificate. Ontario became the first province to drop this requirement in 2012 when, as mentioned previously, its human rights tribunal ruled the requirement was discriminatory. The Alberta Court of Queen’s Bench handed down a similar ruling in April 2014. Ontario has not officially amended their legislation, but are now registering changes without proof of surgery as a matter of policy. British Columbia, Alberta and Manitoba are the only provinces that have formally amended their legislation to eliminate the surgery requirement. In Alberta, the new requirements are set out in regulations .
New Brunswick, Newfoundland and Labrador, PEI and Saskatchewan all require applicants to document that they have undergone gender reassignment surgery, usually by having at least two physicians – the surgeon who performed the surgery and another who did not – certify that fact. Quebec and Nova Scotia also currently require proof of surgery, but changes to the law are on their way (see below). In Quebec, the second physician must practice medicine in Quebec. In New Brunswick and the Northwest Territories, the second physician must be licensed in any Canadian jurisdiction.
The law in this area is changing rapidly as legislation is amended and court challenges are brought regarding surgery requirements. Consulting the relevant statutes will not always give a full picture of the current requirements or upcoming amendments. For current information, contact a trans advocacy organization, such as Egale Canada .
Alberta | No proof of surgery required; |
You must provide:
A declaration, which provides your date of birth, and states that you identify with and maintain the gender identity that corresponds with your desired sex designation; and
Confirmation from a licensed doctor or psychologist licensed in Alberta or another jurisdiction that the sex designation on your birth certificate does not correspond with your gender identityBritish ColumbiaNo proof of surgery required;
A declaration, which states you have assumed, identify with and intend to maintain the gender identity that corresponds with your desired sex designation; and
Confirmation from a doctor or psychologist licensed in BC or the province or territory where you live that the sex designation on your birth certificate does not correspond with your gender identityManitobaNo proof of surgery required;
A declaration, which states you identify with the requested sex designation, you are currently living full-time in a manner consistent with the requested sex designation and you intend to continue doing so; and
A supporting letter from a health care professional licensed in Canada or where you live that your gender identity corresponds with the requested sex designationNew BrunswickProof of surgery requiredNewfoundland and LabradorProof of surgery requiredNova ScotiaProof of surgery still required, but a bill to eliminate the requirement has received royal assent. Under the new law, which is not yet in force, you will written statements from themselves and a member of a profession to be prescribed in the regulations that confirm your gender identity.OntarioNo proof of surgery required;
A declaration, which states your gender identity); and
A note from a doctor or psychologist licensed to practice in Canada that confirms your gender identityPrince Edward IslandProof of surgery requiredQuebecProof of surgery required, but change is pending;
The requirements under the new law have not been set yet.SaskatchewanProof of surgery requiredNorthwest TerritoriesProof of surgery requiredYukonProof of surgery requiredNunavutThere is no provision in the Vital Statistics Act for changing sex designation, even with surgery
Sex reassignment surgery is generally not performed on those under the provincial age of majority, as all clinics in Canada that currently perform reassignment surgery conform to the recognized Standards of Care . These Standards, which are regarding health care for trans persons, forbid irreversible interventions (such as surgery) on patients before they reach the age of majority. As a result, if you are a minor in Canada, you generally cannot change your sex designation in provinces or territories where proof of surgery is required.
In provinces that do not require surgery, the age requirements vary:
Note that legal challenges to the minimum age requirements are currently proceeding in several provinces, including Quebec and Saskatchewan . Click here to listen to an interesting radio interview with a 10 year old who would like to change the sex designation on her birth certificate.
Alberta | No age minimum, but if you are under the age of majority (18), you must have parental/guardian permission |
British Columbia | No age minimum, but if you are under the age of majority (19), you must have parental/guardian permission |
Manitoba | No age minimum, but health care professional must attest to your capacity to make health care decisions |
New Brunswick | No age minimum, but surgery is required and will not be performed if you are under 18; in addition, if you are under the age of majority (19), you must have parental/guardian permission |
Newfoundland and Labrador | No age minimum, but surgery is required and will not be performed if you are under 18; in addition, if you are under the age of majority (19), you must have parental/guardian permission |
Nova Scotia | : No age minimum, but surgery is required and will not be performed if you are under 18; in addition, if you are under the age of majority (19), you must have parental/guardian permission. |
Under new law (not yet in force) : No age minimum, but if you are under 16, you must have parental/guardian permission or apply to the Supreme Court of Nova Scotia for an order dispensing with the requirement of parental consent.OntarioNo age minimum, but if you are under 16, you must have parental/guardian permissionPrince Edward IslandNo age minimum, but surgery is required and will not be performed if you are under 18; in addition, if you are under the age of majority (18), you must have parental/guardian permissionQuebecAge minimum is 18.SaskatchewanNo age minimum, but surgery is required and will not be performed if you are under 18; in addition, if you are under the age of majority (18), you must have parental/guardian permissionNorthwest TerritoriesNo age minimum, but surgery is required and will not be performed if you are under 18; in addition, if you are under the age of majority (19), you must have parental/guardian permissionNunavutThere is no provision in the Vital Statistics Act for changing sex designationYukonNo age minimum, but surgery is required and will not be performed if you are under 18; in addition, if you are under the age of majority (19), you must have parental/guardian permission
British Columbia, Ontario and Northwest Territories will change sex designations only for births registered in their respective provinces. Some provinces will register a change of sex and then transmit it to the jurisdiction where the birth was registered.
