For transgender patients without a lot of disposable income, it is still possible to undergo gender reassignment surgery by qualifying for OHIP coverage. In order to begin the transition process, they must first be referred to the Centre for Addiction and Mental Health by their doctor or nurse. CAMH is the only organization in Ontario with the authority to approve OHIP coverage for gender reassignment surgery, and they require patients to be over the age of 18 and meet a set of stringent criteria including:


  • Receiving a diagnosis of gender dysphoria
  • Getting mental health and substance abuse problems under control
  • Completing at least one year of medically supervised hormone therapy
  • Completing a continuous Gender Role Experience (GRE) in which they document how they live in their new gender

However, neither cosmetic nor gender reassignment surgery are necessary to legally change your gender on government documents including birth certificates, driver’s licenses, and health cards. A legal change of gender requires a person only to fill out an online form and pay a processing fee of $137. This alters all information at a provincial and federal level.

Cosmetic Procedures

For those willing and able to spend extra time and money, cosmetic procedures are a common part of transitioning. Dr. Solomon sees as many as 50 MTF patients a year who are nearing the end of their transformation and wish to further feminize their features.

Common procedures used to create a more feminine appearance include:


  • Rhinoplasty to create a narrower and lower bridge with a more refined tip and narrower base
  • Cheek implants to create a dramatic change to the shape of their face, softening the lines of their cheek and jaw
  • Brow reshaping to smooth the typically fuller male brow into a more feminine appearance
  • Reshaping the Adam’s apple. Made entirely of cartilage, the Adam’s apple can be entirely removed with virtually no risk to the patient

The combined procedures can reach a total of $15, 000 to $20, 000 depending on the treatments chosen, but Dr. Solomon notes that patients see the end results as well worth the price tag, saying, “They’re happier, their self-esteem is high, they’re more comfortable in their own skin.”