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Gender confirming surgery

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.

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Affirming gender identity.

Gender confirming surgery (also known as sex reassignment or gender affirming surgery) does more than change a person’s body. It affirms how they think and feel about their own gender and what it means to who they are.

Ontario is funding surgery as an option for people who experience discomfort or distress with their sex or gender at birth.

How to qualify

Ontario funds two types of gender-confirming surgery: genital and chest.

To qualify for funding, you must:

  • be assessed and recommended for surgery by either one or two healthcare providers (e.g. a qualified doctor, nurse practitioner, registered nurse, psychologist or registered social worker)
  • have a referral for surgery completed and submitted to the Ministry of Health and Long-Term Care by a physician or nurse practitioner; and
  • have the surgery approved by the Ministry of Health and Long-Term Care before the surgery takes place

Approval for genital surgery

To be approved for genital surgery, you’ll need:

  • one of the assessments must be from a doctor or nurse practitioner
  • you have a diagnosis of persistent gender dysphoria
  • have completed 12 continuous months of hormone therapy (unless hormones are not recommended)
  • you have lived 12 continuous months in the gender role you identify with (for genital surgery only)

If you have surgery before getting approval from the ministry, the cost of the surgery will not be covered.

Approval for chest surgery

To be approved for chest surgery you’ll need:

  • have a diagnosis of persistent gender dysphoria
  • have completed 12 months of continuous hormone therapy with no breast enlargement (unless hormones are not recommended) if you’re seeking breast augmentation

After being approved for chest surgery, your family doctor or nurse practitioner can refer you to a specialist who can perform the surgery.

Apply for surgery

To apply for gender confirming surgery, your doctor or nurse practitioner needs to fill out and submit the application along with the assessments and recommendations for surgery, to the Ministry of Health and Long-Term Care. The application is for patients seeking services in Ontario, out of province but within Canada or outside of the country.

Your doctor or nurse practitioner will let you know if your application is approved.

Once you receive approval from the ministry, talk with your health care provider to get ready for the surgery

Additional resources

You can find useful information from organizations, such as:

  • find out about their ongoing project, Trans Health Connection
  • consult their service directory
  • find out about the Gender Identity Clinic (Adult)

Information for healthcare providers

Find out more about your role in providing gender-confirming surgery funded by Ontario.

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To tell the truth, toronto hospital first in ontario to offer trans surgery.

First Published:

A Toronto hospital has become the first in Ontario to offer gender-reassignment surgery.

Doctor Yonah Krakowsky, a urologist and medical lead of the Transition-Related Surgery program at Women’s College Hospital in Toronto says offering the surgery can be life saving.

Janet Macbeth, 40, was the first patient to receive a vaginoplasty – making this not only a milestone for her, but for Canada.

Previously, the trans community had to travel to Montreal or abroad to receive surgery.

Macbeth was approved to travel to Montreal, but chosse to wait until the Toronto program was in place. Once the program was in effect, Toronto’s Women’s College Hospital was officially the only public hospital in Canada to offer the surgery.

While the program is still in its early days, Krakowsky says the teaching hospital’s multidisciplinary approach will help establish a model that can be adopted by medical institutions across the country.

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gender reassignment surgery toronto

Toronto’s Women’s College Hospital launches new program for gender-reassignment surgery

This article was published more than 4 years ago. Some information may no longer be current.

gender reassignment surgery toronto

Janet Macbeth, seen here, was the first patient in Canada to receive a vaginoplasty at Toronto’s Women’s College Hospital. Womens College Hospital

When Janet Macbeth underwent surgery in Toronto on Monday, it was a milestone not just for her, but for Canada.

Ms. Macbeth, 40, was the first patient to receive a vaginoplasty – a four-hour operation that gave her the female genitalia she had always desired – at Toronto’s Women’s College Hospital (WCH), the only public hospital in the country to offer the complex surgery.

“This is such an amazing program and it has so much promise,” Ms. Macbeth said in an interview before her surgery. “It’s something I feel honoured to be a part of.”

As awareness and acceptance of transgender rights has grown, so, too, has the demand for gender-reassignment surgeries, also sometimes called gender-confirming surgeries.

But until now, transgender Canadians have had to travel to the United States or to a private clinic in Montreal to receive any kind of bottom surgery, as procedures replacing a penis with a vagina, or vice-versa, are known.

The formal launch of the vaginoplasty program at WCH should begin to alleviate the Montreal clinic’s waiting list, which has grown substantially since the Ontario government loosened its rules for approving public coverage of gender-reassignment procedures three years ago, according to one of the surgeons who operated on Ms. Macbeth on Monday.

“That was the impetus for this program,” said urologist Yonah Krakowsky, medical director of the new Transition-Related Surgery program at WCH. “How can you open up these assessments and have so many people now approved for surgery without providing any access to surgical care?”

gender reassignment surgery toronto

Toronto’s Women’s College Hospital (WCH) is the only public hospital in the country to offer the complex surgery. Michael Wong/Womens College Hospital

Before Ontario’s former Liberal government made a regulatory change in 2016, the Ontario Health Insurance Plan (OHIP) paid only for gender-reassignment surgeries for patients who had first received approval from one overburdened clinic at the Centre for Addiction and Mental Health (CAMH) in Toronto.

After the Liberals expanded approval-granting powers to health-care providers across the province, the number of gender-reassignment surgeries that OHIP covered in Montreal and outside of Canada jumped from 158 in 2015-16 to 414 in 2018-19, according to the Ministry of Health and Long-Term Care.

At the same time, the province began tracking the number of transition-related surgeries that were already being offered inside Ontario, including chest surgeries and the removal of the uterus or testicles.

Such surgeries nearly tripled from 204 in 2016-17 to 548 in 2018-19, the ministry said.

Other provinces have also seen an increase in demand for genital surgeries, including British Columbia, which is planning to offer bottom surgeries soon at Vancouver General Hospital.

Dr. Krakowsky and his surgical colleagues operated on Ms. Macbeth on Monday under the experienced eye of Marci Bowers, a world-renowned California surgeon who flew in to guide the Toronto team through its first three vaginoplasties at WCH this week.

Dr. Bowers has a transgender history of her own, having grown up as Mark before transitioning more than two decades ago. She has since performed transition-related surgeries on nearly 2,000 patients.

“Many of them consider this life-saving,” Dr. Bowers said. “They’ve battled this for most of their lives. The concept of gender identity is just now coming to light as being a core element of your soul, if you will.”

For Ms. Macbeth, the dawning realization that she was a girl trapped in the wrong body was one of her earliest memories.

Growing up in a conservative family in California and Georgia, she had little choice but to bury her frustrations about her gender identity. The Jerry Springer Show, where transgender people were treated like freaks, shaped her view of the future that awaited her if she came out.

“There were no role models,” Ms. Macbeth said. “There wasn’t anyone saying, ‘Hey, look! Here’s somebody that’s transgender and they have a career and they have a family and they’re living a great life.’ That’s not the representation that I would see.”

Nonetheless, Ms. Macbeth said she partly came out of the closet as a student at the University of California, Santa Cruz, declaring herself queer and trans to some close friends, including the Canadian woman she would go on to marry in 2005.

When the couple moved to Walpole Island First Nation, near Windsor, Ont., Ms. Macbeth, afraid of being shunned in her new country, returned to the closet. She lived as a man until just before their second child, a girl, was born in 2017. Her son is now 5 and her daughter is 2.

“I wanted to be able to show my children that you can be yourself. How can I model that type of behaviour if I can’t even do it myself?” Ms. Macbeth said.

Ms. Macbeth was approved to travel to Montreal for a vaginoplasty, but she chose to wait until the Toronto program – which was already providing other transition-related surgeries – was ready to add vaginoplasties to its repertoire.

Dr. Krakowsky is hopeful that Women’s College Hospital will eventually recruit a surgeon capable of performing phalloplasties, the even-more-difficult feat of constructing a penis.

“Going through surgery – whatever the surgery is – is disruptive and difficult enough as it is,” he said. “We know medical outcomes are better if you don’t travel for health care.”

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Image of three people in surgical scrubs looking down and performing a surgery or procedure

The overarching vision of the Department of Surgery at Women’s College Hospital is to provide innovative, person-centered care, that respects the diverse needs of our community, and focuses on caring for people in their homes rather than in hospitals. We strive to be a Canadian model for how to provide top-quality surgical care and support a sustainable health system for future generations.

 The Department of Surgery at Women’s College Hospital provides a variety of services to patients with many different conditions. We focus on innovation and ambulatory surgery, and are able to treat many patients on a day-surgery basis.

In  General Surgery , our surgeons specialize in common procedures such as gall bladder and hernia surgery, anorectal conditions such as hemorrhoids and anal fissures and breast surgery for benign conditions as well as breast cancer. 

In  Orthopedic Surgery , our surgeons specialize in sports medicine, including soft tissue trauma and sports injuries, as well as complex knee, complex shoulder, foot and ankle, cartilage and joint restoration, revision procedures and hip. We also have a unique day-surgery total joint replacement program, where we provide knee and hip joint replacements without a hospital stay.

In  Urologic Surgery , our surgeons focus on male fertility procedures, as well as male and female sexual medicine and surgery. We also specialize in feminizing transition-related genital surgery (vaginoplasty).

In  Endocrine Surgery , our surgeons have developed innovative programs in same-day surgery of the thyroid and parathyroid glands, as well as removal of adrenal glands.

In Plastic and Reconstructive Surgery , our surgeons specialize in breast reconstruction after breast cancer surgery, as well as other operations on the breast, including transition-related masculinizing and feminizing chest surgery.

