The process for MSP (publically funded) surgeries recently changed. Please see below for updated information. Additional updated information is also available about Surgical Readiness Assessment and for Service Providers.
What gender-affirming surgeries are covered by MSP?
MSP provides coverage for:
- Breast construction (attending specialist physician sends a medical recommendation to confirm breast tissue has been insufficient after 18 months of hormone therapy, or hormone therapy is contraindicated.)
Applications for provincial coverage for breast augmentation surgery are reviewed on a case-by-case basis.
The application for provincial coverage must be completed by the attending surgeon:(Provincial Coverage of Breast Construction Surgery)
Some general guidelines for breast augmentation surgery:
• Client has been on hormones for at least 18 months; and
• Has had little to no breast growth (smaller than a AA cup); and/or
• Significant asymmetric growth (1 and ½ cup size difference)
How does MSP funding work for gender-affirming surgeries?
Surgical Readiness Assessments with Qualified AssessorsHealthcare practitioners designated by the Chief Assessor as qualified to conduct surgical readiness assessments in the Province of British Columbia are covered. Your Primary Care Physician (PCP) will refer you for an assessment. Please check out our Surgical Readiness Assessment page for more information.
Patients recommended for surgery by Qualified Assessor(s) are automatically covered by MSP. Health Insurance BC will receive and pay the bill for the surgery. However, MSP coverage is limited to physician and hospital in-patient medical care services.
What costs associated with gender-affirming surgery will not be covered by MSP?
While MSP pays for the cost of the above surgeries, there are some costs that are not covered. These include:
1. Travel costs to and from Montreal for lower surgeries and surgical revisions. Please note that masculinizing bottom surgeries, erectile and/or testicular implants require at least two trips to Montreal.
2. Supportive garments (for breast construction and chest surgery)
I can’t afford the cost of my flight(s) to Montreal for gender-affirming surgery. What are my options?
You can apply to Hope Air, a Canadian charity that arranges free flights with commercial carriers, for Canadians who must travel to health care.
How do people pay for their extra surgery costs?
Unfortunately, additional costs may be a barrier to surgery for some people. Strategies people have used to cover these costs include throwing a fundraising party and taking out a loan.
What if I am on provincial disability assistance?
If you are on provincial disability assistance, you may wish to contact the Ministry of Social Development and Social Innovation to discuss funding for travel, support garments, and other medically necessary supplies. Your PCP can write a letter of support to obtain these funds.
How does MSP coverage work when I travel outside of BC for surgery?
Provincial coverage information is published (Leaving BC brochure) and available on the Ministry of Health website.
What changed about the MSP funding process?
There are two major changes:
1. In December 2014, British Columbia residents no longer need to apply for MSP coverage for surgeries. Patients recommended for surgery by Qualified Assessor(s) are automatically covered by MSP.
2. Approval letters will no longer be sent out by MSP. As of December 2016, all patients will receive the results of their assessments directly from their PCP or the care provider who referred them for assessment rather than from the Chief Assessor’s Office as previously.
A B.C. woman has been arrested for carrying out an arson attack on the Montreal surgical clinic that is the only place in Canada providing the most complex forms of gender reassignment surgery.
Jayne Ellen Heideck, 42, was detained Monday by RCMP officers in Kelowna, B.C., and is being returned to Montreal.
She will face charges stemming from a fire in early May at the Centre métropolitain de chirurgie in Montreal.
The blaze started when an assailant burst through a backdoor opened by a staff member and ran up into a surgical suite with an incendiary device. Sprinklers dowsed the flames before firefighters arrived, but the blaze still caused $700,000 in damage.
Police were considered the possibility the attack was a hate crime, because of the clinic’s specialty in gender reassignment surgery (or gender affirming surgery, as is the preferred term) as well as other plastic and bariatric procedures. While a trans person might be able to get cosmetic or upper body surgeries elsewhere in Canada, the private Montreal clinic is the only one in the country that performs the most complicated genital surgeries.
After Heideck’s arrest, police confirmed they did not consider it a hate crime, spokesman Const. Manuel Couture told the Montreal Gazette.
Attempts to contact Heideck or her lawyer, if she has retained one, were unsuccessful.
Yet, there has been much speculation in the media she was a former patient whose surgery was “botched” at the clinic.
“Jayne expressed strong dissatisfaction with having had her surgery a few months after having had her surgery; however, I am not aware of any negative surgical outcomes,” said Morgane Oger, chair of the Trans Alliance Society in Vancouver, who has known the woman for years.
“Jayne was extremely happy to have had the surgery when I picked her up from the airport afterwards,” Oger said, adding that was a feeling that continued for “some time afterward.”
She was a happy, easy-going person with all the same struggles that trans persons have.
Heideck has family in Nanaimo, B.C., Oger said, adding she last spoke with her days before her arrest.
In the years before and immediately after the procedure, Oger said Heideck was a “nice, well-meaning person” and a dedicated cyclist who made her living fixing bikes in Vancouver.
“She was a happy, easy-going person with all the same struggles that trans persons have.”
But Facebook posts from Heideck’s account and by self-professed friends suggest she started to spiral into mental illness.
It has not been proved that Heideck committed the violent act, but Oger said, if she did, “Even when somebody has every good excuse, there is not justification for the violence this could have been.”
No one was injured in the fire but there were staff and patients in the building.
Repairs are still underway at the clinic, which is meeting patients one by one to discuss whether procedures need to be rescheduled, relocated or go on as normal.