Navigating Trans and Gender-diverse Health Care

Guidance from prideHealth about how to connect with the information, support, and health services that are right for you.

Social & Legal Transition

Can I change my voice?

If you are looking to change your voice speech therapy is a great option. Speech therapy is an option whether you are pursuing hormone therapy or not. Masculinizing/affirming hormones can often lead to a deeper voice. The degree of deepening may vary from person to person. Feminizing/affirming hormones, however, do not often cause significant changes to the voice. In order to significantly change your voice or reach a desired pitch and tone, you may need voice coaching. Consulting with a speech therapist can be very helpful and can minimize possible damage to your voice. In Nova Scotia speech therapy is covered by the provincial health care plan (MSI).

Where else should I change my name?

  • Canada Revenue Agency
  • Deed, mortgage or lease
  • Bank accounts
  • Insurance policies
  • Academic records – such as university diplomas
  • Record(s) of Employment
  • Workplace health benefits
  • Workplace or student identifications
  • Medical records
  • Emergency contact information listings
  • Any license you hold - such as dog ownership, fishing, etc.
  • Contact information for businesses
  • Your online persona - such as social media and email accounts

Do I need surgery to legally change my gender marker?

No. There is no requirement to have had gender-affirming hormone therapy or surgery, or to have legally changed your name, in order to change your gender marker.

Gender-affirming Surgery

My out-of-province surgery has been approved by MSI, so why is it taking so long?

Once Complexe Chirurgical CMC has all your documents and letters they give them to the pre-operative team who review the information to make sure that nothing is missing. If they need more information because of an existing health condition(s), they will contact the referring doctor to make sure the patient is healthy enough to undergo surgery.

What happens if my provider doesn't know who to refer me to for an assessment?

Please see the WPATH assessment section of this website, or, if you need help understanding the GAS application, contact prideHealth.

Gender-affirming Hormones

I have mental health concerns. Will this impact my ability to get hormones?

Many people experience other mental health challenges in addition to their gender dysphoria (such as anxiety, depression, self-harm, abuse, trauma, substance abuse, personality disorders, eating disorders, dissociation, autistic spectrum, etc.). Often these concerns improve with the treatment of gender dysphoria. They do not need to prevent or delay your hormone therapy. Talk about these concerns with your health care provider so they can develop a plan to support you.

There are a limited number of health care providers who see people with complex mental health issues (psychosis). If this applies to you there may be a longer wait time or more appointments required before you receive your readiness letter. If this applies to you please book an appointment with the Community Mental Health Team.

If I self-prescribe hormones, do I need to see a health care provider?

If you've already started taking hormones (self-prescribed), it's important for your physical health that you contact a health care provider. Using gender-affirming hormones is a medical process that should be monitored to ensure your safety and good health.

What if I'm taking hormones through my health care provider at the IWK and am almost 19?

If you are nearing 19 years old and have been followed by the IWK before being discharged, make sure that your referral to another health care provider has your:

  • baseline blood work
  • current dosage
  • most recent blood work related to your current dosage

If you don't have a health care provider, your information related to hormone therapy (see above) can be sent to Halifax Sexual Health Centre (HSHC). Information sent to HSHC should include your readiness letter. Please note you will still need to self-refer and book your own appointment. A friend or family member cannot book an appointment for you.

Remember you can always access your health records through Note that there may be costs associated with your request.

What about prescription coverage?

With some private health insurance (i.e., Medavie Blue Cross™) you can get injection supplies for free or at a very low cost through any pharmacy.

Everyone who has a Nova Scotia heath card is eligible for the Family Pharmacare Program. Call 902-496-7008 or toll free in Nova Scotia at 1-800-563-8880 for details about this program, or send an email to