Accessibility and Insurance Coverage for Gender-affirming Surgery in Canada: A Cross-Sectional Analysis

Area of Science:

• Medical Research
• Public Health Policy
• Surgical Procedures

Background:

• Increasing visibility and acceptance of the transgender community in Canada.
• Persistent barriers in accessing gender-affirming surgeries (GAS).

Purpose of the Study:

• To assess the current state of gender-affirming surgery (GAS) care in Canada.
• To analyze provincial insurance coverage for GAS.
• To identify regions requiring specialized GAS programs.

Main Methods:

• Cross-sectional study design.
• Examination of provincial health ministry webpages.
• Contacting health authorities and gender clinics for data collection on GAS coverage and procedure distribution.

Main Results:

• 32 unique gender-affirming procedures are covered by Canadian provincial health plans.
• Prince Edward Island offers the highest GAS coverage; Nunavut offers the least.
• Quebec has the most comprehensive in-province GAS program; territories lack in-province access.

Conclusions:

• Significant disparities exist in GAS coverage and availability across Canadian provinces.
• Genital surgeries have the most comprehensive coverage, followed by chest surgeries; facial GAS coverage is minimal.
• Advocacy for broader coverage and specialized surgeon training/recruitment is needed in underserved regions.