Gender Affirming Surgery

Gender affirming surgery, also referred to as sex reassignment or gender confirming surgery, is an insured benefit in Nova Scotia. Coverage for gender affirming surgery is based on what most other Canadian provinces insure, and the process they use to provide access to care.

The funding will help those who are deemed eligible and for whom the surgery is an important part of their gender transition. Counselling, psychotherapy and hormone therapy have always been funded when provided in public institutions in Nova Scotia.

Gender affirming surgery can be categorized into three areas:

  • Removal of the internal and external organs associated with the current sex
  • Construction of the external characteristics of the desired sex
  • Procedures to enhance the appearance and more closely match the desired sex

What's covered

List of approved surgeries and where they are performed

Female to Male (FtM)

Chest Masculinization / Mastectomy

Male to Female (MtF)

Breast Augmentation

Procedures for the purposes of gender affirming surgery that may be done in Nova Scotia include Oophorectomy, Hysterectomy, Orchiectomy and Breast Augmentation. Procedures that may be performed at the Centre Métropolitain de Chirurgie, Montreal, Quebec include Chest Masculinization / Mastectomy, Phalloplasty, Metoidioplasty, Breast Augmentation, Penectomy, Orchiectomy, and Vaginoplasty.

What's not covered

A complete list of coverage exemption can be found on the Gender Affirming Surgery Approval Request Form/ application (PDF)

Who is eligible

Clinical eligibility for gender affirming surgery will be determined through application of the World Professional Association for Transgender Health (WPATH) Standards of Care (SoC)criteria. The patient can be assessed by their physician, specialist, nurse practitioner (NP) trained in the WPATH SoC, or a health care professional (HCP) trained in the WPATH SoC. This assessment is required by other Canadian jurisdictions that insure these surgeries.

Application process

Once the patient has been deemed eligible for surgery by their physician, specialist, NP trained in the WPATH SoC or a HCP trained in the WPATH SoC, and approved by MSI, they will work with a medical team to develop a surgical plan.

If you are interested in accessing gender affirming surgery, you are encouraged to contact your family physician, NP, specialist, community mental health team in your area or  prideHealth (which provides safe and accessible primary health care services for people who are gay, lesbian, bisexual, transgender, intersex and queer).

View more information and resources at transhealth (Nova Scotia Health Authority, Central Zone) website.

To be approved for public funding, patients and their physician, specialist, NP trained in the WPATH SoC or HCP trained in WPATH SoC must complete a Gender Affirming Surgery Approval Request Form / Application prior to having surgery.

Out-of-province coverage

Patients seeking out of province coverage and travel require pre-approval by MSI via the Gender Affirming Surgery Approval Request Form / Application

Out-of-province surgeries will only be approved for funding if they are to be performed at the Centre Métropolitain de Chirurgie , Montreal, Quebec. For eligible individuals who travel to Montreal for gender affirming surgery, many costs directly associated with the procedure are covered and also include transportation and accommodation costs as per the Nova Scotia Out-of-Province Travel and Accommodation Assistance Policy.


For questions about how to access public funding for these surgeries, please contact MSI (in Nova Scotia) toll free at 1-800-563-8880, or email at:

To speak to someone directly about this coverage, please contact the Department of Health and Wellness at: 1-877-449-5476 (toll free) or 902- 424-7538.