Government of New Brunswick

New Brunswick Medicare now covers medically necessary gender-confirming surgeries for transgender persons living in New Brunswick. Gender-confirming surgery is a medically recognized treatment for gender dysphoria.
 

What is the process for someone who wants gender-confirming surgery in New Brunswick?

A patient considering gender-confirming surgery should approach their family physician, nurse practitioner or mental health professional.

The patient would be assessed for clinical eligibility using criteria established by the World Professional Association for Transgender Health (WPATH). This assessment is also required by other Canadian jurisdictions that insure these surgeries. The WPATH assessment involves a comprehensive psychiatric assessment and prolonged medical management before surgery is considered an option.

When the patient has received a positive recommendation from their physician, and approval by New Brunswick Medicare, they will work with a medical team to develop a surgical plan.

What is medical management?

Medical management depends on the particular needs of the patient and may include access to endocrinology (hormone therapy).

What if a patient doesn’t have a primary health care provider?

Mental health professionals can also provide support to transgender patients who are considering this procedure. The Salvus Clinic in Moncton and Clinic 554 in Fredericton can also provide support.

Will patients have to travel for surgery?

This will depend on the surgery required and the surgical plan. Genital surgery is not performed in New Brunswick, but the surgeries are now publicly funded when provided by a Canadian facility approved by New Brunswick Medicare. Mastectomies with chest masculinization (no implants) and hysterectomy with salpingo-oophorectomy must be performed first in a public hospital in Canada, preferably New Brunswick.

Is travel covered?

Travel and/or accommodation expenses outside of hospital are not covered by Medicare.

Are medications covered?

Medications provided in hospital are an entitled service. However, if someone requires prescription drug insurance, it is available through the New Brunswick Drug Plan.

When will a person wishing to have gender-confirming surgery be able to access it?

Gender-confirming surgery is now an insured service under Medicare. Determining when an individual is ready for surgery is a clinical decision between the person and their health-care providers. If a physician, nurse practitioner or psychologist determines that someone is clinically eligible for surgery, a request form is prepared and sent to the Executive Director of Addictions and Mental Health, who in turn forwards it to New Brunswick Medicare for consideration. Upon approval, a surgical plan is put in place by the attending professionals.

I have previously had gender-confirming surgery. Can my surgical expenses be refunded?

Coverage of gender-confirming surgery is not retroactive.

What will specifically be covered under sex reassignment surgery?

 

Male to Female

Female to Male

Covered

Vaginoplasty including: penectomy, orchidectomy, construction of a vaginal cavity and the vulva

Vaginectomy, hysterectomy, salpingo-oophorectomy, mastectomy (with chest masculinization), metoidioplasty, phalloplasty, erectile and testicular implants.

Not covered

Breast augmentation, facial feminization, tracheal shaving, hair removal, travel, accommodation or medications prescribed outside of hospital, voice and communication training

Pectoral implants, travel, accommodation or medications prescribed outside of hospital, voice and communication training

Does New Brunswick have the expertise to perform these types of surgeries?

Genital surgery is not performed in New Brunswick, but the surgeries are now publicly funded at a Canadian facility approved by New Brunswick Medicare. Mastectomies with chest masculinization (no implants) and hysterectomy with salpingo-oophorectomy must be performed in a public hospital in Canada, preferably New Brunswick.

Is chest masculinization and/or chest contouring now publically funded?

Yes, chest masculinization is performed as part of the mastectomy procedure; hence it is covered by Medicare. The province does not cover pectoral implants. Any additional chest contouring done separately from the mastectomies is not covered by Medicare.