Gender-affirming care
Surgery assessments and OHIP paperwork
The step that is almost never the surgery, almost always the bottleneck, and almost never explained.
What this is, precisely
Surgery itself happens elsewhere, with a surgical team. What happens in a family practice is the part before it: the assessment, and the prior-approval paperwork that Ontario requires before it will fund a listed procedure.
Those are two different things and it is worth keeping them apart. An assessment is a clinical appointment that results in a document. Prior approval is a funding decision made by the ministry on the strength of that document. Neither one is surgery, and neither one is performed here as a favour or withheld as a judgement.
A clinic cannot approve your surgery, and any clinic implying otherwise is describing something it does not control. What a clinic can do is make sure the paperwork is complete, correct and not the reason you are waiting.
How the process is shaped
Deciding what you are seeking
Ontario funds specified procedures and does not fund others. Knowing which list the thing you want sits on changes the whole route, and it is worth establishing first rather than discovering late.
The assessment appointments
Clinical appointments with qualified assessors, resulting in the documentation the ministry requires. How many are needed depends on the procedure, and the criteria are set by the ministry rather than by us.
Submission and prior approval
The completed documentation goes to the ministry, which makes the funding decision. This is the step nobody in the room controls.
Referral onward
Approval in hand, the referral goes to a surgical program. Their assessment, their scheduling, their consent process — separate from this one.
The run-up and the recovery
The ordinary medical care around a major operation — pre-operative fitness, medication decisions, recovery, follow-up — is family medicine, and it happens here.
Why there are no timelines on this page
Because the honest answer is that they vary enormously, and a number published as marketing would be a number someone plans their year around. What we can commit to is telling you where your paperwork actually is when you ask.
What we will and will not do
Will: explain which route applies to what you are seeking, carry out the assessments this practice is qualified to carry out, complete the documentation properly, submit it, tell you when it has gone and tell you what came back.
Will not: promise an outcome, promise a date, decide funding, perform surgery, or hold your paperwork hostage to appointments that serve no clinical purpose.
Where an assessment needs someone this practice cannot provide, you will be told that plainly and pointed somewhere real rather than handed back a form.
Common questions
Do you do the surgery?
No. Surgery is done by surgical teams elsewhere. This is a family practice, and what it handles is the assessment, the paperwork and the medical care around the operation.
Do I need to be on hormone therapy first?
It depends on the procedure, and the requirement is set by the ministry rather than by this clinic. It is one of the first things worth establishing, because the answer changes the order you do things in. See hormone therapy.
Will OHIP pay for it?
Ontario funds specified procedures, with prior approval, and does not fund others at all. Which category yours falls into is a question with a real answer, and getting it early saves the most time.
I started this somewhere else and it stalled.
Common, and usually a documentation problem rather than a clinical one. Bring whatever you have, including partial forms and correspondence, and the first job will be finding out where it actually stopped.
Is an assessment a psychiatric assessment?
No, and this is worth separating clearly from starting hormone therapy, which needs no letter at all. Surgical funding in Ontario has its own documentation requirements, set by the ministry, and they are not the same thing as a psychiatric gatekeeping process.