Gender-Affirming Care for Trans, Two-Spirit and Gender-Diverse Residents
The decision to seek out gender-affirming care is a personal one. If you are thinking of medically or surgically affirming your gender, speak to your primary care provider to get advice on what is right for you.
You and your primary care provider might choose to start treatments such as hormone replacement therapy or you might be referred to a specialist for further advice, counselling or to determine the next steps, which might involve surgery.
Your Saskatchewan health coverage pays for some hormone therapies and gender-affirming surgeries. Many surgeries are done in Saskatchewan but there are some surgeries that need to be received at the Centre Métropolitain de Chirurgie (GrS Montréal) in Quebec.
1. How to Access Hormone Therapy
Residents with an active Saskatchewan health card are eligible for coverage of certain hormone replacement therapies listed on the Saskatchewan Formulary or approved under Exception Drug Status. Individuals pay according to their coverage, deductible and/or co-payment. Inquiries about hormone therapy coverage can be directed to the Ministry of Health's Drug Plan and Extended Benefits Branch at 1‑800‑667‑2549 or 306‑787‑8744.
2. How to Access Surgery
If you decide to pursue gender-affirming surgery, you may require a referral to a specialist. The referral could be to a specialist who can perform the surgery in Saskatchewan or to one who can request cost coverage on your behalf for out of province surgery.
The location where surgery is performed is determined on a case-by-case basis. The decision on location depends on the nature and type of the surgery and the availability of physicians with surgical expertise.
3. What Surgeries are Covered
If a covered gender-affirming surgery is not able to be received in Saskatchewan, out-of-province surgeries will only be covered if performed at GrS Montréal in Quebec. All surgeries to be received at GrS Montréal require prior approval from the Ministry of Health.
Currently these surgeries are insured and performed in Saskatchewan:
- Hysterectomy
- Mastectomy
- Oophorectomy
- Orchiectomy
Currently these surgeries are covered and performed at GrS Montréal:
- Metoidioplasty
- Phalloplasty
- Vaginoplasty
- Vulvoplasty
There are also gender affirming treatments that are available within the province or in other provinces that are not insured by the Ministry. To find out more information on what services are available and how to access care you can reach out to one of the Trans Health Navigators listed under additional support.
4. How to Get Approved for Surgery
If you decide that you want to explore surgical options, you will require a referral to a specialist who can either perform the surgery in Saskatchewan or one who can request cost coverage on your behalf for surgery to be performed out of province.
If you are referred out of province for surgery, the following steps must be followed:
- Your primary care provider must refer you to a specialist practising in Saskatchewan. The specialist must practice in a field able to speak to the medical need for you to receive surgery. Some examples include but are not limited to endocrinologists, plastic surgeons, psychiatrists, internal medicine specialists, urologists and gynecologists.
- The specialist must write a letter to the ministry providing specified or required information about your case.
- The request will be reviewed by the ministry’s medical consultant to determine if coverage is approved or denied. Communication will occur back through your identified specialist.
- If approved:
- The ministry will write to GrS Montréal and;
- Confirm coverage of the necessary surgery at a price agreed to; or,
- Request a price quote for the specific surgery you require.
An approval of funding from the ministry does not guarantee that you will meet the requirements for surgery set by the surgeon in Montreal. It is important to work with your primary care provider, as they are responsible for assessing the clinical portion of surgery.
5. Wait Time for Approval
Most requests are reviewed within 30 days; if the request is missing information, the review process may take longer.
If your request is approved, both you and your specialist will be advised of the approval.
6. How Long Approval is Valid
The decision to have surgery is complex. If approved there is no expiry on the approval, but you must have a valid Saskatchewan health card at the time of surgery.
7. Get More Information
You can find more information about provincial support and resources for transgender and gender diverse residents through a variety of sources.
HealthLine 811 – Saskatchewan's confidential 24/7 phone line staffed by registered nurses, client navigators, registered psychiatric nurses and social workers. HealthLine can provide you information on resources within the province.
8. Additional Support
Contact the Trans Health Navigators
If you are seeking gender-affirming health care, including hormone therapy, surgery referrals, finding an affirming primary care provider, and/or accompaniment to appointments, the Trans Health Navigators can help navigate the health care system.
Saskatoon and Northern Saskatchewan Navigator
Email: navigator.north@transsask.ca
Regina and Southern Saskatchewan Navigator
Email: navigator.south@transsask.ca
The Trans Health Navigators are also able to assist in several other ways – including with name changes, changing gender markers and finding support groups.