Surgery and Surgical Clinics

Women’s College Hospital 76 Grenville Street Floor 3, 4, 5 and 8 Toronto, ON M5S 1B2

General Surgery Clinic

Women’s College Hospital 76 Grenville Street Floor 5 Toronto, ON M5S 1B2

Phone : 416-323-6014

Endocrine Surgery

Women’s College Hospital 76 Grenville Street Toronto, ON M5S 1B2

Phone : 416-323-6013 Fax : 416-323-6308

Orthopedic Sports Medicine Clinic

Women’s College Hospital 76 Grenville Street Floor 4 Toronto, ON M5S 1B2

Preadmission Clinic

Women’s College Hospital Floor 8 76 Grenville Street Toronto, ON M5S 1B2

Phone : 416-323-6260 Fax : 416-323-6169

Hours of Service

Monday – Friday 8 a.m. to 4 p.m.

Transition-Related Surgery Clinic

Phone : 416-323-6148 Email : [email protected]

Urology Clinic

Women’s College Hospital 76 Grenville Street Floor 5 76 Grenville Street Toronto, ON M5S 1B2

General Surgery & Toronto Anorectal Program (TARP)

General surgery.

Women’s College Hospital provides General Surgery services for conditions such as gall bladder disease, hernias, and anorectal conditions.

While all of our surgeons perform surgical procedures at Women’s College Hospital, some of our surgeons also work in the Women’s College Hospital clinics, and other surgeons have their clinics at other hospitals.

David Urbach MD, MSc, FRCSC, FACS

headshot of David Urbach

Professor of Surgery and Health Policy, Management & Evaluation Director of Perioperative Services General Surgery

David Urbach is Head of the Department of Surgery and Director of Perioperative Services at Women’s College Hospital, and Professor of Surgery and Health Policy, Management and Evaluation at The University of Toronto. His clinical practice focuses on minimally invasive surgery, particularly gastrointestinal, hernia, adrenal and obesity surgery. He is a Senior Fellow at the Women’s College Hospital Institute for Health System Solutions and Virtual Care (WIHV), and Senior Scientist at the Institute for Clinical Evaluative Sciences (ICES). His research program focuses on surgery-related health services research, including measurement of the quality and outcomes of surgical care, and methods for the evaluation of surgery and other health technologies.

Office: Administrative – 416-323-7712 Clinical: 416-323-7309

Karen Devon MD, MSc, FRCSC, FACS

headshot of Karen Devon

Assistant Professor and Medical Director of the Endocrine Surgery Program Endocrine and General Surgery

Since joining Women’s College Hospital in 2012 Karen continues to be actively involved in various leadership roles including Undergraduate Medical Education Coordinator for Surgery at WCH, Co-Director of the MHSc Bioethics course, and the promotion of humanism and professionalism in surgery. She led the interdisciplinary team that received the 2016 WCH Excellence in Collaborative Innovation Award for the development of the Outpatient Thyroid Surgery Program at WCH. She leads the Department of Surgery Ethics Group, and facilitates the Postgraduate Medical Education (PGME) Surgeon in Society Program. Recognized internationally for excellence in patient care, innovation, research and education

Office: 416-323-6400 ext 7352

Dr. David Lim MDCM MEd PhD FRCSC

Clinical Associate Surgeon Postdoctoral Fellow, Women’s College Research Institute Breast Oncology Surgery and General Surgery

Dr. David Lim is a Breast Surgical Oncologist and General Surgeon and Women’s College Hospital’s Interim Division Head for the Henrietta Banting Breast Centre. He is currently a Postgraduate Fellow within the Canadian Institute of Health Research at the Women’s College Research Institute collaborating on breast cancer research.

  • Dr. Jesse Pasternak
  • Dr. Ted Ross
  • Dr. Jaime Escallon
  • Dr. Michael Reedijk

Toronto Anorectal Program (TARP)

The Toronto Anorectal Program (TARP) is a collaborative benign anorectal surgery clinic that brings together the practice of four University of Toronto faculty colon and rectal surgeons. The Clinic operates as a centralized model, meaning that when a patient is referred to the clinic and appropriate for care, they will be seen for an initial consultation by the next available surgeon.

Following the consult, patients who are suitable for surgery will be scheduled with the next available surgeon to complete the procedure. This means that a patient may have a different surgeon for their consult and subsequent surgery.

The centralized model helps low complexity patients experiencing some anorectal conditions receive surgical care as fast as possible.

The clinic provides care for various benign perianal diseases, including hemorrhoids, anal fistulas, anal fissures and anal polyps.

The Toronto Anorectal Program (TARP) team consists of:

  • Dr. Marisa Louridas
  • Dr. Mantaj Brar
  • Dr Anthony DeBuck

The University of Toronto Department of Surgery has a long history of excellence and innovation in endocrine surgery including the first outpatient program in Toronto.

In our program you will receive comprehensive and compassionate evaluation, treatment and management of diseases of the thyroid, parathyroid glands, and adrenal glands. All of our surgeons are also dedicated to advancement in the field through academic research and in training the next generation of surgeons.

Assistant Professor and Medical Director of the Endocrine Surgery Program

Dr. Devon completed her general surgery training in Toronto and has a fellowship in endocrine surgery and in clinical ethics from the University of Chicago. She is an assistant professor in the Department of Surgery at the University of Toronto. She has expertise in the treatment of all thyroid diseases including thyroid cancer. She has won awards for her innovation in creating our outpatient thyroidectomy and parathyroidectomy programs where she has introduced innovative technologies to allow for a focused, minimally invasive approach.

The orthopedic sports medicine program at Women’s College Hospital is the largest in Toronto, and one of the largest in Canada.  As the epicenter of the University of Toronto Orthopaedic Sports Medicine (UTOSM), the surgeons at WCH provide expert care for patients, weekend warriors and elite athletes with injuries to their knees, shoulders, hips and ankles.

Surgical Team

Dr. jas chahal.

Headshot of Dr. Jas Chahal

Dr. Jas Chahal is Interim Head, Division of Orthopedic Surgery at Women’s College Hospital and Assistant Professor in the Department of Surgery at the University of Toronto. Areas of specialty include shoulder, hip and knee arthroscopy, ligament reconstruction and cartilage restoration. His research interests include clinical outcomes research in sports medicine and translational work on the use of biologics and mesenchymal stem cells in treating orthopedic conditions.

Contact : 416-323-6318

Fax : 416-323-6314

Dr. John Theodoropoulos

Headshot of Dr. John Theodoropoulos

Dr. John Theodoropoulos is Assistant Professor at the University of Toronto, Department of Surgery. His area of specialty and research include Sports Medicine & Arthroscopy. He has received various teaching awards from the Department from Surgery at McGill University and many invitations to speak and present at continuing education seminars. As a distinguished and invited speaker, presenter and lecturer, he has contributed locally, provincially and nationally at meetings and conferences on topics such as ACL reconstruction, cartilage repair and tissue engineering and arthroscopic shoulder repair.

Contact : 416-586-4800 ext. 8699

Fax : 416-586-8501

Dr. Tim Dwyer

Headshot of Dr. Time Dwyer

Dr. Tim Dwyer is Assistant Professor in the Department of Surgery at the University of Toronto. His Surgical practice encompasses open and arthroscopic surgery of the knee, shoulder and hip. His knee surgery focus is on primary (hamstring and BPTB) and revision ACL reconstruction, the management of cartilage and meniscal lesions, as well as disorders of the patellofemoral joint. His shoulder practice deals with all complex shoulder pathology, including shoulder instability and rotator cuff pathology. He performs hip arthroscopy for labral tears and CAM impingement. Primary research focus is on the assessment of surgical competence in Competency Based Medical Education. Other research interests are clinical outcomes following knee and shoulder surgery, including arthroscopicrotator cuff repair, the treatment of massive rotator cuff tears, and ACL reconstruction.

Contact : 416-323-6482

Fax : 416-323-6483

Dr. Danny Whelan

Headshot of Dr. Danny Whelan

Dr. Danny Whelan is Associate Professor at the University of Toronto, Department of Surgery. Dr. Whelan is involved in several multicenter clinical trials in orthopedic sports medicine with an ongoing investigation on ACL reconstruction with hamstring tendon grafts. Other research interests include joint instability, particularly of the knee and shoulder, hip pain in the young adult and randomized trials in surgery.

Contact : 416-864-6002

Fax : 416-359-1601

Dr. Sam Park

Headshot of Dr. Sam Park

Dr. Sam Park is Assistant Professor and Surgeon-Investigator in the Department of Surgery at the University of Toronto. His specialized clinical focus is in the management of adult foot and ankle conditions. These include the early to end-stage arthritis, deformity correction, cartilage lesions, tendon disorders, athletic injuries, factures and trauma, and the foot and ankle sequelae from systemic conditions and neurological disorders. Academic interests include clinical epidemiology and outcomes research on the treatment of various foot and ankle disorders and pathology; and translational science research related to foot and ankle arthritis and joint preservation.

Contact : 416-323-6362

Fax : 416-323-6375

www.utosm.com/team/sampark

Research & Trials

At WCH, UTOSM is focused on clinical trials and qualitative studies involving the knee, hip and shoulder, as well as education research.  UTOSM is currently running randomized trials focused on ACL reconstruction, massive rotator cuff tears, hip arthroscopy, as well as the use of Bone Marrow Aspirate Concentrate (BMAC) for the treatment of shoulder osteoarthritis.  UTOSM is also conducting a series of studies with regards to cartilage implantation, revision ACL reconstruction, the competency of sports medicine fellows, as well as aspects of surgical training.

