Gender-Affirming Health Services

Gender-affirming health services are offered in Prince Edward Island.  

What is gender-affirming health care?   

“Gender-affirming care can be understood as the processes through which a health care system cares for and supports an individual, while recognizing and acknowledging their gender identity and expression” (Trans Care BC). Gender-affirming care is delivered in in accordance with the WPATH Standards of Care (World Professional Association for Transgender Health).

What is transition?   

Transition refers to the unique process a person goes through so they can live and express their gender identity in ways that feel right for them. Everyone is different; there is no right or wrong way to transition. 

Social transition – may include: coming out, using a different name, using a different pronoun (he/she/they), changing style of dress and using gender affirming products such as binders or breast forms. 

Medical transition – may include: hormone therapies, hormone blockers and/or gender affirming surgeries. 

Legal transition – may include: legally changing name(s), changing the gender marker listed on legal documents (driver’s license and/or birth certificate) and changing legal documents to reflect appropriate titles. 

Are there gender-affirming care trained physicians, nurse practitioners or mental health professionals in PEI?

There are physicians, nurse practitioners, and mental health professionals who have gender-affirming care training in PEI. Health PEI is committed to ensuring you are able to access gender-affirming care by connecting you with experienced professionals and providing training opportunities and education to those professionals.

If you require help in identifying a gender-affirming care trained physician, nurse practitioner or mental health professional, please contact the Patient Navigator. 

I am under 16 years of age, how do I access gender-affirming care?

To access these assessments if you are under 16 years of age, contact your family physician or nurse practitioner to be referred to a pediatrician to discuss your transition (social, medical and/or legal).

If you do not have a family physician or nurse practitioner (or do not feel comfortable discussing this with your family physician or nurse practitioner), you may contact the patient navigator by calling 1-844-882-3141 (toll-free) or emailing patientnavigator@gov.pe.ca.

I am over the age of 16, how do I access gender-affirming care?

To access these assessments if you are over 16 years of age, contact your family physician or nurse practitioner to discuss your transition (social, medical and/or legal).

If you do not have a family physician or nurse practitioner (or do not feel comfortable discussing this with your family physician or nurse practitioner), you may self-refer to the Gender Affirming Clinic that is held twice a month at the Sherwood Medical Centre, 2nd floor, 15 Brackley Point Rd., Charlottetown. You can call 902-569-7772 or email GAC@ihis.org.

How can I get hormone therapy?

If you have a family physician or nurse practitioner and they are informed about gender-affirming care, discuss hormone therapy with them. They may be qualified to assess hormone readiness and prescribe and monitor hormone therapy.

Gender-affirming care is prescribed based on the informed consent model. The informed consent model respects a person's right to self-determination. Informed consent ensures you understand all the information about hormone therapy and accept the risks involved. 

If you do not have access to a physician or nurse practitioner, you may access a hormone prescription by obtaining an assessment in accordance with the WPATH Standards of Care (World Professional Association for Transgender Health). To access these assessments, contact the patient navigator by calling 1-844-882-3141 (toll-free) or emailing patientnavigator@gov.pe.ca. Assessments are also available through the Health PEI Community Mental Health Program or through private practitioners. 

What gender-affirming procedures are considered for financial coverage? 

PEI Medicare covers the following procedures:  

• clitoral release
• erectile/testicular implant
• hysterectomy/bilateral salpingo-oophorectomy  
• mastectomy with chest masculinization
• chest feminization
• metoidioplasty
• oophorectomy
• phalloplasty
• scrotoplasty
• vaginectomy
• clitoroplasty
• labiaplasty
• orchiectomy (also referred to as orchidectomy)
• penectomy
• vaginoplasty
• facial surgery
• hair removal and hair replacement therapy as clinically indicated (non-surgical procedure)
• voice therapy 
• hormone therapy, including puberty suppression (non-surgical procedure)

Coverage for gender-affirming surgical procedures

Some gender-affirming surgical procedures are performed in PEI, however most gender-affirming surgeries will be referred out-of-province. In general, travel and accommodation costs are not covered.