Alberta | No explicit requirement that the applicant was born in Alberta |
British Columbia | Legislation requires that the applicant was born in British Columbia |
Manitoba | Legislation requires that the applicant was born in Manitoba. Changes permitting applications from Canadian citizens who have resided in Manitoba for at least one year (the latter will receive a “change of sex designation” certificate, not a new birth certificate) are not yet in force. |
New Brunswick | No explicit requirement that the applicant was born in New Brunswick |
Newfoundland and Labrador | No explicit requirement that the applicant was born in Newfoundland and Labrador |
Nova Scotia | : Applicants born outside of Nova Scotia may apply, and the province will transmit their request to the jurisdiction where their birth was registered. |
Under new law (not yet in force) : Legislation requires that the applicant was born in Nova Scotia.OntarioLegislation requires that the applicant was born in OntarioPrince Edward IslandApplicants born outside of Prince Edward Island may apply, and the province will transmit their request to the jurisdiction where their birth was registered.SaskatchewanNo explicit requirement that the applicant was born in SaskatchewanQuebec Under the new law (not yet in force) : Legislation requires that the applicant was born in Canada and resides in Quebec, or that the applicant was born in Quebec and resides in a place where change of sex designation is unavailable or impossibleNorthwest TerritoriesLegislation requires that the applicant was born in Northwest TerritoriesNunavutThere is no provision in the Vital Statistics Act for changing sex designationYukonApplicants born outside of Yukon may apply, and the province will transmit their request to the jurisdiction where their birth was registered
The Trans PULSE Project prepared a report for the Canadian Human Rights Commission on sex designation in federal and provincial IDs in 2012. The report was prepared for hearings on Bill C-279, a proposal to add gender identity and expression to the Canadian Human Rights Act and to hate crime provisions of the Criminal Code . The report can be found here .
In 2014, the British Columbia Law Institute prepared a report for the Uniform Law Conference of Canada on the state of the Canadian law regarding change of sex designation, and regarding options for reform in 2014. The report can be found here .
The CCLA is an independent, non-profit organization with supporters from across the country. Founded in 1964, the CCLA is a national human rights organization committed to defending the rights, dignity, safety, and freedoms of all people in Canada.
For further comments, please contact us at [email protected] .
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The Ontario government will move to allow more health-care providers to provide patient referrals for sex-reassignment surgeries, a move Health Minister Eric Hoskins said will reduce long wait times currently faced by transgender people.
Hoskins made the announcement at a Friday news conference at the Sherbourne Health Centre in Toronto.
Patients can currently only receive a referral for surgeries paid for by the province's health-care plan through the Gender Identity Clinic program at the Centre for Addiction and Mental Health (CAMH) in Toronto.
Hoskins said the province wants to allow all qualified health-care providers throughout the province to be able to refer patients for this surgery starting in 2016.
"Every Ontarian has the right to be who they are," said Hoskins. "Our health care system should reflect this vision, which is why we are improving access to sex-reassignment surgery."
He said more and more Ontarians are experiencing gender dysphoria, defined as the distress caused by a discrepancy between a person's gender identity and that person's sex assigned at birth. Patients who need surgery often face long wait times.
"One of the most vulnerable times for trans people is when they are ready for surgery, but face a prolonged wait," said Hoskins. "This change would reduce wait times by allowing many trans clients to get surgical approvals from their own local primary care teams."
The wait list for gender reassignment surgery currently stands at more than 1,000 people. The referral wait time in Ontario is typically now more than two years, a wait that will be "dramatically" reduced as a result of the changes, said Hoskins.
Hoskins said the new referral process for gender reassignment surgery will still be based on existing criteria and internationally recognized standards of care. He also said the number of people in Ontario asking for gender identity services has been on the increase in recent years.
"We are moving from a single site [for referrals] to what could potentially be hundreds of sites," he said.
The changes to allow local referrals will come in the form of amendments to the Health Insurance Act. Hoskins said the government will provide additional funds to CAMH while the transition to local referrals takes place.
Dr. Amy Bourns, whose practice includes a special interest in transgender health, said the announcement is "an amazing step forward."
Hoskins was asked about the fact that gender-reassignment surgeries are currently not available in Ontario, even for patients who complete the long referral process. Many Ontario patients go to Quebec or other jurisdictions to have the surgery.
"We need to look at the provision of the surgical services and we're looking at that," he said, pointing out the expanding referrals to health-care providers across Ontario as a "first step."
Related stories.
The Ottawa Hospital is now accepting referrals to its new state of the art gender affirming care clinic.
The clinic is the first of its kind in Ontario and second in Canada to offer trans and non-binary patients facial, top and bottom procedures.
The clinic will have life-changing implications for trans and non-binary individuals, who often face barriers to seek care with long wait times or lack of access in the communities where they live.
"There’s just a massive gap in our health-care system for the treatment of the transgender population and people seeking gender-affirming care," said the clinic’s lead and co-founder, Dr. Nicholas Cormier in a news release .
"What’s so groundbreaking about this new clinic is that everyone is coming together to address this shortcoming in our system."
Before the clinic was opened, patients seeking gender-affirming surgery in Ottawa could only access top surgery but not bottom or facial operations. Previously, a clinic in Montreal was the only location in Canada offering all three procedures.
The clinic will be partnering with other surgical divisions at the hospital—plastic surgery, urology, obstetrics and gynecology.
The hospital will also be working with trans health programs out in the community, such as the Centretown Community Health Centre’s Trans Health Program , which provides patients with a referral to the clinic and CHEO’s Gender Diversity Clinic .