Professional Education

At WCH, UTOSM runs one of Canada’s largest training programs for orthopaedic surgeons wishing to train in sports medicine and arthroscopy. Up to eight surgeons from Canada and across the world are undertaking fellowship training each year at WCH, allowing them to develop skills that will benefit thousands of patients. UTOSM is also the center for orthopaedic resident training in sports medicine at the University of Toronto.

Total Joint Replacement Program

The outpatient total joint replacement program at Women’s College Hospital is a unique collaborative aiming to deliver effective, efficient, and patient-centered care for individuals with hip and knee arthritis. Ideal surgical candidates are motivated patients with well-controlled medical co-morbidities and strong social supports. Patients must live in the Greater Toronto Area to be eligible for same-day discharge.

This innovative program includes pioneering perioperative anaesthesia care and the use of interactive home patient monitoring.

Each surgeon holds a faculty appointment within the Division of Orthopaedics at the University of Toronto

Surgery Team

Dr. david backstein – mount sinai hospital.

Area of Expertise: Total knee replacement, partial knee replacement Office Phone Number: 416-586-8457

Dr. Paul Kuzyk – Mount Sinai Hospital

Area of Expertise: Minimally invasive total hip replacement, total knee replacement Office Phone Number : 416-586-4653

Dr. Oleg Safir – Mount Sinai Hospital

Area of Expertise: Minimally invasive total hip replacement Office Phone Number: 416-586-4653

Dr. Jesse Wolfstadt – Mount Sinai Hospital

Area of Expertise: Total knee replacement, partial knee replacement Office Phone Number: 416-586-4800 ext. 2835

Dr. Michael Zywiel – Toronto Western Hospital

Area of Expertise: Total knee replacement, partial knee replacement, direct anterior (DAA) total hip replacement Office Phone Number: 416-603-5359

Physician referrals are required for all WCH surgical clinics and programs

Download and complete the patient referral form from the  University of Toronto Orthopaedic Sports Medicine (UTOSM)  appointments page.

Please fax your referral to the Toronto Anorectal Program (TARP) at Women’s College Hospital at 416-323-6172

Ocean eReferral Network: For more information about eReferral or to sign up for an account, please email: [email protected]

Transition Related Surgical Program

OHIP funded Transition Related Surgery (TRS) is applied for by qualified health care professionals. This includes providers who are trained in the assessment, diagnosis, and treatment of gender dysphoria in accordance with the World Professional Association for Transgender Health (WPATH) Standards of Care. This may include a Physician or Nurse Practitioner (NP) as well as a Registered Nurse, Psychologist or Registered Social Worker with a Master’s degree. If you are one of the aforementioned professionals interested in becoming a qualified provider, please see our Community Resource page for more information. 

Making a Referral

To make a referral please submit.

  • Transition Related Surgery Referral Form
  • Prior Approval Funding Confirmation Letter -   Prior Approval for Funding of Sex-Reassignment Surgery Form (.pdf). (unless previously discussed with TRS Program NP)
  • Comprehensive   referral template (.docx)  or brief referral with TRS planning visit notes

Before making your referral ensure

The patient meets OHIP eligibility for surgery (unless contraindicated)

You have provided the patient with comprehensive TRS planning visit(s)

Once you receive the OHIP approval form, have completed the referral and have attached a completed cover page, please fax the referral to: 416 323-6310. If you have any questions about the referral or referral process please call: 416 323-6400 x 4339 or x5333.

Once the referral is received, it will be assessed by someone from the TRS team. If incomplete, it will be returned by fax requesting the missing information.

If the referral is complete, it will then be sent to the appropriate surgeon’s secretary and they will be in contact once they have an appointment available.

For OHIP Funding

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 Ministry of Health and Long-Term Care’s  website  outlines the Ontario Health Insurance Plan (OHIP) funding criteria for transition- related surgeries. There is a specific form, the  Request for Prior Approval for Funding of Sex-Reassignment Surgery Form (.pdf) , you must complete in the current referral system to gain access to OHIP coverage. This form can be found  here.

The form is completed and faxed to the MOHLTC at (613)536-3188 once

  • The patient is confirmed to meet the criteria for surgery
  • TRS planning visits  have been completed and the patient wishes to move forward with surgery
  • A surgeon has been chosen (see Our Team)

Once the form is faxed to the MOHLTC, they will fax back a letter with the decision (typically within 1-4 weeks). This Prior Approval Funding Confirmation Letter will be sent to the patient and the referring provider. The form will not be sent to the surgical team as of November 1st, 2019.

Criteria for Surgery

Criteria for surgery must be met prior to referral to a surgeon/program. The criteria for surgery are outlined in the box below. Please ensure your client has met these criteria, unless contraindicated, and please make comments on your referral letter. Criteria for all surgeries, including what is listed in the table, must include  persistent and well documented gender dysphoria, capacity to make a fully informed decision and consent to treatment. 

Surgery Planned Visits

For upper body surgeries including mastectomy with chest contouring and augmentation mammoplasty, only one provider (physician or nurse practitioner) is required to complete surgery planning visit(s) and complete the  Request for Prior Approval for Funding of Sex-Reassignment Surgery Form (.pdf).

For lower body surgeries, including but not limited to orchiectomy, hysterectomy, phalloplasty, metoidioplasty and vaginoplasty, two providers 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 the other may be any of the listed qualified providers.

TRS planning visits are to be completed as you wish, however, to assist you we have created a list of key topics to discuss and include during these appointments. Documentation should confirm that these topics have been reviewed.

Gender History

Discuss the patients current gender identity and process of transition.

Confirm persistent Gender Dysphoria, the patients experience with transition so far, medical and social steps taken or considered Include Eligibility as per the Ministry of Health and Long Term Care and the World Professional Association of Transgender Health (i.e. duration of hormones, gender role experience)

Goals for surgery

Why does the patient want surgery? How will surgery help the patient achieve their gender goals/reduce dysphoria? Are their expectations for surgery realistic? Aware of alternative non-surgical and surgical options If relevant, discussion around fertility and options for preservation reviewed

Detailed surgery discussion/capacity for informed consent

Description of desired surgery, realistic outcomes, risks, side effects (irreversibility), alternate options. (A more detailed and focused discussion about surgical details will take place between the surgeon and client)

Readiness (medical and psychosocial)

How well controlled are medical and mental health conditions Smoking, alcohol, substance use Supports in place (including financial), and aftercare planning

Criteria for TRS Surgery

Criteria for surgery must be met prior to referral to a surgeon/program. The criteria for surgery are outlined in the box below. Please ensure your client has met these criteria, unless contraindicated, and please make comments on your referral letter. Criteria for all surgeries, including what is listed in the table, must include  persistent and well documented gender dysphoria, capacity to make a fully informed decision and consent to treatment. 

  • Unless instructed otherwise, patients should not eat after midnight the day before their surgery. You may continue to drink clear fluids until four hours prior to surgery time. After that, medications can be taken as instructed with sips of water.
  • Patients must have a responsible adult take them home when discharged from hospital.
  • When arriving for surgery, please bring comfortable clothes to wear home, cotton socks to wear in surgery, your health card, an interpreter if required, pen and paper, and dentures, glasses, contact lenses, and hearing aids if necessary.
  • Please do not wear any jewelry, fragrances or cosmetics, including body piercings, perfumes, body lotions / creams, makeup or nail polish.
  • Leave all valuables including large amounts of money, credit cards and jewelry at home. The hospital is not responsible for lost or stolen items.

Please report to the Surgery reception desk on the 8th floor when you arrive for surgery. You must arrive in Surgical Daycare 2 hours prior to your surgery time unless instructed otherwise.

If you have any questions or concerns, please contact a preadmission nurse at 416-323-6400 ext. 4594 from 8 a.m. to 2 p.m., Monday to Friday.

After 2 p.m. a nurse can be reached at 416-323-6104.

This information and more may be downloaded as a printable pamphlet:  Ambulatory Surgery Brochure (.pdf)

Surgical Experience

Scheduled for a surgery at WCH? Our team put together the following videos to provide you with an inside look at what to expect from your surgery experience.

Preoperative Experience

Surgery Day Experience

Postoperative Experience

Frequently Asked Questions

Questions about anesthesiology, what does an anesthesiologist do.

Anesthesiologists are probably best known for putting you to sleep before surgery (known as general anesthesia). These medical doctors specialize in using medication to provide relief for postoperative (temporary) pain. Your anesthesiologist is also responsible for your welfare and comfort during and after surgery. In addition, some anesthesiologists are involved in the treatment of chronic pain (recurring) problems.

What is the difference between analgesia and anesthesia?

Analgesia is a general term for pain relief of any kind. Anesthesia may involve analgesia through loss of physical sensation (called regional anesthesia) in a part of the body. For some surgeries, it includes loss of consciousness as well as analgesia (called general anesthesia).

When would I see an anesthesiologist?

You will see an anesthesiologist when you have surgery that requires anesthesia or sedation. Usually, you will meet your anesthesiologist just before you go into the operating room, although your surgeon may request a consult with an anesthesiologist at your Preadmission Clinic appointment. If you require relief from chronic pain, your doctor might refer you to our Chronic Pain Management Clinic.

What does my anesthesiologist need to know?

Your anesthesiologist will need to know if you have certain medical conditions (for example: drug allergies, diabetes, malignant hyperthermia, porphyria). This may be discussed with an anesthesiologist at your pre-admission clinic appointment.

Do you treat chronic pain?

We offer diagnosis and treatment services to patients who require relief from chronic pain (persistent or recurring) due to a wide variety of medical conditions. You will need a referral from your doctor. For more information, please see the Chronic Pain Management Clinic section.

Questions About Surgery

What type of anesthesia will be used for my surgery.

