Surgery Considerations

Once you have decided to proceed with surgery, there are a number of considerations and steps in getting access to surgery. The following page outlines what's involved.
Surgery Options

Consider what you are hoping for out of your surgery, and explore which option may be the best fit for you. All surgeries have different benefits, complications and risks. It is important to figure out what you think is best for your body. 

Work with your primary care provider when you are deciding the type of surgeries you want to have as this might influence the surgical readiness assessment process. Consider your sexual health when deciding on the external genital surgery, there are several factors to consider:

  • Are you okay with having visible scars?
  • Is the site of sexual sensation important to you?
  • How many operations are you prepared to have?
  • What level of risk are you willing to accept?
  • Do you have any health-related restrictions on your options?
  • What can you afford to do (in terms of aftercare costs, time off work, etc.)?
Other factors, specific to the surgery you are choosing:

  • Do you want to still use your internal genitals (vagina)?
  • Do you want to urinate standing up or sitting down?
  • Do you want to have penetrative sex with your erctile tissue (penis)?
You may also want to discuss reproductive health with your provider should you plan to have children in the future. Visit the Sexual Health and Reproductive Health page for more information.

For more information around gender-affirming surgeries which are currently funded by BC MSP (see Surgery Funding for funding information), what's involved in and after the procedure and how to access this surgery after completing a surgical readiness assessment, visit their respective pages here:

Surgical Assessment

Once you have decided on the surgery you would like access, one or two surgical readiness assessments are often required, depending on the surgery.  The WPATH (World Professional Association for Transgender Health) Standards of Care are a set of clincal guidelines that most care providers use to inform their practice in BC. The assessment is a requirement of the surgeon so it is best to work with your primary care provider and surgeon to understand what is needed for your particular situation.

The latest vesion of the standards was published in 2011 and includes many positive changes:

  • they recognize trans and gender non-conforming identities to be a matter of diversity, not pathology.
  • they no longer use the term “Real Life Experience” and only genital surgeries have the requirement of a period of time living congruently with gender identity
  • you no longer have to identify as a woman or a man to meet the criteria – people who have non-binary identities (such as genderqueer) are also eligible for gender-affirming surgeries.

For more information, on how to get an assessment, what is involved in the assessment, and eligibility for surgery visit the Surgical Assessment page.

Surgery Funding

Once you have completed the necessary surgical readiness assessment(s) by qualified assessor(s), the results of the assessment(s) are forwarded directly from your primary care provider or the care provider who referred them for assessment.  If you are approved and decide to proceed, your provider will forward a referral for surgery to the surgeon of your choice or processes as listed respectively on each surgery page here:

Funding for surgery depends on the surgery you are planning to have. The surgeries listed above are all funded through the BC Medical Services Plan, with billing handled by your primary care provider and surgeon (like any other publicly funded surgery). There is an additional step for funding approval for gender-affirming breast augmentation which is handled by the surgeon at the point of consultation. For more information, visit the Surgery Funding page.

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