Clinical Resources

This section contains resources to support clinicians providing gender-affirming care, including guidelines and standards, helpful links for supporting patients to access surgery, primary care tools, and online resources.

Guidelines and standards

Endocrine Therapy for Transgender Adults in British Columbia: Suggested Guidelines – a document with protocols for the prescribing clinician relating to physical assessment, prescription planning, initiation of endocrine therapy, and ongoing maintenance (VCH, 2015)
Endocrine Treatment of Gender-Dysphoric/Gender-Incongruent Persons: An Endocrine Society Clinical Practice Guideline (Endocrine Society, 2017)
Guidelines and Protocols for Hormone Therapy and Primary Health Care for Trans Clients (Sherbourne Health Centre, 2015)
Guidelines for the Primary and Gender-Affirming Care of Transgender and Gender Nonbinary People (Center of excellence for transgender health, 2016)
Standards of Care for the Health of Transsexual, Transgender, and Gender Nonconforming People Version 7. (WPATH, 2011). Available for download from WPATH

Supporting patients to accessing care

For forms and checklists, see Medical Forms

Funding Coverage

Funding Coverage - information on funding coverage options for the range of gender-affirming care your client might seek.

PharmaCare Special Authority Request Form as noted in the above Funding Coverage document.

Funding Request Template Letters - template letters to help GPs/NPs when supporting eligible clients request funding for medical/post-surgical supplies.

Surgery Options & Referral Process

For information on gender-affirming surgeries, see our Surgery section and review the surgical summary sheets in link below
Surgical Summary Sheets - information about gender-affirming surgeries for discussion between primary care providers and clients (Rainbow Health Ontario)
Surgery Referral - information on how to refer clients for upper and lower gender-affirming surgeries. See Medical Forms for a checklist for referring patients for surgery

Other assistance for your clients

For assistance in supporting your patient post-operatively, contact our health navigation team
Travel Assistance Program (TAP) - support with travel costs for eligible B.C. residents who must travel within province for non-emergency medical specialist services not available in their own community
Hope Air - a charity that provides free flights for financially disadvantaged Canadians for medically necessary travel

Primary care tools

Gender-affirming Care for Trans, Two-Spirit, and Gender Diverse Patients in BC: A Primary Care Toolkit: A toolkit developed by Trans Care BC in collaboration with its Primary Care Working Group. The group was comprised of family physicians, nurse practitioners and nurses with expertise in trans care by virtue of the volumes of patients they have seen and the care they have managed. This Primary Care toolkit has been developed not as a standard of care but rather as a general guide to assist clinicians who are or may be taking on similar work.
Sample questions for patients seeking hormone therapy (from the Primary Care Toolkit).
Sexual health screening notes for trans and gender diverse clients in BC - from the Primary Care Toolkit.
Sexual health screening and pelvic examination - provides affirming and trauma-informed sexual health care and pelvic examination.
Affirmative Care for Transgender and Gender Non-Conforming People: Best Practices for Front-line Health Care Staff - tips and strategies for front line staff to improve communication and create a more affirming environment (National LGBT Health Education Center, 2016)
Evaluating Decision-Making Capacity for Gender-Affirming Medical Interventions

Online resources

Canadian Professional Association for Transgender Health (CPATH) - a non-profit, interdisciplinary professional organization which works to support the health, wellbeing, and dignity of trans and gender diverse people
Center of excellence for transgender health at the University of California, San Francisco - for guides and fact sheets for providing gender-affirming health care services for trans communities
Trans PULSE – for community-based research on problems identified within Ontario trans communities regarding access to health and social services
World Professional Association for Transgender Health (WPATH) – a non-profit, interdisciplinary professional and educational organization devoted to transgender health

Articles on medical care for youth

Rafferty, Jason (2018) Ensuring Comprehensive Care and Support for Transgender and Gender-Diverse Children and Adolescents - a policy statement from the American Academy of Pediatrics. Pediatrics, 142(4)
Clark, Beth A; Veale, Jaimie F; Greyson, Devon; Saewyc, Elizabeth (2018). Primary care access and forgone care: a survey of transgender adolescents and young adults. Family Practice, 35(3), 302–306
Ehrensaft, Diane (2017). Gender nonconforming youth: current perspectives. Adolescent Health, Medicine and Therapeutics 2017:8 57–67
Olson, Johanna; Forbes, Catherine; Belzer, Marvin (2011). Management of the Transgender Adolescent. Arch Pediatr Adolesc Med. ;165(2):171-176.
Olson, Johanna and Garofalo, Robert (2014). The Peripubertal Gender-Dysphoric Child: Puberty Suppression and Treatment Paradigms. Pediatric Annals, 43(6), e132–e137.
Vance Jr, Stanley R.; Ehrensaft, Diane; and Rosenthal, Stephen M. (2014). Psychological and Medical Care of Gender Nonconforming Youth. Pediatrics, 134(6)

For information on trans identity and gender, see our Trans Basics pages.

For resources for families, and children and youth, see Articles, Books & Movies.

For information on Trans Care BC education resources and trainings, see our Education section.

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