For Dr. Cormier, the clinic is the culmination of many years of caring for the gender-diverse community.
"Accessing gender-affirming surgery is just one small component of gender-affirming care," Cormier said. "That’s where these community partners really come into play."
The Ottawa Hospital also launched the Gender and Diversity Specialty Clinic in January 2022, providing care for medically complex trans and non-binary patients.
some gender-affirming surgeries are available at other Canadian hospitals.
Women’s College Hospital has been increasing its capacity and growing its team in order to provide this life-saving care for its patients requiring gender-affirming surgeries. Its transition related team started out in 2019 with nurse practitioner Emery Potter and medical director. The team has since grown.
Vancouver General Hospital also offers top and bottom surgery.
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Don’t hesitate to contact McLean Clinic today to learn more about double incision top surgery and other types of FTM top surgery. A member of our staff will be more than happy to assist you.
Don’t hesitate to contact McLean Clinic today to learn more about double incision top surgery and other types of top surgery. A member of our staff will be more than happy to assist you.
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In the recent years, transgender health care in Canada has seen dramatic improvements. More provinces have expanded their public healthcare packages to accommodate gender-affirming surgeries, including FTM/N top surgery or genital reconstruction procedures, for gender dysphoria treatment. However, access and availability of transition-related treatments are still far from reach for most members of the LGBTQ+ community because of the long wait times.
What's the average waiting time to get a gender-affirming surgery in Canada? The country's first study on transgender patients' experiences published in 2017 by researchers from the University of British Columbia revealed it's anywhere from one month to nine years. The results of the study showed frustrating inconsistencies in trans patients' experience across the country.
In this article, we break down the study's key findings to pinpoint where the bottleneck is coming from and what's causing the delay in delivering life-saving surgical procedures for the Canadian LGBTQ+ population .
The application process towards a gender-affirming surgery in Canada is divided into several steps. The first one is a surgery readiness assessment. Whether you are getting a transition-related operation done from a publicly funded or private clinic , a surgical readiness assessment is required by most surgeons to ensure that a potential patient is prepared and will get the best results post-surgery.
According to Trans Care BC , the primary criteria for most types of gender-affirming surgery in British Columbia are:
Before even receiving a readiness assessment, the individual needs to follow several processes to qualify for one. This can range from:
Getting referred to an assessor through your primary care provider:
Depending on the type of gender-reaffirming surgery, one or two assessments carried out by different assessors may be required. Surgical readiness assessments can be covered if they are qualified assessors working in the publicly-funded health care system. You can also have them conducted by qualified private assessors, such as psychologists or clinical counsellors.
Getting assessed:
Once you've been referred, you have to wait for a schedule for your surgical readiness assessment. The actual appointment lasts between one to two hours, where you'll discuss your gender identity , medical history, and surgical aftercare plan . In some cases, you may be asked to come back to provide additional information.
Get a recommendation:
The qualified assessor may or may not recommend you for surgery or recommend you return for further assessment. They would send their recommendation directly to your primary care physician, who will send you a referral for surgery.
In British Columbia, most people (60%) easily or very easily got referred to an assessor, and half of these trans people (50%) did not have to spend any money on their assessment appointment(s).
Half (50%) of the respondents in BC waited 150 days or less between the referral and their most recent surgery readiness assessment appointment. This is in contrast to the average of 180 days other patients in the country reported. However, BC's wait time also had unusual fluctuations, with some people waiting for a single day to as long as 1,825 days or more than five years.
On the other hand, the average wait time between referral and assessment in BC also differed according to the types of gender-affirming surgery planned.
Data suggests that for all types of gender-affirming surgery in Canada, 71% had their surgery paid for, at least partially, through a government health care plan . The vast majority (93%) only had one source of funding. Almost seven out of 10 Canadians had their transition-related surgery funded with a public health plan, and one in three people said they used their own money as their sole source for surgery funding.
Unfortunately, not everyone receives approval for the life-changing surgery they had in mind. Aside from having an existing medical condition that increases the risk of being on general anesthesia, many hopefuls are deemed ineligible due to two primary reasons:
After getting approved for funding, the vast majority of participants (84%) said they did not have any problem getting a referral to a surgeon for gender-affirming surgery. More than half (57%) also said they were able to choose the surgeon they wanted.
The average wait time between getting an approval and surgery date was less than 12 months or less for half of the surgeries in BC. In other parts of Canada, the wait time was eight months or less for half the surgeries.
The researchers said each patient's experiences were so diverse, with waiting times ranging from a month up to 108 months or nine years. The longest wait times were reported in the following gender-reaffirming surgeries in Canada:
Interestingly, the researchers also noted that 50% of the people taking the survey were currently waiting for their surgery and/or had a scheduled surgery date, and had already been waiting for at least 17 months. Half of the people who were now waiting for surgery but did not have a scheduled surgery date had been waiting 11 months or more when they took the survey.
Elizabeth Saewyc, one of the lead authors on the study, gave VICE a few valid points regarding what her thoughts were on the potential causes of the long waiting process for accessing gender-affirming surgery in Canada .
The long wait times for gender-affirming surgery in Canada have been exacerbated exponentially by the unexpected arrival of the COVID-19 pandemic. Both public and private hospitals and clinics had to cancel scheduled surgeries and other transition-related procedures to adhere to stringent lockdown restrictions placed in different countries worldwide. Currently, we see many health care providers tackling their backlogs with surgeries booked up to 2022.
