Surgery Referral

There are different referral processes depending on the surgery you’re having. This section provides details on how to get a referral for surgery and where to send it.
Upper Body Surgery

Trans Care BC maintains the central waitlist for chest construction and breast construction (breast augmentation) surgeries. Surgeons across BC have partnered with Trans Care BC to work from the shared waitlist so people wishing to have this kind of surgery can receive access to the first available surgeon or a surgeon of their choosing. The central list is used so that people are seen in priority order by date of referral no matter where they live across the province.

‎Most surgeons who provide publicly funded chest construction surgeries in BC work from the Trans Care BC upper surgery central waitlist.


How to get a referral

  • Have your primary care provider complete the Trans Care BC upper surgery referral form and indicate surgeon choice based on first available (within your home region or within BC) or a specific surgeon.
  • Have the completed referral form sent to Trans Care BC along with a copy of your completed surgical readiness assessment, current BMI, and medical history.

Next steps

Trans Care BC sends confirmation to your primary care provider that they have received the referral package within 10 business days. If the referral is incomplete, Trans Care BC will ask for the missing information. Referrals must have completed information before they will be processed.


Trans Care BC may contact clients if clarification is required about their choice of surgeon.


The surgeon's office will contact you to schedule appointment(s) and surgery.


If you would like find out your place on the wait list or change your choice of surgeon, please contact Trans Care BC.

‎Breast construction (breast augmentation) is only publicly funded in certain circumstances and the plastic surgeon is required to submit a funding request to MSP. See the breast construction and surgery funding pages for more information on this. 


How to get a referral 

Via Trans Care BC upper surgery central waitlist tosurgeons working with Trans Care BC:


  • Have your primary care provider complete the Trans Care BC upper surgery referral form and indicate surgeon choice based on first available (within your home region or within BC) or a specific surgeon.
  • Have the completed referral form is sent to Trans Care BC along with a copy of your completed surgical readiness assessment, current BMI, and medical history 
  • Once you are referred to a surgeon, the surgeon must submit a funding request to MSP. 
  • No consultation fee is charged by surgeons on central list for trans clients seeking publicly funded breast construction.

Via Direct referral 

  • You can also be referred to any other plastic surgeon not working from the Trans Care BC central wait list who is trained to perform breast construction surgeries. 
  • Once you are referred to a surgeon, the surgeon must submit a funding request to MSP. 
  • Some plastic surgeons may charge private fees for consultation.

Next steps 

If you are referred via the Trans Care BC upper surgery central waitlist, Trans Care BC sends confirmation to your primary care provider that they have received the referral package within 10 business days. If the referral is incomplete, Trans Care BC will ask for the missing information. Referrals must have completed information before they will be processed.


Trans Care BC may contact clients if clarification is required about their choice of surgeon.


In all cases. the surgeon's office will contact you to schedule appointment(s) and surgery.


 

Lower Body Surgery

Orchiectomy, hysterectomy & bilateral salpingo-oophorectomy

After you have completed your Surgical Readiness Assessment(s), your primary care provider will refer you directly to:

  • A urologist for orchiectomy; or
  • An obstetrician or gynecologist for hysterectomy & bilateral salpingo-oophorectomy.

If you have any questions about available surgeons in BC for these procedures, you can contact Trans Care BC.

Genital surgeries

Vaginoplasty, vulvoplasty, clitoral release, metoidioplasty or phalloplasty are not currently performed in BC.  These surgeries can be accessed at GRS Montreal or, if appropriate, to an available surgical centre in the United States.

These surgeries are currently offered at the GRS (Gender Reassignment Surgery) Clinic in Montreal, Quebec. This is the only facility in Canada that offers lower gender-affirming surgeries that is funded by MSP. The following are the steps to follow if you wish to have your referral sent to GRS Montreal.


