Accessing Chest Surgery

Which surgeons provide publicly funded gender affirming surgeries in BC and how do I get referred/refer my client?

Find a comprehensive list of surgeons on our meet the surgeons page.

Chest construction

Referrals for chest construction should be sent to the central wait list managed by Trans Care BC by a primary care provider/your doctor or nurse practitioner. The referral could include the surgeon of choice (if known), or first surgeon available in the referral letter. Referrals are routed to the requested or first available surgeon.

Breast construction

For breast surgeries, referrals can be sent by a primary care provider/your doctor or nurse practitioner to the surgeon of choice. Breast construction is only publicly funded in certain circumstances and a plastic surgeon is required to submit a funding request to MSP if appropriate. The surgeons featured on our website do not charge a fee for those seeking publicly funded breast construction.

How does the central wait list work?

 

The surgeons collectively work together from a shared central list: there is one list for chest surgeries and one list for breast surgeries. The central list is used so that you/clients are seen in priority order by date of referral no matter where you/they live across the province.

    • If your/client’s surgeon of choice operates off the central list, all referrals for chest construction or breast construction must go through the central wait list held by Trans Care BC to ensure equity. You/clients can still choose your/their preferred surgeon (or the first available).
    • Referrals made through the central list and routed to individual surgeons’ practice are ordered according to date of referral to the central list.
    • Once the client decides on a surgeon, their referral is sent to that surgeon’s office, who will contact the client directly to book an appointment.
    • Trans Care BC is working with regional health authorities and surgeons to streamline the waitlist management process for upper surgeries with a goal of improving communication to you/clients and your/their providers.

I am /my client is, already on the waitlist in one location but would like to change to another What should I do?

If you/your client has not had a consultation with a surgeon yet, you can notify the surgeon’s office and say that you’d like your referral changed to another surgeon.Ensure you indicate the name of the surgeon the client wishes to see instead. Please note: this may affect your/your client’s wait time.

What’s being done to address the wait times for these procedures?

The number of upper surgeries performed has been increasing each year. In 2016/17, 90 upper surgeries were completed, compared with 56 the year before. In fiscal years before that time (since 2012), only 30-38 surgeries were performed.

  • This fiscal year (2017/18), we expect approximately 90 surgeries to be completed.
  • Wait times for surgery will fluctuate depending on available surgeons and operating room time; the current publicly funded wait time from referral to surgery is several years.
  •  Trans Care BC is working with regional health authorities and existing surgeons to train other surgeons to offer these procedures, and increase the number of surgeries performed to reduce wait times.

I’ve had trouble connecting to find out about my/my client’s status on the waitlist. Who do I contact for updates about my/my client’s referral or surgery?

If you/your client is scheduled for consult or surgery, connect with the appropriate surgeon’s office first.

If your client is waiting for a consultation or you need help troubleshooting, you can contact Trans Care BC at 1-866-999-1514.

Is there any travel assistance available?

Hope Air provides travel assistance for eligible clients who are required to travel for care. The assistance is based on financial need. BC also offers travel assistance through the Medical Services Plan (MSP) Travel Assistance Program (TAP).

If you are approved for TAP, you may also qualify for a Request for Non-local Medical Transportation Assistance

If you need advice you can contact Trans Care BC health navigators at 1-866-999-1514

I have/my client has, a higher BMI. What are my/their options?

Clients can be seen by any surgeon for consultation to determine if they are eligible for surgery regardless of their BMI. As part of the consultation, the surgeon will do an individualized assessment of readiness for surgery and may refer higher risk patients to anaesthesia for a further assessment.  The surgeon will also discuss surgical outcomes.

Anesthesia generally looks at a number of factors in addition to BMI,  including blood pressure and the presence of other medical conditions such as asthma or diabetes.

For patients with significant risk factors, surgery in a hospital setting may be required.  Currently, access to in-hospital surgical time is more restrictive than private surgical settings which may result in longer wait times for these patients.

Some variation does exist among surgeons related to BMI requirement for surgery