The type of anesthesia depends on the type of surgery or procedure being done. General anesthesia (being asleep) is often used for major surgery, for example. However, certain types of surgery might use regional or local anesthesia instead, which numbs the part of the body being operated on while you remain awake. Sedation (relaxing medication) might also be used for short procedures, depending on the nature of the surgery.

How should I prepare for surgery?

Extensive information about how to prepare for surgery may be found on the Preadmission Clinic, Preparing for Day Surgery and Pamphlets and Links sections.

What is Patient Controlled Analgesia (PCA)?

PCA involves a device that lets the patient adjust their comfort after major surgery. When the patient presses a button, a computerized pump delivers a pre-measured dose of pain medication through an intravenous (IV) line.

What does the anesthesiologist do?

Before surgery:  You will be required to attend an appointment at the Preadmission Clinic within two weeks prior to your surgery. You or your surgeon may request a consultation assessment with an anesthesiologist to discuss any concerns that you might have. If you have any special medical conditions (for example: drug allergies, diabetes, high blood pressure, malignant hyperthermia, porphyria) you will need to discuss this at the preadmission visit. If you don’t need to see an anesthesiologist at your preadmission appointment, you will meet him or her on the morning of your surgery, usually just prior to going into the operating room.

During surgery:  Your anesthesiologist is responsible for your safety and comfort during the operation. He or she administers the anesthetic, provides any necessary medication and operates the equipment that keeps your vital signs functioning throughout the operation.

After surgery:  The anesthesiologist supervises your post-operative recovery and monitors your functioning as you wake up. Your anesthesiologist ensures you are comfortable and pain free, and orders any pain medication as needed.

More Information

The following information is provided to help you understand what an anesthesiologist does and how to work most effectively with him or her as it relates to your surgery:

Patients may be required to visit the preadmission clinic in advance of their surgery to register and to discuss with a nurse what will happen the day of surgery and what to expect when discharged home.

During the appointment, patients will have preoperative tests such as x-rays, electrocardiograms (ECG), consultations with an anesthesiologist or other tests requested by their surgeon.

Setting up the appointment

Your doctor’s secretary will book this appointment for you. There you will be registered, and have your blood tests and an interview with a nurse to learn about your procedure and how to prepare for it. If you have any special medical conditions that could interact with anesthesia, be sure to mention this at your appointment.

Your doctor may also request a consultation with an anesthesiologist as part of your preadmission visit.

If you wish to see an anesthesiologist in advance, tell your surgeon who must book a consultation for you.

What to bring to your appointment:

  • An interpreter, if you need one or would like one.
  • Your completed patient questionnaire.
  • Any medication you are taking.
  • Your provincial health insurance card.
  • Any private insurance information.
  • Any other documentation your doctor has given you (history and physical; letters from your specialists).
  • A book to read; money for coffee or lunch.
  • Any questions you might have.

Pamphlets and Links

Some of the links on these pages go to external websites that may include information about health-care insurance or credentials that are not applicable to Canadians.

Preparing for Surgery

Women’s College Hospital pamphlets:

Ambulatory Surgery Brochure (.pdf)

Special Considerations

Anesthesia Awareness – Information and Registry

Malignant Hyperthermia

Organizations

Canadian Patient Safety Institute

Canadian Porphyria Foundation

Malignant Hyperthermia Association of the United States

  • Anorectal Clinic Patient Resources PDF

Endocrine Clinic

Patient resources.

  • Visit the AAES Patient Education Site
  • www.endocrinesurgery.org
  • thyroid.ca/
  • www.thyroidcancercanada.org
  • www.thyroid.org
  • Department of Surgery
  • Division of Orthopaedic Surgery
  • University of Toronto Orthopaedic Sports Medicine (UTOSM)

Referral Process for Patients

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.

WCH Patient Resources* *These resources are intended to support patients of Women’s College Hospital.

For information on vaginoplasty surgery, recovery and support please visit the vaginoplasty resources page.

Community Resources

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 are in an emergency, in crisis or need someone to talk to, there is help.

Gender Identity Clinic

The Gender Identity Clinic offers services to individuals and their primary care practitioners in regard to gender identity and expression.

Individuals over 17 who wish to explore issues related to their gender identity, which may include any degree of transgender expression.

Community professionals looking for support and consultation to help their clients reach their goals related to gender identity and expression.

Ask your health care provider to fill out the CAMH adult referral form. Here is a link to the online referral form . Forms should be faxed to Access CAMH at 416 979-6815. If you have any questions about the referral process, call Access CAMH at 416 535-8501 and press 2.

Types of Treatment and Services Offered

For individuals, consultation and support may include:

  • diagnostic assessments in support of affirming a diagnosis of Gender Dysphoria in support of transition related surgeries. 
  • individual support and treatment *Please note that our clinic does not offer long-term therapy
  • surgical and hormone eligibility assessments *Please note that our clinic does not prescribe hormones
  • group-based services

If you are interested in accessing LGBTQ2S affirmative psychotherapy, please check the service provider listing at Rainbow Health Ontario to find out options for psychotherapy in your region. 

For community professionals, consultations may include:

  • completing a mental health assessment
  • consultation with regard to completing a surgery referral assessment
  • being a second assessor for surgery referrals

Program Overview

The Gender Identity Clinic at CAMH offers specialty services to both individuals and their primary care practitioners in Ontario with regard to issues related to gender identity and expression, including gender expansive, trans and non-binary identities. The program offers a comprehensive response to the variety of clinical issues experienced by clients. The clinical team is interdisciplinary and includes social work, psychiatry and psychology staff with specialized expertise in trauma-informed mental health and addiction care.

Our Services

For community professionals.

Primary care providers can diagnose for gender dysphoria, prescribe transition-related hormones, and refer for transition-related surgeries. If you are new to the field of trans care, Rainbow Health Ontario provides education, clinical support, and mentorship to primary care providers across Ontario. All courses provided by Rainbow Health Ontario are Mainpro+ certified. Please visit learn.rainbowhealthontario.ca for more information on courses offered at this time.

Rainbow Health Ontario also hosts a free bi-monthly Trans Health Mentorship Call to support clinicians in their practices. To register for this call, please visit learn.rainbowhealthontario.ca

IMPORTANT: Rainbow Health Ontario does not accept referrals or provide direct services of any kind.

Hormone Therapy

We would encourage referring physicians and/or nurse practitioners to consider prescribing hormone therapy (HT) for their trans clients.

If you are unsure about prescribing HRT:

  • We recommend that you review the published Guidelines and Protocols for Comprehensive Primary Health Care for Trans Clients available through Sherbourne Health Centre , and review the WPATH Standards of Care
  • If, after reading this document, you feel confident in your knowledge of HT, then you can prescribe in advance of the client’s initial assessment. If HT is your client’s sole gender goal, then there is no need to access the clinic once hormones have been prescribed. 
  • If you are aware of complicating medical concerns and these medical concerns have prevented the initiation of hormone therapy, please consider making a referral to endocrinology on the client’s behalf.
  • If you are interested in training to develop further competency in health care for trans clients, please contact Rainbow Health Ontario, which will take you to various training opportunities offered by that organization throughout the province of Ontario.

*If hormone replacement therapy is the primary reason for referral, we would ask that you consider these above-mentioned recommendations, as it will help to reduce unnecessary waiting for your client in terms of further medical transition.*

The clinic plays a significant role in training health professionals in culturally competent delivery of mental health assessment and treatment services to trans and gender expansive communities. We train and provide practicum and residency opportunities for social work students, psychologists and people from other health disciplines, including more than 10 PhD-level clinical psychologists over the past five years.

Consultation

Additionally, we provide support and consultations to primary care practitioners and other health care providers to help their clients reach their goals related to gender identity and expression. This may include consultations in regard to completing a mental health assessment, consultation in regard to completing a surgery readiness assessment, or being a second assessor for surgery readiness. The clinic will work collaboratively with you and your organization/practice to help you meet your client’s goals. Clinicians and organizations wanting consultation by the clinic for clients currently on our waitlist can contact our clinic at 416 535-8501 ext. 30985.

We have also launched an ECHO (Extension for Community Healthcare Outcomes) for trans and gender diverse health care . Please consider joining us for free CME-accredited training and consultation.

For Individuals

The clinic offers consultations and support to individuals over 17 years of age who wish to explore issues related to their gender identity, which may include any degree of transgender expression. Clients are seen for an assessment with one of our team members to determine the client’s transition goals, as well as to provide any diagnostic impressions regarding mental health and substance use. Recommendations about how to assist clients in meeting their transition goals are then made. This may include individual support and treatment, group-based support and treatment, as well as recommendations for surgery funding and referrals for clients seeking transition-related surgeries. The clinic follows the World Professional Association for Transgender Health Standards of Care (WPATH),V7 for transition-related surgery (TRS) .

Rainbow Health Ontario has an Ontario Service Provider Directory where you can search for a provider by region. Please go here to find a provider in your area.

If you cannot find anyone in your area after searching the provider directory, you can contact [email protected] . Please note that Rainbow Health Ontario cannot guarantee there will be a provider in your area to prescribe hormones or refer for surgeries.

Additionally, Rainbow Health Ontario’s Trans Health Knowledge Base can provide you with answers to general questions related to navigating the Ontario health care system. Go here for more information . 

For clients living outside the GTA

Given the context of the Covid-19 pandemic, our clinic provides virtual appointments via the Webex platform.

Given our referrals come from across the province, our clinic is equipped to see clients via telemedicine when possible. Typically, the first assessment in our clinic is in person in Toronto, and subsequent appointments for clients who live outside of the GTA may be made using telemedicine.

If you live in the north, you may be eligible for a Northern Travel Grant to cover basic travel costs to and from your appointments with CAMH. If you are an ODSP recipient, you may similarly be eligible to have basic travel costs reimbursed. Please ask your local provider for further details.

