Gender affirming care includes a range of social, psychological, behavioral and medical interventions (like hormone treatment and gender affirming surgeries) that support and affirm an individual's gender identity.
Several healthcare services and expenses that support gender affirming care (like psychological services, counselling and hormone treatment) are insured benefits if you receive care in publicly funded healthcare facilities in Nova Scotia.
Nova Scotia Pharmacare Programs provide coverage for hormonal therapies. Some therapies are covered by regular benefits. Some therapies require a request from a doctor. Patients can access their usual drug insurance for any required hormone therapies, according to the rules of their specific plan.
Trans care (including readiness assessment or psychosocial assessment, hormone treatment and follow-up visits after hormone treatment or surgical procedures) is offered by physicians and nurse practitioners.
Gender affirming surgery (sometimes called sex reassignment or gender confirming surgery) is surgery to affirm a person's gender identity. Gender affirming surgery is a publicly funded service in Nova Scotia.
Gender affirming surgeries include procedures to enhance and more closely match the desired internal and external primary or secondary sex characteristics.
The following gender affirming procedures are publicly funded when a Gender Affirming Surgery Application is approved by Medical Services Insurance (MSI) before the surgery takes place.
Some surgeries are available in Nova Scotia and at Centre Métropolitain de Chirurgie-GrS Montreal, Quebec (a pre-approved out-of-province partner facility). Some surgeries are only available at Centre Métropolitain de Chirurgie-GrS Montreal. The location of the procedure is determined on a case-by-case basis. It depends on the nature and extent of the surgery and the availability of infrastructure and clinical expertise.
|Available in Nova Scotia and Montreal||Only available in Montreal|
When gender affirming procedures can't be performed in Nova Scotia, out-of-province surgeries will only be publicly funded if performed at GrS Montreal. You need to get approval from MSI before the surgery.
For eligible individuals who travel to Montreal for gender affirming surgery, many costs directly associated with the procedure are covered. These include transportation and accommodation costs as per the Nova Scotia Out-of-Province Travel and Accommodation Assistance Policy.
Not all procedures and expenses related to gender affirming surgeries are covered. There's no public funding available for:
Clinical eligibility for gender affirming surgery is outlined in the Gender Affirming Care Policy (PDF). The policy is based on the World Professional Association for Transgender Health's (WPATH) Standards of Care for the Health of Transgender and Gender Diverse People, Version 8 (PDF).
The Department of Health and Wellness regularly reviews the Gender Affirming Surgery Application and eligibility criteria to make sure they meet applicable policies and standards, including the World Professional Association for Transgender Health's Standards of Care.
If you're interested in accessing gender affirming care or gender affirming surgery, you can start the readiness or psychosocial assessment and referral process by contacting:
A psychosocial assessment is required for:
If you don't have a healthcare professional who can conduct the assessment, contact prideHealth.
Any required letters must be completed and signed by a doctor, nurse practitioner or specialist and sent to MSI for pre-approval. More details on the assessment, referral and approval process are outlined in the Gender Affirming Care Policy (PDF).
Application form: Gender Affirming Surgery Application (PDF)
For questions about the approval process for these surgeries, contact MSI (in Nova Scotia).
For questions about out-of-province travel and accommodation, contact the Department of Health and Wellness - Benefit Eligibility.