  1. Your primary care provider will send a referral letter, with a copy of your surgical readiness assessments, to the GRS clinic. 
  2. The GRS Clinic will send a form to Health Insurance BC to confirm that MSP will fund the out-of-province surgery. 
  3. The GRS Clinic will contact you to complete some forms, and then book a date for surgery. (You can request a phone consultation if desired.) 
  4. An in-person consult may be required for some surgeries prior to your surgery date.
  5. You will be required to contact the GRS Clinic to confirm the surgery date. Your primary care physician may send pre-op lab work results to the GRS Clinic prior to your surgical date.

Trans Care BC's care coordination team is available to help support coordination of your referral and provide additional follow up after your surgery, working alongside your primary care provider and surgeon.  If you would like receive support by Trans Care BC, please Contact Us.

This referral option is available only to residents of BC with valid MSP coverage and is only for medically necessary surgeries that are:


  • Covered by MSP;
  • Recommeded by a qualified specialist; and,
  • Not available to the patient in Canada.

In this case, patients with medical complexities requiring hospital-based surgical facility for patient safety, surgery out-of-country may be an option.


Applying for coverage

You wil need to be assesed by a qualified specialist who, if appropriate, will submit an application to the BC Ministry of Out-of-Country (OOC) Health Services program. There is no guarantee of out-of-country funding for surgery even if all conditions are met.


Contact Us if you would like more information about out-of-country surgery.

*Updated July 31 2019* 


Preparations are well underway to open the Gender Surgery Clinic at Vancouver General Hospital (VGH) by the end of September 2019.


An information session for potential clients, those waiting for access and care providers will be held and webcasted in September 2019 prior to the clinic opening. Clients, their loved ones and care providers will have the opportunity to meet the surgeons and ask questions during the session. Check back to this page for updates about details on the information session.


Who are the surgeons?

  • The two surgeons associated with the new program are Drs. Genoway (plastic and reconstructive surgery) and Kavanagh (reconstructive urology)

Where will the lower surgeries take place?

  • All lower surgeries will take place at VGH while upper surgeries will continue at UBC Hospital and other VCH sites, including Lions Gate Hospital.

Which surgeries will be available in the new lower surgical program?

  • The surgical program will cover gender-affirming genital procedures including: vaginoplasty, vulvoplasty, metoidioplasty, ALT phalloplasty, RFF phalloplasty and clitoral release.
  • More information on each procedure is available under Feminizing surgeries and Masculinizing surgeries 

How do I get approved for surgery with the new surgical program?

  • Two surgical readiness assessments by a qualified assessor will be required and attached with a referral to the new surgical program from your primary care provider.
  • If you have any other questions or concerns, or need help navigating care feel free to contact us.
How do I get referred to the Vancouver Gender Surgery Clinic?
  • Referrals will need to be sent to the new clinic once it is open. No referrals can be accepted yet.
  • In the coming weeks we will be working with our partners at the Ministry of Health and Vancouver Coastal Health to finalize the referral process and surgery pathways.
  • Check back to this page for updates about referral process.
Will the program be taking patients from outside of BC?
  • As BC patients are the priority, the Vancouver surgical program will not be taking patients from outside BC at this time.

Can B.C. patients still travel to Montreal for lower surgery?

  • Yes. The Montreal surgical centre will remain an option for BC patients and is covered by MSP.

Is the option to receive lower surgery in the United States still available?

  • Patients who are already approved by MSP for out-of-country surgery will be able to continue, if they choose, as long as the MSP funding approval remains valid and is supported by local specialists. Recommendation from a BC specialist is required by MSP to provide advice on out-of-country care.
  • If you already have care in progress out-of-country, please contact a Trans Care BC team member to discuss your individual situation.
  • For B.C. patients unable to have surgery in Canada for medical reasons, the option to be considered for surgery out-of-country remains available through the MSP out-of-country surgery process. This is a standard MSP application process for any type of medical care. Read more about MSP guidelines.
  • Read more about out-of-country and out-of-province care under Surgery Funding.

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