Transition-Related Surgery (TRS) - Frequently Asked Questions

T hese FAQ's are designed to provide a brief overview of the assessment and referral process in Ontario for persons considering gender-affirming surgeries funded by the Ministry of Health and Long-Term Care (MOHLTC). For more information on types of surgery, see the TRS Surgical Summary Sheets update .

For specific questions or more detailed information pertaining to gender-affirming surgeries, please don't hesitate to contact our office at 416 535-8501 ext. 30985.

Significant improvement in wait times for assessment

From 2008–2016 the Ministry of Health and Long Term Care (MOHLTC) regulation stipulated that CAMH was the sole assessment site for OHIP-funded transition-related surgery (TRS) (from 1998-2008 TRS was not funded by OHIP). In March 2016, the MOHLTC introduced a regulation change that improves and expands access to assessment for TRS for Ontarians, empowering primary care providers to provide surgery referrals and assessments. CAMH and its community partners championed this expansion of access to assessments for gender-affirming surgery. In anticipation of this important system change, CAMH partnered with Sherbourne Health Centre (including Rainbow Health Ontario) and Women’s College Hospital on a proposal to expand access to surgery-related care. Thanks to funding from the MOHLTC, the Trans Health Expansion (THEx) partnership is working on several key priorities including improving access to assessment, building capacity of primary care providers, and enhancing access to surgery and post-surgical recovery and support.

The funding helped our clinic to hire new staff members and in doing so, we were able to significantly decrease wait times for assessment. Prior to March 2016 the wait for assessment was over 30 months, and to date it is less than one-third of that. We continue to work to see more clients and reduce the current wait times.

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Transgender Health Care Access

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Despite being one of the most progressive countries in the world on gay and transgender rights , the hurdles of transgender healthcare access in Canada remain a leading cause of activism for its community members. 

Stethoscope, Pride flag, and miniature Canadian flag

According to a 2020 report by Trans PULSE , more than 80% of trans and non-binary respondents said they have a primary care provider, however, 45% of them revealed that they'd experienced having one or more unmet health care needs within the past year. It's a stark contrast to only 4% of the general population reported having unmet medical needs in 2015 to 2016.

What Kind of Specialized Health Care is Needed?

Trans people require access to specialized healthcare services to address their unique and more pressing concerns, such as:

  • Hormone replacement therapy 
  • Gender-confirming surgeries or any medical procedure designed to align their physical characteristics to their gender identity
  • Trans-specific gynecologic, urologic, and reproductive care
  • Mental health treatment : CMHA data suggests LGBTQ+ individuals have higher rates of depression , anxiety, obsessive-compulsive and phobic disorders, suicidality, self-harm, and substance use and are at twice the risk for post-traumatic stress disorder (PTSD) than heterosexual people.

LGBTQ+ equal rights symbol

Publicly Funded Gender-Affirming Medical Care in Canada

Access to transgender health care in Canada differs from province to province. However, there are still evident barriers at the national level that can have a huge impact if the relevant people were to take the necessary action. Presently, Canadian provinces and territories provide public funding for medically essential gender-confirming procedures for transgender people .

The 2018 national scan by UFCW Canada, the country's private-sector union, and the Canadian Professional Association for Transgender Health (CPATH) compiled a list of the transition-related procedures offered in each province and territory.

Here's what we found:

  • Manitoba - The Manitoba government provides state funding for gender transition surgeries, including orchiectomies (removal of testicles), penectomies (removal of the penis), vaginoplasties (reconstruction of the vagina), mastectomies (removal of breast tissue), hysterectomies (removal of the uterus), and oophorectomies (removal of the ovaries).
  • British Columbia - Trans Care BC covers both feminizing (orchiectomy, vaginoplasty, valvuloplasty, and breast reconstruction) and masculinizing gender-confirmation surgeries (clitoral release, hysterectomy, bilateral salpingo-oophorectomy, metoidioplasty, and phalloplasty).
  • Saskatchewan - The most common gender-affirming surgeries like hysterectomy and mastectomy are covered and provided in Saskatchewan. More complicated transition-related surgeries may be sought after outside the province and can be 100% covered by the Ministry of Health if approval is given beforehand.
  • Alberta - Alberta's Gender Surgery Program covers phalloplasty, metoidioplasty, or vaginoplasty. However, procedures that are cosmetic in nature, including chest contouring , breast augmentation for those with breast growth, facial feminization, tracheal shave, and voice pitch surgery are classified as uninsured services.
  • Ontario - OHIP covers most types of sex reassignment surgeries, such as chest and genital procedures, including private clinic stays outside of Canada. 
  • Quebec - Members of the LGBT community can have gender-reassignment surgeries (mastectomy, penectomy, vaginectomy, hysterectomy, scrotoplasty, metoidioplasty, phalloplasty, and erectile and testicular implant) and treatment for free through Quebec's public health care insurance plan. However, surgeries deemed to be purely aesthetic in nature, such as breast implants or plastic surgery to achieve a more feminine look, are not included in their insured services.
  • Nova Scotia - Gender-affirming surgeries are also an insured benefit in Nova Scotia. Hysterectomy, oophorectomy, orchiectomy, penectomy, breast augmentation, breast reduction, mastectomy or chest masculinization surgeries are available in the province. Surgical expertise for phalloplasty, metoidioplasty or vaginoplasty is provided at the Centre Métropolitain de Chirurgie in Montreal.
  • Newfoundland and Labrador - Under the Medical Care Plan (MCP), transition-related surgeries are covered in Newfoundland and Labrador. These include breast augmentation, mastectomy with chest masculinization, hysterectomy, orchiectomy, salpingo-oophorectomy, and genital reconstructive procedures like vaginoplasty, metoidioplasty, and phalloplasty. 

In 2019, transgender surgery assessments were made available in the province. Meaning, the province no longer requires trans and non-binary individuals to be evaluated by the Centre for Addiction and Mental Health in Toronto, Ontario, to determine whether they would be approved to undergo gender reassignment surgery.

  • Prince Edward Island - All gender-confirming surgeries are covered by PEI Medicare but are referred out-of-province to the Centre Métropolitain de Chirurgie (CRC), also known as GRS Montreal. They also have drug assistance programs for those who need access to hormone replacements.
  • Yukon -Trans individuals living in the Yukon Territory get coverage for gender-affirming surgeries to treat gender dysphoria, which includes chest and genital surgeries and genital reconstructive surgeries. Yukon is the only territory in Canada that provides this coverage on their health insurance plan. In 2017, the Yukon Legislative Assembly passed amendments to the Vital Statistics Act , providing the LGBTQ+ community legal protection against discrimination and allowing them to change their gender markers on their birth registrations without undergoing transition-related operations. 
  • New Brunswick - In 2015, non-binary and trans activist , AJ Ripley, was featured in the VICE documentary "On Hold: Canadian Transgender Health Access." They talked about the lack of state-funded treatment services for the trans community, especially in New Brunswick, where they live and where LGBT rights were not in the province's human rights code. Ripley also started an online crowdfunding campaign called "Take My Breasts Away," seeking financial aid for their FTM top surgery. They also had an in-person consultation with our very own Dr. Hugh McLean about their FTM top surgery. Fast forward to 2020, New Brunswick Medicare now covers medically necessary gender-confirming surgeries for transgender persons living in the province. These include female-to-male transition surgeries (vaginectomy, hysterectomy, salpingo-oophorectomy, mastectomy with chest masculinization, metoidioplasty, phalloplasty, erectile and testicular implants) and male-to-female procedures (vaginoplasty, penectomy, orchidectomy, construction of a vaginal cavity and the vulva).  

Nevertheless, pectoral implants , breast augmentation, facial feminization, tracheal shaving, hair removal, travel, accommodation or medications prescribed outside of a hospital, voice and communication training are excluded from the province's list of insured benefits.

https://www.youtube.com/embed/rUMYIykH_U8

On the other hand, sources show that although appointments to see primary-care providers are covered in the Northwest Territories and Nunavut, the assessment for hormone replacement therapy and other transition-related surgeries and treatments are not covered.

What Are the Potential Barriers?

Unfortunately, despite strides in the right direction, there are still solid barriers to getting full access to transgender health care in Canada.

Sources suggest that transgender individuals under-utilize or intentionally avoid healthcare services altogether. The Trans PULSE survey revealed that at least 12% of trans and non-binary respondents said they avoided going to the emergency room in the past year when they needed care, simply because they were trans. 

There are several contributing factors to what truly prevents them from getting the treatment they need. Based on a 2013 study, trans people in Canada and the United States report high levels of violence, harassment, and discrimination when seeking stable housing, employment, health or social services.

In the last five years, the Trans PULSE report also shows that respondents experienced abuse and harassment related to their gender identity in the forms of:

  • 68% verbal harassment
  • 16% physical assault
  • 26% experienced sexual assault

Beyond the lack of transgender-specific health care policies in some provinces in Canada, we can say the fear of being harassed, discriminated against, or outed in a public setting played a pivotal role in why the LGBTQ+ population is hesitant to go to state-funded clinics or hospitals. 

 Hands holding a cardboard sign supporting LGBTQ+ rights

Access to state-funded transgender healthcare in Canada becomes much more critical in light of the fact that bisexual and trans people are over-represented among low-income Canadian households. It means they do not have the financial resources to pay for private clinics, which offer a more comprehensive range of LGBTQ-specific treatment services.

An Ontario-based study found that half of trans individuals live on less than $15,000 a year in 2010. A decade after, the 2020 Trans PULSE survey still paints the same picture for the LGBTQ+ community. Most of the respondents were highly educated, with 50% saying they had a college or university degree and 19% having a graduate or professional degree. At least 43% reported having full-time employment. Still, more than half of the respondents aged 25 and up stated they had a personal annual income of less than $30,000. 

