Surgery Funding

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:

Feminizing surgeries:

    • Orchiectomy
    • Vaginoplasty
    • 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)

Masculinizing surgeries:

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.