Gender affirming surgery (GAS), also referred to as sex reassignment or gender confirming surgery, is an insured benefit in Nova Scotia (NS). Coverage for GAS is consistent with what most other Canadian provinces insure, and so are the processes used 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 NS.

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

The location where the procedure is performed will be determined on a case by case basis and will depend upon the nature and extent of the surgery and the availability of surgical expertise:

List of insured GAS surgeries when they are performed in approved locations

Only available in NS	Available in NS and Centre Metropolitain de Chirurgie in Montreal	Available only in Centre Metropolitain de Chirurgie in Montreal
Hysterectomy	Orchiectomy	Phalloplasty
Oophorectomy	Penectomy	Metoidioplasty
	Breast Augmentation	Vaginoplasty
	Breast Reduction
	Chest Masculinization / Mastectomy

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 GAS 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 GAS, you are encouraged to contact your family physician, NP, specialist or community mental health team in your area. If you do not have primary care providers or connections with care providers listed above, contact prideHealth, which can help you to navigate the system and find appropriate providers for your GAS application.

prideHealth may also provide further information to help you better understand the process.

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

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 GAS, 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: MSI@medavie.ca

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.