One of the biggest concerns caused by the long wait times in gender-affirming surgery in Canada would be its detrimental effects on the mental health of the LGBTQ+ population , who are already at an increased risk for:
This is cemented in a quote by N. Nicole Nussbaum, former president of Canadian Professional Association for Transgender Health and staff lawyer at Legal Aid Ontario, "Trans people are at the highest risk of suicide and self-harm between the period that they've mentally decided to transition and when they complete their medical transition ."
For inquiries about gender-affirming surgery in Canada or to learn more about what an FTM top surgery at McLean Clinic is like , don’t hesitate to reach out to us. A member of our team will be more than happy to answer your questions.
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Transition-related surgery (TRS) refers to a range of surgical options that can help people feel that their physical characteristics more closely reflect their gender identity or expression. These options can support one in feeling more comfortable in their body and may help to improve your mental wellness.
In order to receive provincially-funded transition-related surgeries, you will need a surgery assessment from one or two health providers, depending on the surgery, one of which being a qualified primary care provider like a Physician or Nurse Practitioner.
If you have a primary care provider and would like to start a discussion with them about transition-related surgery, you can click here for tips on how to start that conversation.
If you do not have a primary care provider and would like to access transition-related surgery, you can reach out to Centretown Community Health Centre’s Trans Health Program to get connected with surgery referral support.
Disclaimer: this section uses medical terminology.
Upper Surgery (Chest or Breast Augmentation) needs one assessment by a qualified Physician or Nurse Practitioner. Lower Surgery (Genital Surgery) needs an additional assessment from any qualified Physician, Nurse Practitioner, Psychologist, or Registered Social Worker (Master’s Degree).
Under the Ministry of Health and Long-Term Care (MOHLTC), the following surgical procedures are provincially-funded:
*Patient must have completed twelve continuous months of hormone therapy with no breast enlargement unless hormones are contraindicated
Prior to beginning the referral process for transition-related surgeries, the following eligibility criteria must be met:
As of right now, OHIP does not cover the following procedures identified as medically necessary by the World Professional Association for Transgender Health:
*OHIP does not cover travel costs involved in obtaining surgery. If you are in financial need and must travel to obtain an OHIP approved procedure, Hope Air can provide free air travel and accommodation. You can learn more about this option here.
For an overview of transition-related surgeries, risks, benefits and additional information, review Rainbow Health Ontario’s TRS Summary Sheets here .
Step 1: Connect with Qualified Providers.
The MOHLTC requires 2 qualified providers submit a “Request for Prior Approval for Funding of Sex Reassignment Surgery” form (can be found on the “Clinical Resources” section of our resource library ).
Who is a qualified provider?
The MOHLTC criteria for a qualified provider includes Physicians, Nurse Practitioners, Registered Nurses, Psychologists and Registered Social Workers. Eligible providers are expected to self-assess if providing transition-related surgical referrals is within the scope of their practice. There is no single training course that “qualifies” a provider, but providers are encouraged to undertake professional development and training activities to build their capacity on trans health services.
If your primary care provider is not able to submit a Prior Approval form on your behalf, Centretown Community Health Centre can help.
Step 2: Participate in a Transition-Related Surgery (TRS) Planning Visit
A TRS planning visit is a collaborative visit between a patient and a qualified provider to discuss TRS and how to optimize the patient’s experience and outcome. Topics discussed include reviewing World Professional Association for Transgender Health (WPATH) and MOHLTC criteria, confirming the diagnosis of gender dysphoria, reviewing the stability of medical and mental health conditions, confirming surgery-specific informed consent and planning aftercare.
Step 3: Complete the Prior Approval Form
Following your Transition-Related Surgery Planning Visit, your provider can complete, sign, and submit the “Request for Prior Approval for Funding of Sex-Reassignment Surgery” (also known as the “Prior Approval” form) to the MOHLTC.
The number of qualified providers who must complete independent TRS surgery planning visits and sign a Prior Approval form is based on the type of surgery requested.
Upper body surgery requires a TRS planning visit(s) by one qualified provider (either a P hysician or Nurse Practitioner).
Gonadal or external genital surgery requires independent TRS planning visits with two qualified providers, one of whom must be a Physician or Nurse Practitioner, while the second can be a Physician, Nurse Practitioner, Registered Nurse, Psychologist, or a Registered Social Worker with a Masters of Social Work.
Once the application is submitted, the MOHLTC will then send a response letter with the outcome of the funding application.
If approval is not received, your qualified provider can contact the MOHLTC to provide additional information, the application can be resubmitted, and/or an internal review of the initial application can be requested by your provider.
Step 4: TRS Referral Letter Sent to TRS Surgeon
Once an approval letter is received from the MOHLTC, your provider can send a referral letter to the transition-related surgery surgeon. TRS referral letters are often more in-depth than typical referral notes and often include details about your TRS planning visits. Surgeons will often request additional documentation, including medication lists, lab results and other information.
Step 5: Complete TRS and After Care
Once referred to a TRS surgeon, you will be contacted by the surgeon or clinic to sort out additional details, and will receive more information as your surgery date nears.
Concerns have been raised about mastectomies in teens when uncertainties exist about long-term health effects and the possibility of regret
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As tensions rise over the medical care of trans children, a new analysis shows hundreds of adolescents in Canada have undergone female-to-male “top surgery” — double mastectomies — over the past five years.
