Province Reduces Barriers for Gender-Affirming Surgery

Starting today, July 20, the Province is removing barriers and cutting wait times for Nova Scotians seeking gender-affirming surgery. 

“People told us the application process for gender-affirming surgery created needless hardship and painful delays in getting the care they need. This can have a serious impact on their mental health, and it hurts gender-diverse people and their loved ones,” said Health and Wellness Minister Michelle Thompson. “We’ve listened, and we are making changes the community recommended. We will continue to work with transgender and gender-diverse Nova Scotians, hear their needs and offer supports more quickly.”

Gender-affirming surgery helps people’s physical appearance align with their gender identity.

Until today, surgery applications had to include a letter of support from a Nova Scotia specialist and a letter from a specialist confirming post-operative care if the surgery was happening in Nova Scotia.

Now, those letters are no longer required. This will significantly reduce wait times because it can take between six and 18 months to see a specialist, which more than doubled patients’ wait times.

A letter from a physician or nurse practitioner confirming post-operative care is still required if the surgery is happening outside Nova Scotia.

Another benefit for patients is the addition of healthcare providers who can provide a psychosocial assessment letter, which is still required with a surgery application. Now, physicians, nurse practitioners and specialists who have specific skills in gender-affirming care can complete the assessment, provide the letter and sign the application. This change will also help reduce wait times because people previously had to find and wait for mental health clinicians specifically trained in gender-affirming care to complete the process.

“These changes will make it easier for trans, non-binary and gender diverse people to access the care they need. This will not only improve the health and wellness of queer and trans folks, but also reduce barriers to specialists for others who need them most. This is a great step toward more equitable access to gender-affirming care while reducing barriers and stigma. It is a privilege to be part of this change and to advocate for 2SLGBTQIA+ community.”
     – Garry Dart, prideHealth Co-ordinator, Nova Scotia Health

“Trans, non-binary and gender-diverse people face many hurdles in their journeys before they even access life saving gender-affirming healthcare. Removing delays, barriers and simplifying their passage is a welcome step towards easing that unnecessarily difficult journey. I look forward to being part of that further easement of those journeys and want to thank the team for this step.”
     – Veronica Merryfield, founder, Cape Breton Transgender Network

“Sexual Health Nova Scotia is thrilled that trans and gender-diverse people around the province have been consulted, resulting in positive changes to the process of accessing gender-affirming surgeries. These changes are an important step in reducing barriers to accessing critical services and creating more equitable systems of care. We look forward to further consultation with the community to continue to improve gender affirming services in the province.”
     – Stella Samuels, Executive Director, Sexual Health Nova Scotia

“Halifax Sexual Health Centre is thrilled to learn that community advocacy efforts to reduce barriers to gender-affirming surgery have been recognized by the Province. We are confident that the changes to the application process will have a positive impact on our patients. We are excited to reach out to patients currently awaiting specialist letters to tell them the good news.”
     – Abbey Ferguson, Executive Director, Halifax Sexual Health Centre

Quick Facts:
— the 2SLGBTQIA+ community makes up between 10 and 20 per cent of Nova Scotia’s population
— gender-affirming surgery has been an insured benefit in Nova Scotia since April 1, 2014; in 2021, 101 applications were approved for these surgeries
— Nova Scotia’s eligibility criteria and application process for gender-affirming surgery are guided by the World Professional Association for Transgender Health current Standards of Care for the Health of Transsexual, Transgender, and Gender Nonconforming People
— healthcare providers offering gender-affirming care must have specific skills that align with association standards

Additional Resources:
More information, including the list of publicly funded gender-affirming surgeries in Nova Scotia, is available at:

World Professional Association for Transgender Health:

Mandate letter of the Minister of Health and Wellness:

Source: Release

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