Gender-affirming Surgery (GAS) is a broad term. It covers any surgical procedure that changes or makes one's body align more closely with their gender identity.
|Breast / Chest Reduction||
|Chest Masculinization / Mastectomy||
Learn more about GAS:
Chest Masculinization / Mastectomy / Breast Reduction
Removal (ectomy): Oophorectomy, Hysterectomy, Penectomy, Orchiectomy or Reconstruction (plasty): Phalloplasty, Metoidioplasty, Vaginoplasty
List of MSI insured GAS (when performed in approved locations):
|Available in NS and Centre Metropolitain de Chirurgie in Montreal||Available Only in Centre Metropolitain de Chirurgie in Montreal|
|Breast / Chest Reduction|
|Chest Masculinization / Mastectomy|
Click through the tabs for more information.
*Distress that is caused by a discrepancy between a person’s gender identity and that person’s sex assigned at birth (and the associated gender role and/or primary and secondary sex characteristics) (Fisk, 1974; Knudson, De Cuypere, & Bockting, 2010b).
You will need a licensed Nova Scotia doctor (family doctor or specialist), Nurse Practitioner or Health Care Provider to complete the GAS application form and apply to MSI on your behalf. You will also need a doctor or Nurse Practitioner who is able to provide post-operative care. This could be the surgeon if the procedure is done locally.
If you don’t have a family doctor you can register for one at the Nova Scotia Health's Family Practice Registry.
You can access WPATH clinicians by self-referring to Community Mental Health by calling (toll-free) 1-888-429-8167. Explain you are requesting a WPATH assessment for gender-affirming surgery. The person on the phone will do an initial screening and make decisions on where to refer you based on where you live and wait times. You will then be placed on a waitlist and given the first appointment at the closest mental health clinic.
What to expect from your appointment for WPATH surgical or hormone assessment
You may be asked if a learner (medical student, resident, other health care student) can be present for teaching purposes. This is typical with all appointments in these clinics.
You can access a WPATH trained social worker by referral from your doctor. The fax number for doctor referrals is 902-473-3770. Please note: If you have serious mental health concerns your referral may be more appropriate for community mental health.
What to expect from the appointment
Your appointment will be with a social worker trained in WPATH SoC. Appointments are typically a single three hour session. Letters are typically provided within the week to patient and referring doctor.
If the surgery will be done in Nova Scotia, then the referral will go directly to the surgeon (e.g Urology or Gynecology). Please see the MSI Surgical Criteria chart above for surgery(s) that can be done in Nova Scotia.
Once approved, your surgeon will be in touch to book your surgery. Please note that the surgeons wait for MSI approval before booking your surgery. Wait times for orchiectomy is around 3-6 months, 6-9 months for hysterectomy.
If the surgery will be done in Montreal at Complexe Chirurgical CMC, you can be referred to a physician specialist (typically an Endocrinologist, Psychiatrist or Plastic Surgeon) to get a letter of support. Most specialists prefer you to have your WPATH assessment(s) complete before they will see you.
Once your doctor has the necessary letters for your surgery, you will complete and sign the application and they will send your letters and the GAS application to MSI. The approval process through MSI usually takes several weeks.
Your doctor needs to write a letter stating you require an escort to travel with you to Montreal if you want their costs covered by MSI.
MSI requires for all surgeries that people have a letter from their doctor saying they will provide post-operative care. If you do not have this, your doctor can include this in their letter of support for you.
Once MSI has approved your surgery, they will send your referring doctor and you a copy of the approval, which is valid for 24 months (2 years). They will also include a copy of the Out-of-Province Travel Information and Expense Claim Form (which you have to submit within 30 days of returning from Montreal).
Once approved, your doctor will send a copy of your assessment(s) and MSI approval to Montreal. Complexe Chirurgical CMC will send you back a package that needs to be completed.
If you've been approved for surgery in Montreal, MSI provides out-of-province travel accommodation and assistance.Out-of-Province Travel Forms and Accommodation Assistance Policies:
If you require medical assistance after your surgery, please immediately contact your surgeon and/or the doctor who has agreed to provide your post-operative care. Urgent care can also be provided by a walk-in clinic or the emergency department of your local hospital. If you are not sure who to see, you can call 811 to get health advice from a Registered Nurse.