Hospitalizations and day surgery visits for bilateral mastectomies for gender reassignment surgery have risen sharply, from 536 in 2018-19, to 985 in fiscal 2022-23, according to data compiled for National Post by the Canadian Institute for Health Information.
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Of the 4,071 visits in total involving gender-affirming mastectomies or breast reductions reported since 2018, 602 involved youth 18 and under.
Of those, 303 involved teens 17 and younger. The youngest age was 14.
The numbers tell only part of the story. The CIHI data exclude Quebec hospitals as well as surgeries performed in private clinics like the McLean Clinic in Mississauga, which describes its surgeons as “industry pioneers” for top surgery — mastectomies and breast reductions in those assigned female at birth, and breast augmentation for those born male transitioning to female.
One specialist in transgender health issues said that, when applying for OHIP funding for people seeking top surgery, “50 to 70 per cent will go to McLean.”
Female-to-male chest surgery involves removing the breasts to achieve a flatter, more masculinized torso, to better align the person’s physical body with their gender identity and reduce gender dysphoria, defined as the persistent distress that can accompany the incongruence between the gender one identifies with and one’s gender at birth.
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If this was just about ... kids being allowed to wear what they want and say what they want and be called whatever name they want and it stopped there, who would care?
But concerns have been raised about intervening with permanent, body-altering surgeries in adolescents when uncertainties exist about the long-term health effects, the possibility of regret and whether their trans identity will be lifelong.
Last week thousands gathered in cities across the country for duelling protests over gender policies in schools. Earlier this month delegates to the federal Conservative party’s policy convention voted 69 per cent in favour of prohibiting “life altering medicinal or surgical interventions” on minors under 18 to treat gender confusion or dysphoria.
Sweden, the world’s first country to authorize legal gender transitions in 1972, last year began limiting mastectomies for teenage girls to research settings. “The uncertain state of knowledge calls for caution,” the head of Sweden’s National Board of Health and Welfare said in a statement reported by AFP.
Public coverage for the surgeries varies from province to province. Most cover the cost of the mastectomy itself, but not several thousand dollars or more in extra add on fees for “chest contouring,” liposuction procedures to give the body a more sculpted, masculine look.
The rise in surgeries reflects a dramatic shift in the sex ratio of children and teens being referred to specialized gender identity clinics across the country, from once predominantly young boys to children born female.
One study involving 174 trans and non-binary children and teens referred to 10 gender identity clinics in Canada found 34 per cent of those assigned female at birth were referred for top surgery. Most were 15 or 16 at the time of referral.
Ontario’s Health Ministry declined to respond when asked the number of OHIP approvals for gender-affirming mastectomies in the most recent year available, including the proportion in youth. The McLean Clinic said its surgeons were unable to accommodate a request for an interview.
According to CIHI, of the 536 hospital visits for transgender reassignment mastectomies in 2018-19, 76, or 14 per cent, involved 18-year-olds and younger.
That age group accounted for 18 per cent of visits for mastectomies (174 out of 991) reported in fiscal 2021-22, and 14 per cent of visits (135 out of 985) in 2022-23.
The percentage dipped last year as hospitals grappled with pandemic-driven surgical backlogs. “But the private clinics just kept churning them through,” said one doctor familiar with trans medicine who requested anonymity fearing professional repercussions.
“The fact that you can’t get the numbers from private clinics…. It’s very cloak-and-dagger,” the doctor said. “They’re still billing OHIP. That’s tax dollars. That should be publicly accessible information. We need to see these numbers and ask questions,” the doctor said.
“If this was just about the schools, and just about kids being allowed to wear what they want and say what they want and be called whatever name they want and it stopped there, who would care? But medicine got involved.”
For a double mastectomy, typically two incisions are made on the bottom border of the pectoral muscle or chest area, according to the McLean Clinic’s website. “The skin is then lifted to surgically remove the breast tissue underneath.” The nipples are removed, re-sized and repositioned by grafting “to suit the new masculine appearance of the chest.”
It’s a day-surgery procedure performed under general anesthesia that takes approximately two hours. Complications can include bruising, wound infections and scarring. People lose nipple sensation as well as the ability to breastfeed should they become pregnant.
The uncertain state of knowledge calls for caution
Major medical groups like the American Academy of Pediatrics have strongly endorsed a gender-affirming approach to care to promote “optimal physical, mental and social wellbeing.” Eligibility for gender-affirmative surgeries in teens should be determined on a case-by-case basis, the AAP said in a 2018 policy statement the organization recently reaffirmed, while at the same time calling for a review of the evidence to develop an “expanded set of guidance.”
The growth in referrals to specialized clinics could be due to greater awareness and social acceptance, and the teaching of gender identity in school, experts said. But it’s not clear why it’s concentrated in children and teens born female.
Denying or holding back access to gender-affirming care “can have negative consequences for some youth,” SickKids in Toronto said in a statement. “Decisions for care should be made by youth, their families and their health-care providers, who are best-positioned to support them.”
Trans teens are known to be at higher risk of harassment and cyberbullying, wrote the authors of a recent review on the surgical and ethical considerations of gender affirming surgery in teens. Early access to surgery may reduce the bullying, they said, or help facilitate “age-appropriate romantic and sexual development in adolescents who may otherwise be prevented from engaging in these activities due to gender dysphoria.”
But the evidence is largely anecdotal, they said. The handful of published studies on surgery in minors involved relatively short follow-up periods.
“What we do know is that regret does take place, and it does take place later on in life,” said one trans medicine specialist, who also agreed to speak on the condition of anonymity for fear of being labelled “transphobic.”
