Does OHIP Cover FTM Surgery?

Unfortunately OHIP does not cover female-to-male sex reassignment surgery for Ontarians. However, this was not always the case.

From 1970 to 1998, OHIP had covered sex reassignment surgery for female-to-male and male-to-female procedures as long as they had been approved by the Clarke Institute of Psychiatry.Many of the procedures that are part of the transition were covered, including ones that weren’t regularly insured in other cases. Breast enlargement, breast augmentation, mammoplasty, and breast reconstruction were insurable only if the necessary authorization from the Ministry of Health was acquired in advance.Ontario Cuts Funding for FTM SurgeryIn October of 1998, the government of Ontario delisted gender reassignment surgery as an insurable benefit under OHIP, and ever since there has been objections from various groups against the decision.One such group is the Ontario Human Rights Commission who has taken a position of scrutiny on the decision making process, as well as the fairness of the change in insurance policy.It was reported in a local newspaper that the money saved from not paying for gender reassignment surgery would be reallocated to cardiac surgery, but the OHRC has long since requested a deeper explanation for the sudden elimination of funding.Recent Changes to OHIP Are Too RestrictiveIn 2008, some of the procedures were re-enlisted as insurable under OHIP, and $200,000 was earmarked on the health care budget which exceeds billions in Ontario. A handful of participants were chosen to undergo rigorous psychological evaluation, a policy that resembles the authorization process through the Clark Institute of Psychiatry in previous decades.Bulletin 4480 seems to imply that the Gender Identity Clinic at the Centre for Addiction and Mental Health is the only recommendation that OHIP will accept when considering coverage of sex reassignment surgery. The bulletin also seems to suggest that only mastectomy would be covered, but it’s vague about specific details. Generally speaking, the government of Ontario will not cover gender reassignment surgery procedures.Future developments in this area of policy are unclear, especially as many Ontarians are entering old age and will incur increased medical costs. There are various other medical concerns competing for funds in the healthcare budget, but without further advocacy for the transsexual and transgender communities, progress may not occur.At this time, the only feasible route to having top surgery in a timely manner is to self-finance the surgery without compensation from OHIP.