The Price of Waiting

Based on the VICE documentary, 30% of the annual suicide attempt rate among trans people were those who seriously considered suicide if they were made to wait for gender-affirming surgery. The risk drops to 11% if they are given access to a full medical transition.

These figures powerfully illustrate that although a lot of progress has been made to improve transgender health care in Canada, more work needs to be done to give each and every person in the LGBTQ+ community complete access to timely treatment services.

For more information on FTM/N top surgery and other gender-affirming surgeries, don't hesitate to reach out to us. A friendly member of our team will be more than happy to answer your questions.

Contact McLean Clinic today!

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Why surgery wait times put transgender people at risk of suicide

gender reassignment surgery toronto

Written by Iman Sheikh

Apr 29, 2015

transgender symbol

The Ontario Ministry of Health has designated only a single site to evaluate the eligibility of transgender people seeking surgery.

A prescription for 450 mg of the anti-psychotic drug Seroquel.

This was the answer Rachel Lauren Clark received when she told doctors at a Toronto hospital she wanted gender reassignment surgery (GRS). The regular adult dose is 50 mg.

Article continues below

great american thaw

“I was a zombie,” she said, “a complete and utter zombie. I took it at eight o’clock at night and woke up at eight in the morning and couldn’t even function. So then they gave me another drug called Modafinil, which they give to narcolepsy patients to wake them up.”

Clark took the pharmacological cocktail for a year before she realized the only drug that could fix her gender dysphoria was estrogen. A psychiatrist suggested to then 40-year-old Clark that if she was even remotely considering GRS, also known as sex reassignment surgery, she should start the process immediately. Clark did. She received a date for her surgery: June 8, 2015. Just 11 days shy of her 46th birthday.

Why the six-year delay in treatment? Because the Ontario Ministry of Health has designated only a single site to evaluate the eligibility of transgender people seeking surgery. In fact, the Adult Gender Identity Clinic at Toronto’s Centre for Addiction and Mental Health (CAMH) is the sole gatekeeper for access to GRS – not only for patients across Ontario, but also those in Newfoundland and Labrador .

The surgery, even once an initial meeting with a doctor has been completed, is still years away for those who want it. The process looks something like this: a transgender person seeking surgery must have completed a year of hormone replacement therapy, as well as lived for at least a year in the gender for which they‘re undergoing GRS before a doctor will consider advancing their case. Then the person needs additional consultations with at least two different CAMH doctors, and both must agree the patient is a strong candidate. Only then will gender reassignment surgery be covered by OHIP.

Once the surgery has been approved, there’s only one clinic in Canada, located in Montreal, which performs the entire range of gender reassignment surgeries. It has a six- to eight-month waiting list. CAMH Gender Identity Clinic Head Dr. Chris McIntosh said the waiting list will continue to grow unless the Ministry also develops expertise in other parts of the province.

“The number of people seeking intervention surgery is so much greater than it ever was before,” he noted. “It’s probably due to the general awareness of transgender issues. It’s expanding all the time, and people who would have never thought that this was something they would do start to consider it as a possibility.”

Bypassing the CAMH process and paying out of pocket is also an option. The Montreal clinic performs private surgeries with the same prerequisites for candidates as public surgeries (hormone replacement therapy and a year of living experience), but accepts letters of recommendation – two for SRS and one for breast augmentation or top surgery – from a therapist, counselor, psychologist, psychiatrist or social worker. One letter must be from someone with a Ph.D., and the other from someone with at least a master's degree.

The clinic charges approximately $20,100 for male-to-female sex reassignment surgery and $8,000 for breast implants. The female-to-male process costs approximately $10,000 for top surgery, and $45,000 for a phalloplasty. Many transgender Canadians also travel out-of-country, to places such as Thailand, where the cost of gender reassignment surgery is only 30-50 per cent of North American prices. As of 2014, two to three patients receiving male-to-female reassignment surgery  per day in Thailand are foreigners.

One of the biggest concerns around the long wait times for Ontario is the adverse effects it has on the mental health of transgender people. For Rachel Lauren Clark, her stress levels were off the charts.

“I have a female brain and male sex characteristics,” she said. “It caused me a lot of anguish and psychological pain. There’s a lot of risk around being a trans person. You hear comments like, ‘If I saw a trans person in the change room with my wife, I would kill them.’”

Suicide is a serious risk for transgender people awaiting gender reassignment surgery. Trans PULSE, a research project created to look at problems related to transgender communities, found 50 per cent of transgender Ontarians seriously considered suicide because they were transgender. Around 43 per cent had actually attempted suicide.

“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,” said N. Nicole Nussbaum, former president of Canadian Professional Association for Transgender Health and staff lawyer at Legal Aid Ontario.

Most medical professionals in Ontario are also not trained to deal with transgender issues, making reducing suicide rates particularly challenging.

“We’re very concerned because there isn’t very good education in most medical schools about trans issues,” CAMH’s Dr. McIntosh said. “Most of the people who practice now would have received no training in this. Gender dysphoria is quite distinct from psychosis. Anti-psychotics are not an appropriate course of treatment.”

Mental health is just one of the many areas affected by inordinately delayed surgery times. According to Clark, a current student at U of T’s Emmanuel College, who moved to Toronto from New York in 2003, she can’t get a student loan because she can’t change her name on her Permanent Resident card until the surgery is complete. Also, her PR card is expired because she has to appear in person to renew it. The problem: she has been living as a female for the last three years.

“My PR card has my name and gender as male,” she explained. “They’ll let me renew it with the old information but I have to appear as that former person and gender to do that, and I look nothing like the old photo.”

Because of the PR card dilemma, Clark hasn’t visited her mother in three years. Whenever she enters or exits Canada, she’s interrogated by border control officers.

“You get dragged into customs and they ask a load of questions,” she said. “They’re not doing this in a private room, it’s in front of everybody and it’s a hugely embarrassing situation that’s very, very difficult. For me, it’s not even worth it to travel.”

Employment is another issue affected by delayed wait times for surgery. Despite an almost 30-year career in IT, it was very difficult for Clark to find a job when she came out as a transgender woman.

“There’s quite a bit of employment discrimination ,” Nussbaum said. “We know transgender people have trouble getting references in their current name and gender. We need some policy at the federal level.”

Bill C-279 , a federal transgender rights bill that would add gender identity to the list of grounds protected from discrimination under the Canadian Human Rights Act and under the hate propaganda section of the Criminal Code, has been stalled in the Senate for three years. Calgary MP Rob Anders strongly opposed the bill, saying its goal is to give men access to women's washrooms , which led to the nickname "bathroom bill."

“Instead of making it about basic human rights, they’ve made it about whether transgender women are going to go into the washroom and rape women and children,” said Clark. “They’re saying, ‘Rachel’s going to walk into the washroom with her completely useless penis and rape my wife or my granddaughter.’ The idea behind that reaches all new levels of absurdity.”

A Ministry of Health spokesperson said the government’s exploring options around wait times and points of access to surgery, but didn’t provide specifics. CAMH’s Dr. McIntosh stressed the urgency of the Ministry getting involved.

“We really want the province to help us,” he said. “Often times, people may decide this is really what they want to do and be quite sure about it. Then they contact CAMH and are told that we’re currently seeing people who were referred 18 months ago. Unfortunately we are seeing increased rates of suicide ideation, and because our clinic is so small, we can’t offer any treatment ourselves.”

Image credit: PhotoComIX/Flickr.com

Iman Sheikh

Iman Sheikh is a former digital media producer at TVO.org. 

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Blog / Cosmetic Surgery / Gender Reassignment / Top Surgery in Toronto: 6 Different Techniques at Visage Clinic...

Top surgery in toronto: 6 different techniques at visage clinic.

top surgery, Toronto top surgery, top surgery Toronto, gender reassignment surgery, gender reassignment surgery Toronto, Toronto gender reassignment surgery, Toronto transgender, transgender Toronto, transgender

“Top surgery”  is a common term for our Toronto transgender community, more specifically my female-to-male (FTM) patients. It refers to the removal of breast tissue and to the masculinization of their chest, a strong component of gender reassignment surgery .

I have been performing top plastic surgery here in Toronto since 2001.

I offer 6 different techniques of top surgery for my FTM transgender patients , of which there are 3 main versions.  The choice of technique is not only dictated by the patient’s anatomy, but also by the patient’s choice of scar locations and the likelihood of a required second procedure, often called “second stage,” when discussing plastic reconstructive surgery.

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Drawings by Dr. Marc DuPéré

The simplest of all 3 techniques is the “ keyhole ” technique. The term is quite simple to understand for lay people as it refers to a “small opening”, i.e. a keyhole (yet confusing to inexperienced plastic surgeons as the keyhole technique in breast surgery refers to something else). This keyhole technique in masculinization of the chest refers to a small incision, between 5 and 7 o’clock at the areola’s border. The areola is the flat disk around the nipple. This technique was borrowed from our plastic surgery work on males with gynecomastia (breast tissue on males). Via this small incision at the brown-beige areolar line, most of the breast tissue can be removed. This technique is excellent for small breasts, small areolae, and young, elastic, and recoiling skin as no skin and no areolar tissue are removed. A strong advantage is most of the nipple feeling is preserved.