“If we know that people can come to this realization that maybe this may have not been the best decision for them, if that takes place after five years or 10 years, we don’t have all the information to allow patients to make an informed decision.”
For such a permanent decision as the removal of healthy breasts, “I’m always looking at the why, and because that hasn’t been answered yet, that’s what leads to my ambivalence,” the specialist said.
“What all this says to me is that we need to be much more thoughtful in our approach and in our assessments.”
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Form Number | 5041-77 |
Title | Request for Prior Approval for Funding of Sex-Reassignment Surgery |
Description | Form to be completed by providers on behalf of patients seeking prior approval for insured sex-reassignment surgery. |
An Ontario resident is fighting the government to secure public funding for a specialized gender-affirming surgery argued to be "experimental" by the provincial health insurer.
The prospective patient, identified only as K.S. in documents filed with the provincial Health Services Appeal and Review Board (HSARB), is seeking coverage under the Ontario Health Insurance Plan (OHIP) for a penile-preserving vaginoplasty, a procedure in which a vaginal cavity is surgically created while keeping the penis intact.
“There have been so many times that I have had to justify myself to just be,” K.S. told CTV News Toronto in a statement submitted through her counsel. “People who aren’t trans or nonbinary don’t have to get that permission to exist.”
K.S., whose identity is protected under a publication ban, identifies as nonbinary. She presents as predominantly female and uses she/her pronouns, but does not align with the gender binary.
The procedure she seeks is not widely practiced. In what most consider a traditional vaginoplasty, the erectile tissue is inverted to create a vaginal cavity. In a penile-preserving vaginoplasty, the vaginal cavity is created using a skin graft instead. There is currently no peer-reviewed research on the outcomes of the technique, only offered by a small number of private clinics, none of which are in Canada.
Since 2023, K.S. has been engaged in a series of appeals put forth to the review board following an initial denial by OHIP to cover the surgery.
Having experienced gender dysphoria since her teenage years, K.S. first applied for funding in 2022, seeking to have the surgery performed at the Crane Center for Transgender Surgery in Austin, TX. OHIP denied her request, claiming it wasn't included in the list of insured services under OHIP.
Without coverage, K.S. said undergoing the procedure would be nearly impossible – it costs tens of thousands of dollars that she doesn’t have.
READ MORE : What gender-affirming care is and how it can be life-saving
The legal battle that has played out in front of the review board has seen K.S. repeatedly make her case for why such a specialized procedure is medically necessary, measuring years of suffering through gender dysphoria against the assumed risk of a procedure not yet in the mainstream.
“The absurdity of managing to get through all the unjustly imposed barriers only to still be told that my surgical request is not valid has been heartbreaking,” she said.
When reached for comment, the Ministry of Health, which oversees health insurance in Ontario, said it could not comment on cases that are before the review board.
The case unfolds a critical juncture for transgender care in Canada — just weeks ago, Alberta unveiled sweeping policy changes including a ban for all gender-affirming surgeries for minors aged 17 and under — and, according to experts, could stand to inform national conversations of access to healthcare faced by non-binary population across the country.
With no options to secure the surgery outside of insurance, K.S. appealed the government’s initial denial of funding in April 2023 .
“I felt I had no choice," she said. “There quite literally is no ‘do or don’t’ when it comes to treating gender dysphoria.”
Throughout the two-day hearing, lawyers representing the province argued that for a vaginoplasty to be considered an insurable service, a patient also needed to undergo a penectomy, as is considered the standard of practice in Ontario.
It called upon Dr. Yonah Krakowski, a sexual medicine surgeon at Women’s College Hospital, to provide expert testimony. Krakowski said that, while he supports patient autonomy, he believed wider expert opinion would deem the procedure sought by K.S. as “experimental” at this time.
Self-represented, K.S. argued, in part, that the denial singled her out based on gender identity and that nowhere in the provincial legislation or regulations was it a requirement that someone transition from one binary gender to another in order to be eligible for funding.
During the hearing, K.S. put forth “impressive legal challenges,” lawyer John McIntyre told CTV News. McIntyre, now representing K.S. in OHIP’s recent appeal.
“The process was incredibly challenging for her, as she was not only up against lawyers and the government, but she was having to fight against the view that her identity was not valid,” McIntyre said.
The challenge proved worth it – five months later, the three-person review panel ruled in K.S.’ favour . Her procedure, now deemed an insured service, would be paid for.
The victory didn’t come easily, K.S. said. “More than once during the legal process, the impacts of statements and opinions expressed by OHIP and its lawyers drove me to tears, messed with my sleep, and caused significant anxiety, unintended weight loss, and chest pains,” she said.
But it wasn’t long before OHIP filed its own appeal. Now, despite the unanimous ruling last year in her favour, K.S. must make her case for the panel for a second time — the thought of which brings her “despair.”
“The very idea that one should have to endure the significant legal process after already having to fight every single aspect of the medical system to just meet the criteria is unfair,” she said.
McIntyre called his client one of the “bravest people” he’s ever met.
“The only reason why she keeps pushing is the hope she can protect other trans and nonbinary folks from having to endure the same problems,” he said.
This time, K.S. isn’t alone in her fight for funding. McIntyre and Egale, a non-profit organization advancing equality and justice for LGBTQ2S+ Canadians, are helping her navigate OHIP’s appeal.
In early January, Egale signed on as an intervenor in the case .
