New Brunswick Medicare now covers medically necessary gender-affirming surgeries for transgender persons living in New Brunswick. Gender-affirming surgery is a medically recognized treatment for gender dysphoria.
Gender-Affirming Surgery
Questions and Answers
What is the process for someone who wants gender-affirming surgery in New Brunswick?
A patient considering gender-affirming 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 latest version of the World Professional Association for Transgender Health (WPATH), similar to other Canadian jurisdictions that insure these surgeries. The WPATH assessment involves a comprehensive biopsychosocial assessment before surgery is considered.
When the patient has received a recommendation from their physician, nurse practitioner, and/or mental health professional, 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 hormone therapy.
What if a patient doesn’t have a primary health care provider?
WPATH-trained mental health professionals can also provide support to transgender patients who are considering this procedure. A list of eligible professionals can be found at the following link : Specialized care for people who identify as a sexual or gender minority (2SLGBTQIA+) - Horizon Health Network
Will patients have to travel out-of-province 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 publicly funded when provided by a Canadian facility approved by New Brunswick Medicare. Mastectomies with chest masculinization (no implants), hysterectomy with or without salpingo-oophorectomy and orchidectomies, must be performed first in a public hospital in Canada, preferably New Brunswick. This also applies to breast augmentation, if approved.
Is travel covered?
Travel and/or accommodation expenses are not covered by Medicare.
Are medications covered?
Prescription medication is not covered under Medicare but may be covered by the New Brunswick Drug Plan or private insurance.
When will a person wishing to have gender-affirming surgery be able to access it?
If an individual, in partnership with their physician, nurse practitioner, or mental healthcare professional, determines that they meet the clinical eligibility criteria for surgery, a request form is prepared and sent to New Brunswick Medicare for consideration.”
I have previously had gender-affirming surgery. Can my surgical expenses be refunded?
Coverage of gender-affirming surgery is not retroactive.
What will specifically be covered under gender-affirming surgery?
|
Male to Female |
Female to Male |
Covered |
Vaginoplasty including: penectomy, orchidectomy, construction of a vaginal cavity and the vulva. Breast augmentation may be considered on a case-by-case basis after failed hormone treatment as per WPATH. |
Vaginectomy, hysterectomy, salpingo-oophorectomy, mastectomy (with chest masculinization), metoidioplasty, phalloplasty, erectile and testicular implants. |
Not covered |
Facial feminization, tracheal shaving, hair removal, travel, and accommodation, medication prescribed outside of hospital or other devices (i.e.: dilators). Private voice and communication training is not covered under Medicare, however, may be accessible through hospitals. |
Pectoral implants, travel, and accommodation or medication prescribed outside of hospital. Private voice and communication training is not covered under Medicare, however, may be accessible through hospitals. |
Does New Brunswick have the expertise to perform these types of surgeries?
Genital surgery is not performed in New Brunswick, but the surgeries are publicly funded at a Canadian facility approved by New Brunswick Medicare. Mastectomies with chest masculinization (no implants), hysterectomy with or without salpingo-oophorectomy and orchidectomy must be performed in a public hospital in Canada, preferably New Brunswick.
Is chest masculinization and/or chest contouring publicly 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.