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1 step up would be the “ periareolar ” or “ donut ” technique. I used this technique for moderate-sized breasts where there is a mild excess of skin to be excised along with small-to-moderate breast tissue. It is done via excision of a “donut-shaped” area of skin around the areola and closing it to a smaller “male-size” areola. There is a limit to the extra skin that can be removed with this technique, and therefore it works best for small-to-medium breasts. I sometimes use this technique for larger breasts when patients are very reluctant to do the under-the-breast incision of the double-incision technique; yet, a second-stage procedure is often required to deal with some mandatory residual breast tissue required to maintain the viability of the nipple-areolar complex with the mandatory long pedicles (as seen with larger and pendulous breasts). The final scar is a circle around the areola. Because a larger circle is closed to a smaller circle, there are commonly little folds around the areola that tend to efface and disappear over 1 to 3 months; otherwise, a small scar revision might be required. In this technique, if more skin is excised, the tension on the closure with various upper extremity movements is greater and the likelihood of scar widening is greater. If the amount of skin is lesser, then there might be some residual loose skin after surgery. So as an experienced plastic surgeon, I must determine the right balance of skin excision; the patient also knows that a revision might be required. Finally, because the nipple-areolar tissue is not completely severed, there is a very small possibility of maintaining some sensation.

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By far the most common technique is the so-called “ double incision ” technique. This is what I recommend for larger breasts. It allows for the removal of all breast tissue and the resizing of the areola. Revisions are rare. The drawbacks are an incision in the small fold under the breasts and the time required for the new areola-nipple complexes to heal since those are grafted. The sexual feeling in the grafted nipples is also lost, but the “pressure” feeling and the ability to detect “cold/warm” usually returns to the nipples over time. The loss or necrosis of nipples (failed to “take” and heal) is possible but very rare.

A 4th technique would be liposuction alone, but it rarely provides an excellent masculine result.

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Finally, the old-style anchor reduction can be applied here too with complete excision of the breast tissue and preservation of a pedicled nipple-areolar complex. There is an added vertical scar which may seem very unsightly over the chest in a male. It is an “added” scar and does not serve many purposes over the double incision technique, except for the small theoretical chance of maybe saving some sensation to the nipple. I reserve this for patients who want to do anything to preserve some feeling, with large breasts and with hairy chest where the vertical incisions will be harder to see.

Adding a pectoral implant   (a 6th procedure!) is another powerful procedure in masculinizing one’s chest. Pectoral augmentation will instantly give a patient’s chest a muscular, manly look. Pectoral implants can be added easily during “top surgery”, using either the conventional underarm incision or the IMF incision of the double incision technique.

In summary, TOP surgery is often the first procedure my FTM patients will undergo here in Toronto in their journey through gender reassignment . Following this, the next most common procedures will be masculinizing the face and the body , often with liposuction and etching , fillers to face, chin implant, jaw angle implants, calf implants, pectoral augmentation, etc.

If you have any questions or concerns, please contact us or call (416) 929-9800 (Yorkville) to book your first visit at Visage Clinic.

Dr. Marc DuPéré, Aesthetic, Cosmetic, and Plastic Surgeon

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gender reassignment surgery toronto

Poilievre backs banning trans women from women's sports, change rooms and bathrooms

Conservative leader says federal jurisdiction may limit what he can do to restrict trans women's access.

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Conservative Leader Pierre Poilievre stepped into the debate over trans rights on Wednesday, saying "biological males" should be banned from women's sports, change rooms and bathrooms.

"Female spaces should be exclusively for females, not for biological males," Poilievre said in Kitchener, Ont.

The Conservative leader made the comments after being asked if, as prime minister, he would introduce legislation to prevent "transgender women" or "biological men" from participating in female sports or entering female prisons and shelters. 

"A lot of the spaces … are provincially and municipally controlled, so it is unclear ... what reach federal legislation would have to change them," Poilievre said.

"But obviously female sports, female change rooms, female bathrooms should be for females, not for biological males," he added. 

  • Pierre Poilievre says minors should not have access to puberty blockers
  • Alberta premier says legislation on gender policies for children, youth coming this fall
  • Analysis Pierre Poilievre tries to walk a fine line on transgender rights — and blames Trudeau

Last month, Alberta Premier Danielle Smith unveiled a slate of controversial legislative changes, expected to be tabled in the fall, that will significantly alter the province's student gender identity, sports and surgery policies. 

Those changes include a pledge to forbid transgender women in Alberta from competing in women's sports leagues. Smith did say, however, that her government will work with sports leagues in the province to set up co-ed or gender-neutral divisions for sports.

Advocates have said the terms "biological males" and "biological females" are problematic because they deny the identities of transgender and non-binary people.

Puberty blockers

Smith said that her government's policies will also prohibit hormonal treatment, puberty blockers and gender-affirming surgery for children 15 years and younger.

Poilievre said earlier this month that he does not support trans kids taking puberty blockers — medicines that are used to pause puberty before a possible gender transition or other interventions, like hormone therapy.

When questioned about Smith's changes in the foyer of the House of Commons, Poilievre said the decision to pursue transgender treatments should be reserved for adults alone.

"Puberty blockers for minors? I think we should protect children and their ability to make adult decisions when they're adults," he said.

Asked to state definitively if he was opposed to puberty blockers for people under the age of 18, Poilievre said he was.

gender reassignment surgery toronto

'Female spaces' should be 'exclusively for females,' Poilievre says

Smith said her proposed changes mean top and bottom gender reassignment surgeries will be banned for minors aged 17 and under (though bottom surgery is already limited to adults) and teens aged 16 and 17 will only be able to start hormone therapy with permission from their parents, a physician and a psychologist.

Smith's sweeping changes will also require students aged 15 and under to get permission from their parents before they can use a name or pronoun at school other than the one they were given at birth.

Trudeau says Poilievre is 'picking a fight with trans kids'

This pronoun policy follows similar moves by New Brunswick and Saskatchewan.

New Brunswick Premier Blaine Higgs's changes to Policy 713 require school staff to get the consent of parents before letting LGBTQ students under age 16 use the names and pronouns they choose in classrooms.

In October, Saskatchewan passed legislation requiring schools to seek parental consent if a student wants to use a different pronoun or name.

The province used the notwithstanding clause to enact the legislation, but a federal judge ruled earlier this month that the legislation can still be challenged in court despite the use of the clause.

In the wake of those and Smith's policies, Poilievre had said that he would "let parents raise kids and provinces run schools and hospitals. That's my common-sense approach."

  • Poilievre tells Trudeau to 'butt out' of New Brunswick's policy on LGBTQ students
  • Challenge of Sask. school pronoun law can proceed despite notwithstanding clause, judge rules

Last fall, 69 per cent of delegates to the Conservative Party's policy convention  voted in favour of a motion  that said those under the age of 18 should be prohibited from accessing "life-altering medicinal or surgical interventions" to treat "gender confusion and dysphoria."

Trudeau responded to Poilievre's remarks later Wednesday, telling reporters in Edmonton that Poilievre would "rather pick a fight with trans kids" than deal with the real problems facing Canadians.

"I think Mr. Poilievre and politicians like him are choosing to attack some of the most vulnerable people in our society as a way of deflecting from the fact that they are very good at creating division and anger," Trudeau said Wednesday. "But so far they have been terrible at putting forth any concrete solutions for the big problems that all Canadians are facing in their daily lives."

The prime minister said Poilievre has no policy solutions for issues such as housing, climate change and child care.

gender reassignment surgery toronto

Poilievre 'championing hateful policies,' retired trans hockey player says

About the author.

gender reassignment surgery toronto

Senior writer

Peter Zimonjic is a senior writer for CBC News. He has worked as a reporter and columnist in London, England, for the Daily Mail, Sunday Times and Daily Telegraph and in Canada for Sun Media and the Ottawa Citizen. He is the author of Into The Darkness: An Account of 7/7, published by Random House.

With files from J.P. Tasker

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Republican Ohio Gov. Mike DeWine bans gender transition surgery for minors

R epublican Ohio Gov. Mike DeWine signed an executive order Friday banning gender reassignment surgery from being performed on minors. 

“This ban is effective immediately,” the Ohio governor told reporters after signing the order.  

A week ago, DeWine vetoed comprehensive legislation that would have outlawed doctors from prescribing hormones and puberty blockers for minors, as well as performing gender reassignment surgeries.

The legislation, House Bill 68, would have also barred transgender females from playing on high school and college sports teams consistent with their gender identity. 

The governor argued that his veto “did not reflect one way or another” on the other issues House Bill 68 sought to address and that Ohio needed “to stay focused on the important one.”

“There’s a broad, broad consensus against surgeries for minors, so let’s put that into a law so we can move on and talk about other things,” DeWine said. 

Ohio joins more than 20 other states that have enacted prohibitions on gender reassignment surgery for minors since 2021. 

DeWine acknowledged that gender reassignment surgeries on minors are rare in the Buckeye State, but said his executive order ensures that the controversial medical procedure will be stamped out. 

“If we look at what evidence there is, there is very little that that is occurring, but let’s make sure, and that’s what this does,” he said. 

DeWine also announced new rules that seek to collect data on transgender medical treatment in Ohio and prevent “fly-by-night” operations that don’t provide patients with mental health counseling. 

“I am concerned that there could be fly-by-night providers, clinics, that might be dispensing medication to adults with no counseling and no basic standards to ensure quality care,” he said. 

“It’s clear the most important part is the mental health counseling, DeWine added. “It needs to be lengthy, and it needs to be comprehensive.” 

The rules will be open for a period of public comment before being adopted. 

The Republican-controlled Ohio General Assembly could override DeWine’s veto of House Bill 68 with a three-fifths majority vote. 

Lawmakers plan to return early from their winter recess to vote on the override, according to the Ohio Capital Journal, but it’s unclear if they body has the votes to do so. 

“I have a job. They have a job. They do their job. I do my job,” DeWine said of a possible override vote.