"The concern I have is this a tendency to treat these requests [...] as experimental," counsel for Egale, Daniel Girlando, told CTV News Toronto.
Girlando said the organization decided to step in, in part, because it feels that the ability to express one’s self in a way that doesn’t “necessarily reflect a binary gender” is important. “That means that some [OHIP applicants] will have customized requests,” he said.
The lawyer pointed to the World Professional Association of Transgender Health (WPATH), a leading authority on gender-affirming medical and surgical care, for guidance in this case. The WPATH’s Standard of Care guidelines note that “gender diverse presentations may lead to individually customized surgical requests some may consider ‘non-standard.’”
“In this evolving world, where standards are fast-changing and when we’re dealing with a small number of population, are we supposed to wait, what, years before there is enough data to deem these procedures experimental?” Girlando questioned.
Some experts say that’s exactly what Ontario should do.
Kinnon MacKinnon, an assistant professor at York University who studies the intersection of healthcare and gender, said in this case, the province will have difficulty establishing a risk-to-benefit ratio, as it has no data to draw from.
“In terms of medical ethics, clinical decision making, and funding, the risk-to-benefit ratio has to be favourable and with there being no studies, it would be hard to make the argument that the procedure is medically necessary,” he told CTV News in an interview last week.
“I think the priority right now should be to collect higher quality and long-term outcomes data to inform better care because I think we need a better sense of long-term outcome following certain surgeries,” he continued.
K.S. agrees more data collection is needed, but claims the province is failing to invest in the effort.
"They never get to collect the data because people like me are generally firewalled before we can get there," she said.
While K.S. said the harm done to her over the last two years has been “irreparable," she hopes to pave the way for others to express themselves freely.
“Our fundamental existence is not optional," she said. "There’s a reason we see higher suicide rates for trans and non-binary people, and a positive ruling will save lives."
OHIP’s appeal will be heard virtually on Feb. 27.
Ctvnews.ca top stories.
Explosions went off in Beirut and multiple parts of Lebanon in an apparent second wave of detonations of electronic devices, Hezbollah officials and state media said Wednesday, reporting walkie-talkies and even solar equipment detonating a day after hundreds of pagers blew up.
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Black men who are the victims of racial profiling and harassment by police forces in Quebec say they are being asked to sign non-disclosure agreements in order to receive their settlement cheques.
The federal Liberals' political lieutenant for Quebec, Pablo Rodriguez, will run for the leadership of the Quebec Liberal Party (PLQ). He is scheduled to make the announcement Thursday in Gatineau.
Quebec provincial police are investigating the death of a five-year-old boy found in a home about 55 kilometres southwest of Montreal.
Negotiations on the future of Wellington Street in front of Parliament Hill appear to have stalled, more than a year after the federal government and the City of Ottawa began talks on the street.
Dark Fork has announced plans to open the city's first "dine-in-the-dark restaurant" on George Street, where patrons will eat in a dark dining room where cellphones and other sources of artificial light are forbidden.
Ottawa Fire Services says a dog has been brought to safety following a two-storey townhome fire in Kanata North Wednesday morning.
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Security video shows a man breaking into a thrift store operated by a Sudbury animal rescue and stealing items from a jewelry case Tuesday morning.
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Manitoba Premier Wab Kinew said an MLA ousted from his caucus this week was given a choice before he was shown the door.
Winnipeg’s executive policy committee unanimously voted in favour of a purchase agreement for Portage Place Mall on Tuesday.
Transport Canada has ordered a bankrupt tidal power company and a bankruptcy trustee to produce a plan to remove four huge moorings abandoned in the water near Walton, N.S.
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A 16-year-old biennial event aimed at fostering business in the country's eastern Arctic and northern regions has been cancelled indefinitely as a dispute unfolds between Inuit in Canada and a Labrador group claiming to share their heritage.
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Flames tore through a residential development, including both homes that were occupied and under construction, in southwest Edmonton early Wednesday morning.
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A 65-year-old Lac Ste. Anne County resident was killed in a crash in Strathcona County early Tuesday morning.
Alberta's premier announced a plan Tuesday evening during a televised address her government will boost the amount of money being spent on new school construction over the next three years to $8.6 billion, an increase of $6.5 billion from what was originally promised in the 2024 budget.
A large low-pressure system in southern Saskatchewan has prompted rainfall warnings in that province with as much as 50 millimetres of rain possible.
Calgary city council has voted to end work on the first phase of its long-sought $6.2-billion Green Line light rail transit project at a cost of at least $2.1 billion.
The Government of Saskatchewan has said it will not accept asylum seekers under a recent federal proposal to relocate them across Canada.
A new financial literacy course is now a requirement to graduate high school in Saskatchewan.
Catherine Sanche says her cousin and best friend Emily Sanche never feared her boyfriend Thomas Hamp would hurt her in the weeks leading up to her death in February 2022.
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TransLink says it is one step closer to meeting its net-zero emissions targets after converting its West Coast Express commuter trains between Vancouver and the Fraser Valley to renewable diesel fuel.
A B.C couple has been ordered to stop living in a motorhome on the property where their under-construction home – which they were first given a permit to build more than six years ago – has become an “eyesore,” according to a recent court decision.
The RCMP is investigating a fatal collision between a motorcycle and a pickup truck that closed down the Fraser Highway in Langley, B.C., late Tuesday afternoon.
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How to apply for gender confirming surgery (also known as sex reassignment surgery) in Ontario. If you are eligible, this service is covered under OHIP. As of March 1, you can seek an assessment for surgery from qualified health care providers across the province.