To qualify for coverage from PEI Medicare for surgical procedures completed out-of-province, in advance of the surgery, you must:  

1. Be assessed and recommended for surgery by a qualified physician or nurse practitioner.
    
2. Have a physician or nurse practitioner complete and submit the Gender Confirming Surgery Prior Approval Request Form with any necessary attachments to Health PEI’s Out of Province Coordinator.
    
3. Receive written approval for the surgery, in advance of the surgery, from the Out of Province Coordinator. *Requests for retroactive financial coverage of surgeries completed without prior approval will not be considered.

Approvals for surgeries completed in PEI do not need to go through the out of province coordinator. 

Surgical procedures completed in PEI must follow the non-surgical approval process outlined below. 

Coverage for gender-affirming non-surgical procedures

Most non-surgical procedures can be completed in PEI.
 

1. To qualify for coverage from PEI Medicare for non-surgical procedures completed in PEI, in advance of the procedure, you must:  Complete a Gender Confirming Procedure Prior Approval Request Form and submit it to the Health PEI Gender-Affirming Clinic with any necessary attachments. 
   
   This must include a  brief description as to how this procedure will reduce gender incongruence.  You may choose to have a qualified physician, nurse practitioner, registered nurse, psychologist or registered social worker write a letter of support  to submit with your application.  This letter should be written in accordance with the WPATH Standards of Care. 
    
2. Receive written approval, in advance of the procedure, by the Gender-Affirming Procedure Approval Committee. *Requests for retroactive financial coverage of procedures completed without prior approval will not be considered.  

If you need to travel out-of-province for a gender affirming surgical or non-surgical procedure, you will need to follow the steps outlined at Financial Assistance for Out-of-Province Medical Travel.

Who can I talk to about preparing for and recovering from gender-affirming procedures? 

Your health care provider who referred you for surgery will have information that is most relevant to your unique situation. Consult with them about what you should do to prepare for the procedure and how to plan for post-procedure care.  

If you require medical assistance after your surgery, please contact your surgeon and/or your referring physician or nurse practitioner. Urgent care can be accessed through a walk-in clinic or the emergency department of your local hospital. If you are not sure who to see, you can call 811 to get health advice from a registered nurse. 

How can I change my name and gender on my PEI Health Card?

To legally change your name, you must be 18 years of age or older and reside in PEI for at least three months. If you are the legal guardian of a minor under the age of 18 who has been living in the province for at least three months, you can apply to legally change their name on their behalf. Learn more about legally changing your name and the applicable fees.

As of June 2016, the Vital Statistics Act [PDF | 220 KB] was amended to make it easier for gender-affirming people to change their gender on government issued identification. You can apply to change your gender on your birth certificate by submitting:

• a written declaration stating that you assume, identify with, and intend to maintain the gender identity that corresponds with the requested amendment; and
• a written statement from a medical practitioner who is authorized to practice medicine in the province, confirming that the sex recorded on your registration of birth does not correspond with your gender identity.

If you were born in PEI, contact Vital Statistics at 1-877-320-1253 (toll-free) or email vsmontague@gov.pe.ca. If you were not born in PEI, contact the government agency responsible for issuing birth certificates where you were born. 

Once your name and gender has been legally changed, contact the PEI Medicare Office at 1-800-321-5492 (toll-free) to request a name and gender change on your PEI Health Card and health record. You may be required to provide your new birth certificate.

What are my rights and responsibilities as a patient?

Everyone has the right to receive the best and safest health care possible, including the right to express yourself in relation to your care. You are responsible to be an involved patient – you are encouraged to ask questions, listen to the answers and talk about any concerns you may have. Learn more about Patient Rights and Responsibilities.

Where can I learn more about gender identity, expression and diversity?

For more information, please visit:

• PEI Transgender Network
• Trans Care BC
• The 519 Space for Change - Education and Training Resources