“My job was to study this issue and decide whether to sign it. As I said a week ago, for me to sign the bill, for this to become law in the state of Ohio, I’ll be saying that the government knows best, knows better than parents, about their own child’s health.”

Republican Ohio Gov. Mike DeWine bans gender transition surgery for minors

India TV News

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Indore man undergoes gender reassignment surgery to marry his boyfriend, here's what happened next

A 28-year-old man met vaibhav shukla on social media in 2021 and underwent gender reassignment surgery after he promised marriage upon the transformation. read to know what happened next..

Arushi Jaiswal

The man has approached the police station to file a complaint. According to police, the accused has been identified as Vaibhav Shukla, a resident of Uttar Pradesh's Kanpur.

Here's what victim said

The police further said that the after meeting the accused on social media in 2021, the victim underwent gender reassignment surgery as Shukla has promised marriage following the transformation. However, after the surgery, Shukla reneged on his promise, refusing to fulfill his commitment.

Recalling his ordeal, the victim said, "I underwent gender reassignment surgery as per Shukla's request, believing in his commitment to marry me. However, he not only reneged on his promise but also subjected me to unnatural acts."

Left with no alternatives, the victim approached the Vijay Nagar police and filed a complaint against the accused. "I spent a significant amount on the surgery, and now I'm left in despair. I urge the authorities to take strict action against Shukla," the victim added.

What did police say?

According to the police, the victim initially met the accused, Vaibhav Shukla, on Instagram about three years ago, and they entered into a relationship. Shukla then persuaded the victim to undergo gender reassignment surgery with the promise of marriage. Additionally, the accused engaged in unnatural sexual activities with the victim. However, after the surgery, Shukla reneged on his promise to marry the victim and even threatened the victim with serious consequences.

India Tv - Indore

"The accused allegedly engaged in unnatural acts with the victim. A case has been registered against Vibhav Shukla under IPC Section 377 (unnatural sex), and 506 (criminal intimidation). We are further looking into the case," Vijay Nagar Police Station in-charge Chandrabhal Singh told news agency ANI.

"Efforts are on to trace and nab the accused," Singh added. 

(With ANI inputs)

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  1. Transition Related Surgery

    About Contact Information For Providers Patient Resources As you all know, these are unprecedented times. Currently our Transition-Related Surgery (TRS) Program at Women's College Hospital is focusing our efforts on catching up on the backlog of cancelled surgeries and consultations after our program was on hold for several months.

  2. Gender Reassignment Female-to-Male Surgery in Toronto

    For many transgender people here in Toronto, gender reassignment or confirmation surgery is an incredibly important step toward looking and feeling complete. Request a Consultation Gender Reassignment: Female-to-Male (FTM) In addition to offering "top surgery" to FTM patients, Dr. DuPéré also offers a variety of procedures to masculinize features.

  3. Gender confirming surgery

    Information for healthcare providers Affirming gender identity Gender confirming surgery (also known as sex reassignment or gender affirming surgery) does more than change a person's body. It affirms how they think and feel about their own gender and what it means to who they are.

  4. Gender Reassignment

    Your Options Gender Reassignment: Female-to-Male (FTM) Dr. DuPéré uses a variety of customized techniques for chest reconstruction and contouring. He also offers pectoral augmentation, calf augmentation, and nonsurgical options for facial masculinization. Gender Reassignment: Male-to-Female (MTF)

  5. Male-To-Female Gender Reassignment Surgery in Toronto

    Dr. DuPéré uses a device called the Keller Funnel, which eliminates direct contact with the implant. This minimizes the risk of infection and later complications. Recovery & Results MTF breast augmentation patients should expect to be comfortably back to work within about 1 week.

  6. Toronto home to first public hospital in Canada that offers transition

    WATCH ABOVE: Transition-related surgery program launches in Toronto. Caryn Lieberman reports - Jun 24, 2019 ... spearheaded the effort to have gender reassignment surgeries available at the ...

  7. Information on Sex Reassignment Surgery (SRS) and Trans Health Care in

    Information on Sex Reassignment Surgery (SRS) and Trans Health Care in Ontario Answers to Frequently Answered Questions about SRS and Trans Health Care in Ontario.

  8. Women's College Hospital's TRS program increasing capacity to provide

    Women's College Hospital's TRS program increasing capacity to provide life-saving gender-affirming surgeries November 14, 2022 By Sam Pender This week is National Transgender Awareness week and providing life-saving gender-affirming surgeries and care remains as important as ever.

  9. Toronto hospital first in Ontario to offer trans surgery

    A Toronto hospital has become the first in Ontario to offer gender-reassignment surgery. Doctor Yonah Krakowsky, a urologist and medical lead of the Transition-Related Surgery program at...

  10. Toronto's Women's College Hospital launches new program for gender

    When Janet Macbeth underwent surgery in Toronto on Monday, it was a milestone not just for her, but for Canada. ... the number of gender-reassignment surgeries that OHIP covered in Montreal and ...

  11. Ontario expands referrals for gender reassignment surgery

    Dr. Amy Bourns at the announcement to expand referrals for gender reassignment surgery. The Ontario government will move to allow more health-care providers to provide patient referrals for sex ...

  12. Ontario boosts access for trans people seeking gender confirmation surgery

    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 ...

  13. The Orthodox Jew who became a gender-reassignment surgeon

    The Orthodox Jew who became a gender-reassignment surgeon By Yonah Krakowsky | April 30, 2018 Photograph by Nikki Mills I attended an all-boys, Orthodox Jewish high school in Toronto, where...

  14. Surgery

    Women's College Hospital 76 Grenville Street Floor 5 Toronto, ON M5S 1B2. Phone: 416-323-6014

  15. Canada Has Nation-Wide Funding For Gender-Affirming Surgery

    Surgeons who practice gender-affirming genital surgery are only located in Montreal, Toronto and Vancouver.

  16. Gender Identity Clinic

    The Gender Identity Clinic offers services to individuals and their primary care practitioners in regard to gender identity and expression. Intended For Individuals over 17 who wish to explore issues related to their gender identity, which may include any degree of transgender expression.

  17. Find a Surgeon for Gender Affirming Surgery

    Online since 2011, TransHealthCare has helped thousands of transgender and non-binary people from around the world find a surgeon. Find Surgeons by Procedure Body Sculpting Breast Augmentation Buttock Augmentation Facial Feminization Facial Masculinization Hair Grafting Hysterectomy Metoidioplasty Nullification Orchiectomy Phalloplasty

  18. Transgender Health Care Access

    In 2019, transgender surgery assessments were made available in the province. Meaning, the province no longer requires trans and non-binary individuals to be evaluated by the Centre for Addiction and Mental Health in Toronto, Ontario, to determine whether they would be approved to undergo gender reassignment surgery.

  19. Gender Surgeons in Canada

    Dr. Brassard and his team perform more than 200 gender-affirming surgeries a year at Centre Métropolitain de Chirurgie in Montréal, Quebec, Canada. Dr. Maud Bélanger Dr. Nicholas Cormier Dr. Jennifer Klok Dr. Marietta Zorn Dr. Jayson Dool Dr. Philip Solomon Dr. Shaun Tregoning Dr. Homan Cheng Dr. Ashlin Alexander Dr. Mario Jarmuske

  20. Why surgery wait times put transgender people at risk of suicide

    The Ontario Ministry of Health has designated only a single site to evaluate the eligibility of transgender people seeking surgery. A prescription for 450 mg of the anti-psychotic drug Seroquel. This was the answer Rachel Lauren Clark received when she told doctors at a Toronto hospital she wanted gender reassignment surgery (GRS).

  21. Gender-Affirming Surgery

    Genital gender-affirming surgery for individual's with assigned female at birth anatomy falls into two main categories: metoidioplasty and phalloplasty. In both categories the main differentiating factor between the various surgical options is the desire to stand to urinate.

  22. PDF Gender affirming options for gender independent children and adolescents

    Also known as sex reassignment surgery, this includes various surgical procedures a person may choose to undergo to better represent their gender identity. If your child is considering surgery, contact your primary care provider. This provider can guide the process or make a referral to one of the transgender youth clinics in Ontario.

  23. Top Surgery in Toronto: 6 Different Techniques at Visage Clinic

    It refers to the removal of breast tissue and to the masculinization of their chest, a strong component of gender reassignment surgery. I have been performing top plastic surgery here in Toronto since 2001. I offer 6 different techniques of top surgery for my FTM transgender patients, of which there are 3 main versions.

  24. Poilievre backs banning trans women from women's sports, change rooms

    Smith said her proposed changes mean top and bottom gender reassignment surgeries will be banned for minors aged 17 and under (though bottom surgery is already limited to adults) and teens aged 16 ...

  25. Woman sentenced to prison for 'transphobic' posts about prostitute in

    During sentencing, it said: "The derogatory statements regarding gender identity … reflect the contempt she feels towards the group of transgender people who have not undergone genital reassignment surgery, and show, by questioning the gender (of the victim), a clear desire to inflict ridicule, and managing to generate [in the victim ...

  26. Utah representative proposes gender reassignment surgery benefits ...

    U tah State Rep. Sahara Hayes (D- Salt Lake) has introduced a joint resolution aimed at providing gender reassignment surgery health benefits to the state of Utah's 22,000 employees.. Hayes's ...

  27. Republican Ohio Gov. Mike DeWine bans gender transition surgery ...

    Story by Victor Nava • 1mo. Republican Ohio Gov. Mike DeWine signed an executive order Friday banning gender reassignment surgery from being performed on minors. "This ban is effective ...

  28. Indore man undergoes gender reassignment surgery to marry his boyfriend

    A 28-year-old man met Vaibhav Shukla on social media in 2021 and underwent gender reassignment surgery after he promised marriage upon the transformation. Read to know what happened next.