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HESA Committee Report

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APPENDIX B: MAP OF PUBLICLY FUNDED GENDER AFFIRMING MEDICAL CARE IN CANADA

 

A map of Canada provides information on gender affirming medical care funded by the provinces and territories. The map also shows whether gender affirming surgeries are performed in the territory or province concerned. In Yukon, the following gender affirming medical care is covered by the public system: penectomy, orchiectomy, vaginoplasty, labiaplasty, clitoroplasty, vaginectomy, hysterectomy, salpingo-oophorectomy, metoidioplasty, phalloplasty, mastectomy, scrotoplasty, erectile and testicular implant, clitoral release, chest contouring/chest masculinization, assess for hormone therapy, private clinic stay, travel and psychiatric. The following gender affirming medical care is not covered by the public system in Yukon: breast augmentation, counselling, facial feminization, voice and communication training, tracheal shaving and laser/hair removal. Coverage for care outside Canada is unclear. Gender affirming surgeries are not available in Yukon. In British Columbia, the following gender affirming medical care is covered by the public system: penectomy, orchiectomy, vaginoplasty, labiaplasty, clitoroplasty, vaginectomy, hysterectomy, salpingo-oophorectomy, metoidioplasty, phalloplasty, mastectomy, scrotoplasty, erectile and testicular implant, clitoral release, chest contouring/chest masculinization, assess for hormone therapy, private clinic stay, services outside Canada and psychiatric. The following gender affirming medical care is not covered by the public system in British Columbia: counselling, travel, facial feminization, voice and communication training, tracheal shaving, laser/hair removal. Breast augmentation is sometimes covered in British Columbia. Some gender affirming surgeries are performed in British Columbia. In Alberta, the following gender affirming medical care is covered by the public system: penectomy, orchidectomy, vaginoplasty, labiaplasty, clitoroplasty, vaginectomy, hysterectomy, salpingo-oophorectomy, metoidioplasty, phalloplasty, mastectomy, scrotoplasty, erectile and testicular implant, clitoral release, assess for hormone therapy, private clinic stay, travel and psychiatric. The following gender affirming medical care is not covered by the public system in Alberta: breast augmentation, chest contouring/chest masculinization, counselling, services outside Canada, facial feminization, voice and communication training, tracheal shaving, laser/hair removal. Some gender affirming surgeries are performed in Alberta. In Saskatchewan, the following gender affirming medical care is covered by the public system: orchidectomy, vaginectomy, hysterectomy, salpingo-oophorectomy, mastectomy, assess for hormone therapy, counselling and psychiatric. The following gender affirming medical care is not covered by the public system in Saskatchewan: chest contouring/chest masculinization, travel, facial feminization, tracheal shaving, and laser/hair removal. In some cases, the following gender affirming medical care is covered by the public system in Saskatchewan: penectomy, vaginoplasty, breast augmentation, labiaplasty, clitoroplasty, metoidioplasty, phalloplasty, scrotoplasty, erectile and testicular implant, clitoral release, private clinic stay, services outside Canada and voice and communication training. Some gender affirming surgeries are performed in Saskatchewan. In Manitoba, the following gender affirming medical care is covered by the public system: penectomy, orchidectomy, vaginoplasty, labiaplasty, clitoroplasty, vaginectomy, hysterectomy, salpingo-oophorectomy, metoidioplasty, phalloplasty, mastectomy, clitoral release, chest contouring/chest masculinization, assess for hormone therapy, private clinic stay, travel, services outside Canada and psychiatric. The following gender affirming medical care is not covered by the public system in Manitoba: counselling, facial feminization, voice and communication training and tracheal shaving. In some cases, the following gender affirming medical care is covered by the public system in Manitoba: breast augmentation, scrotoplasty, erectile and testicular implant and laser/hair removal. Some gender affirming surgeries are performed in Manitoba. In Ontario, the following gender affirming medical care is covered by the public system: penectomy, orchidectomy, vaginoplasty, labiaplasty, clitoroplasty, vaginectomy, hysterectomy, salpingo-oophorectomy, metoidioplasty, phalloplasty, mastectomy, scrotoplasty, erectile and testicular implant, clitoral release, assess for hormone therapy, counselling, private clinic stay, services outside Canada and psychiatric. Breast