In Ontario, for minors under 17 years of age, applications for change to legal identification are required to have supporting certification from a prescribed professional, and parental consent. As of April 2012, transition-related surgery is no longer required for a change in registered gender on Ontario documents. MEDICAL INTERVENTIONS
Gabe Poulos, 22, had breast removal surgery at age 16 and has been on sex hormones for seven years. The Asheville, North Carolina, resident struggled miserably with gender discomfort before his ...
Launched in September 2023, it is the only clinic in Ontario and the second in Canada to offer all three of the following gender-affirming procedures: The clinic's lead and co-founder, Plastic Surgeon Dr. Nicholas Cormier, has some more wonderful news to share: "We're currently accepting patient referrals from physicians," he announces ...
Since 17-year-old Seelie Romard of Sydney, N.S., first started seeking gender-affirming treatment in 2021, he says he's visited a pediatrician, a physician who specializes in gender care, and a ...
Answers to Frequently Answered Questions about SRS and Trans Health Care in Ontario. The document offers information on the current status of SRS in Ontario and related health care for trans patients under the Ontario's Health Insurance Plan (OHIP) which has not been readily accessible.
The resource is intended for persons considering transition-related surgery in Ontario, and the people supporting them. ... are required to complete separate surgery planning visits and complete the Request for Prior Approval for Funding of Sex-Reassignment Surgery Form (.pdf). One of the providers must be a physician or Nurse Practitioner and ...
Trans and gender-diverse Ontarians have timely access to all necessary surgical interventions and care. Individuals with non-binary gender identities have full access to transition-related services as indicated in the WPATH SOC7. Primary health care teams guide clients through the process of preparing for transition-related surgeries.
assignment surgery) in Ontario. If you are eligible, this. service is covered under OHIP.As of March 1, you can seek an assessment for surgery from qualified health ca. ovince.Affirming gender identityGender confirming surgery (also known as sex reassignment or gender affirming surgery) does mor.
There are potentially more than 800 health-care professionals across the province who can now assess patients for sex-reassignment surgery, a change Ontario adopted March 1 to trim the more than ...
Complete, sign, and submit the "Request for Prior Approval for Funding of Sex-Reassignment Surgery" (also known as the "Prior Approval" form) to the MOHLTC. The number of qualified providers who must complete independent TRS surgery planning visits and sign a Prior Approval from is based on the type of surgery requested.
In the Ontario and Alberta decisions discussed earlier, the requirement for gender reassignment surgery was found to be discriminatory. As a result of these rulings, several provinces, including Alberta, British Columbia, Manitoba, Ontario, and Quebec, have taken steps to amend their laws to remove reassignment surgery from the requirements ...
The wait list for gender reassignment surgery currently stands at more than 1,000 people. ... He also said the number of people in Ontario asking for gender identity services has been on the ...
Published Jan. 10, 2024 5:45 a.m. PST. Share. The Ottawa Hospital is now accepting referrals to its new state of the art gender affirming care clinic. The clinic is the first of its kind in ...
However, BC's wait time also had unusual fluctuations, with some people waiting for a single day to as long as 1,825 days or more than five years. On the other hand, the average wait time between referral and assessment in BC also differed according to the types of gender-affirming surgery planned. Vaginoplasty - 212 days. Labiaplasty - 255 days.
Step #3. Step 3: Complete the Prior Approval Form. Following your Transition-Related Surgery Planning Visit, your provider can complete, sign, and submit the "Request for Prior Approval for Funding of Sex-Reassignment Surgery" (also known as the "Prior Approval" form) to the MOHLTC. The number of qualified providers who must complete ...
Ontario is proposing to expand access to referrals for sex reassignment surgery for transgender people. Currently, patients can only receive a referral for insured surgery through the Gender Identity Clinic program at the Centre for Addiction and Mental Health in Toronto. Through amendments to the Health Insurance Act, which are currently ...
Bill 77 from Parliament 41 Session 1 of the Legislative Assembly of Ontario: Affirming Sexual Orientation and Gender Identity Act, ... , patient under 18 years of age ... sex-reassignment surgery or any services related to sex-reassignment surgery. Person may consent (3) Subsection (1) does not apply if the person is capable with respect to the ...
According to CIHI, of the 536 hospital visits for transgender reassignment mastectomies in 2018-19, 76, or 14 per cent, involved 18-year-olds and younger. That age group accounted for 18 per cent ...
It was the first time such a surgery had been covered by the Ontario Health Insurance Plan. [133] It was also the first widely publicized sex reassignment surgery in Canada. [132] The first transgender healthcare clinic to offer genital surgery was the Centre Métropolitain de Chirurgie Plastique in Montreal, which opened in 1973. [132]
Form to be completed by providers on behalf of patients seeking prior approval for insured sex-reassignment surgery. Need help downloading or filling forms? Please check our Help page for solutions to common issues.
Published Feb. 16, 2024 8:20 a.m. PST. Share. An Ontario resident is fighting the government to secure public funding for a specialized gender-affirming surgery argued to be "experimental" by the ...
Results . NBGQ individuals reported a lower likelihood of having received genital GAS compared to binary-identifying participants (55.0% vs. 84.1%; OR = 0.23; p = .002), also after correcting for confounding factors, such as sex assigned at birth (OR = 0.28; p = .03; 95% CI .09-.90).Patient-reported outcomes indicated poorer post-treatment body satisfaction and gender recognition, self ...