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OHIP Covered FTM Criteria

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FTM Surgery And OHIP Coverage

Completing the FTM transition can involve many different steps. You can make alterations through hormone therapy, changing the tone of your voice, or building muscle.

But the ultimate change comes when you undergo FTM surgical procedures. Unfortunately, surgery can be costly. Out of all the changes you can make, having a FTM procedure can be the most drastic and expensive. Thankfully, your gender confirmation surgery may be covered by the Ontario Health Insurance Plan (OHIP). The following are the criteria you need to meet in order to have your FTM procedure covered by OHIP:

  1. Receive A Proper Diagnosis: The first step to having your FTM procedure covered is to be professionally diagnosed with gender dysphoria. This requires seeing a mental health specialist, such as a psychologist, psychiatrist, or a behavioral therapist. After speaking with you in-depth about the issues you’re facing, they’ll be able to make a proper diagnosis.
  2. Demonstrate That You’re Prepared For Treatment: In addition to receiving an official diagnosis, you must demonstrate that you’ll be comfortable permanently living as a male. You can complete this step in a number of ways including:
  • Living in your community as a male
  • Altering your appearance to match your target gender
  • Talking to family members about your desire to have the FTM procedure
  • Spending time in counselling to confirm that gender reassignment is right for you
  • Receiving testosterone treatments
  • Choosing to be addressed by a male name
  • Some professionals recommend that you have hormone therapy and live as a male for at least a year before having gender confirmation surgery.
  1. Acceptance Of The Risks
  2. Before applying to have your FTM procedure covered by OHIP, you need to be counselled on the potential risks and implications involved with gender reassignment surgery. A medical professional will speak to you about fertility loss, aftercare requirements, risks to your health, and other aspects in order to assess your ability to accept those conditions.
  3. Get Approval From The Ministry Of Health And Long-Term Care
  4. You must have your FTM procedure approved by Ministry of Health and Long-Term Care before the surgery takes place. If you have the surgery prior to making the application, your procedure will not be covered by OHIP. OHIP provides funding for both genital and chest surgery, but the requirements for approval are slightly different. To receive approval for chest surgery, you’ll need to have a doctor or nurse practitioner make an assessment and submit the proper form. On this form, they’ll confirm that the three steps mentioned above have been completed. The requirements for genital surgery are a bit stricter. Instead of needing just one evaluation, you’ll need to have two qualified medical professionals complete the assessment and recommend that you receive surgery. In order to receive a recommendation, you’ll need to spend 12 continuous months receiving testosterone treatments and living as a man.

Once you complete these four steps, you’ll be on your way to an OHIP-covered FTM procedure.