Gender-affirming care
What happens at your first appointment
Written down in advance, because deciding whether to book should not require guessing what you are walking into.
What you will not be asked
You will not be asked to prove anything about your childhood. You will not be asked to describe your body in more detail than the medicine requires. You will not be asked how long you have known, or to justify a decision you have already made.
You will not need a letter from a psychiatrist or a psychologist to start hormone therapy here. That is the Ontario informed consent model, and it is the standard set out in the provincial guidelines for gender-affirming primary care — not a concession we are making.
The appointment is a medical conversation about a medication, run the way any other medical conversation about any other medication is run.
What it will cover
What you want
Which changes matter to you and which you would rather avoid. Different goals point to different options, and there is no single correct answer to work toward.
Your health
The ordinary medical history — what you take, what you have had, what runs in your family. Some conditions change the safest option; almost none rule everything out.
Effects, risks and reversibility
Which changes are permanent, which are not, which are quick and which take years. This is the part the consent model is actually about, and it is a conversation rather than a form.
Fertility
Raised because it has to be raised before starting, not because there is a right answer. If you want to look at options first, that is a reason to pause; if you have already thought about it, saying so is enough.
Bloodwork
A baseline set, usually drawn in the building the same day. See bloodwork and monitoring for what is measured and why.
What to bring
The name you want used and your pronouns, which go in the chart at the front rather than buried in it. A health card if you have one. A list of anything you take, including anything you have obtained outside the medical system — that is information, not a confession, and it changes what is safe.
Records from anywhere you have been seen before, in whatever language they are in. If you have none, that is ordinary and it does not mean starting over.
If you are already taking hormones
Bring what you are taking and the dose if you know it. Continuing safely is a different appointment from starting, and it is the more common one.
Will I leave with a prescription
Often, yes. Sometimes not — if the bloodwork needs to come back first, or if something in your history needs sorting out before it would be safe, or if you want to go away and think. Any of those is a normal outcome rather than a refusal, and you will be told which one it is and what happens next before you leave.
What will not happen is a decision deferred to somebody else without a reason you can hear.
Common questions
Do I need a referral?
No. You will be able to book this yourself. See your first visit for how booking will work generally.
Do I have to be out?
No. Nothing about this appointment requires you to have told anyone. The name we use in the room is the name you give us, and what appears on paperwork is a separate question with its own answer.
Is it covered by OHIP?
The appointment is an ordinary insured visit. The medication is a separate question and depends on your drug coverage rather than on OHIP — the pharmacy on the ground floor will work that out with you.
What if I change my mind?
Then you change your mind, and that is a legitimate medical decision like any other. Stopping is a conversation about how, not a conversation about whether you were serious.
Can I bring someone?
Yes. Anyone you want in the room can be in the room.