augmentation is covered in some cases. The following gender affirming medical care is not covered by the public system in Ontario: chest contouring/chest masculinization, travel, facial feminization, voice and communication training, tracheal shaving and laser/hair removal. Some gender affirming surgeries are performed in Ontario. In Quebec, the following gender affirming medical care is covered by the public system: penectomy, orchidectomy, vaginoplasty, labiaplasty, clitoroplasty, vaginectomy, hysterectomy, salpingo-oophorectomy, metoidioplasty, phalloplasty, mastectomy, scrotoplasty, erectile and testicular implant, clitoral release, assess for hormone therapy, counselling, private clinic stay, laser/hair removal and psychiatric. Breast augmentation is covered in some cases. Quebec is the only province where all gender affirming surgeries are performed. The following gender affirming medical care is not covered by the public system in Quebec: chest contouring/chest masculinization, travel, services outside Canada, facial feminization, voice and communication training and tracheal shaving. In New Brunswick, the following gender affirming medical care is covered by the public system: penectomy, orchidectomy, vaginoplasty, labiaplasty, clitoroplasty, vaginectomy, hysterectomy, salpingo-oophorectomy, metoidioplasty, phalloplasty, mastectomy, scrotoplasty, erectile and testicular implant, clitoral release, chest contouring/chest masculinization, assess for hormone therapy and psychiatric. The following gender affirming medical care is not covered by the public system in New Brunswick: breast augmentation, counselling, private clinic stay, travel, services outside Canada, facial feminization, voice and communication training, tracheal shaving and laser/hair removal. Some gender affirming surgeries are performed in New Brunswick. In Nova Scotia, the following gender affirming medical care is covered by the public system: penectomy, orchidectomy, vaginoplasty, labiaplasty, clitoroplasty, vaginectomy, hysterectomy, salpingo-oophorectomy, metoidioplasty, phalloplasty, mastectomy, erectile and testicular implant, clitoral release, assess for hormone therapy, private clinic stay, travel and psychiatric. The following gender affirming medical care is not covered by the public system in Nova Scotia: breast augmentation, counselling, services outside Canada, facial feminization, voice and communication training, tracheal shaving and laser/hair removal. In some cases, chest contouring/chest masculinization is covered by the public system in Nova Scotia. Scrotoplasty coverage is unclear. Some gender affirming surgeries are performed in Nova Scotia. In Prince Edward Island, the following gender affirming medical care is covered by the public system: penectomy, orchidectomy, hysterectomy, salpingo-oophorectomy, mastectomy, assess for hormone therapy, counselling and psychiatric. The following gender affirming medical care is not covered by the public system in Prince Edward Island: vaginoplasty, breast augmentation, labiaplasty, clitoroplasty, vaginectomy, metoidioplasty, phalloplasty, scrotoplasty, erectile and testicular implant, clitoral release, chest contouring/chest masculinization, private clinic stay, travel, services outside Canada, facial feminization, voice and communication training, tracheal shaving and laser/hair removal. Some gender affirming surgeries are performed in Prince Edward Island. In Newfoundland and Labrador, the following gender affirming medical care is covered by the public system: penectomy, orchidectomy, vaginoplasty, labiaplasty, clitoroplasty, vaginectomy, hysterectomy, salpingo-oophorectomy, mastectomy, scrotoplasty, assess for hormone therapy, counselling and psychiatry. The following gender affirming medical care is not covered by the public system in Newfoundland and Labrador: breast augmentation, metoidioplasty, phalloplasty, erectile and testicular implant, clitoral release, chest contouring/chest masculinization, private clinic stay, facial feminization, tracheal shaving and laser/hair removal. In some cases, the following gender affirming surgeries are covered by the public system in Newfoundland and Labrador: travel, services outside Canada and voice and communication training. Some gender affirming surgeries are performed in Newfoundland and Labrador. In Nunavut, gender affirming medical care is not covered by the public system, and gender affirming surgery is not available. In the Northwest Territories, gender affirming medical care is covered on a case-by-case basis, and gender affirming surgery is not available.

Source:  Publicly Funded Gender Affirming Medical Care in Canada, p. 1, Canadian Professional Association for Transgender Health, 2019.

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