Out-of-Province Surgery

Vaginoplasty, vulvoplasty, clitoral release, metoidioplasty or phalloplasty are currently not available to be performed in BC.  Below are referral options for these surgeries.

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 BC Medical Services Plan (MSP). The following are the steps to follow if you wish to have your referral sent to GRS Montreal.

  1. Your primary care physician will send a referral letter, with a copy of your assessments, to the GRS clinic. 
  2. The GRS Clinic will send a form to Health Insurance BC to confirm that BC Medical Services Plan 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.


Out-of-country option for surgeries

In situations of medical complexity, a hospital-based surgical facility may be recommended for patient safety. In this case, or when a medically necessary procdure is not available in Canada, surgery in the United States (US) may be possible. This is pursued through application to the BC Ministry of Health Out-of-Country Health Services program. 

This program is available to all residents of B.C. with valid MSP coverage and is only for medically necessary surgeries that are:

  1. covered by MSP;
  2. recommended by a qualified specialist; and,
  3. not available to the patient in Canada. 
Patients need to be assessed by a qualified specialist who, if appropriate, will complete the OOC application.

Funding approval is required for each patient who is seeking care out-of-country. There is no guarantee of out-of-country funding for surgery even if all key readiness considerations are met. 

Applying for out-of-country procedure

Currently out-of-country applications are being completed by either Dr. Krista Genoway or Dr. Alex Kavanagh and appointments for these are coordinated through Trans Care BC's care coordination team. Patients/clients seeking out-of-country surgery should Contact Us  for further information.

In order to be eligible for surgery out-of-country, patients must have:

  • Completed all required surgical assessments
  • Had a hysterectomy/BSO (if one is required for your lower genital reconstruction)
  • Completed or have a plan in place for hair removal (as required by your surgeon)
  • And be able to travel to the US for surgery (have a valid passport and able to enter the US)

Approval for out-of-country surgery is at the discretion of MSP. Wait times for consultation and surgery dates are based on surgeon availability. Trans Care BC's care team provides guidance to clients to access funding for surgery. In order to address the scheduling list in an equitable way, patients will be attended to in priority order based on key readiness considerations and date of completed assessment. Other factors may be considered on a case-by-case basis.

We thank you for your patience as we try to support people who are interested in accessing this out-of-country option.

SOURCE: Out-of-Province Surgery ( )
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