Surgical Assessments

And support from start to finish.

What Are Assessments?

For some people, surgeries are a part of gender-affirming care. To get surgery, you’ll need to have an assessment. Sometimes you’ll need two.

Assessments let you and your clinician talk through the risks, recovery and outcomes of surgery. They also make sure you’re able to consent, which is important because transition-related surgeries have some outcomes that are irreversible.

In Alberta, the surgical assessment and approval process varies depending on which surgery you'd like to get.


Navigating this can be overwhelming, which is where we step in!

Assessment Steps

Top Surgery

Mastectomy and Breast Augmentation*

* Breast augmentation is only covered if you have had little to no breast growth after 12 months of continuous hormone therapy.

Step 1

Assessment

Your virtual assessment with a Foria clinician

Step 2

Referral

Foria writes a referral to your surgeon

Step 3

Review

Your surgeon accepts at their discretion

Step 4

Application

Your surgeon applies for provincial coverage on your behalf *

Step 5

Approval

Funding approval is sent directly to your surgeon

Orchiectomy & Hysterectomy

Step 1

Assessment

Your virtual assessment with a Foria clinician

Step 2

Referral

Foria writes a referral to your surgeon

Step 3

Review

Your surgeon accepts at their discretion

Step 4

Approval

Surgery is automatically covered by provincial insurance

Bottom Surgery

Vaginoplasty, vulvoplasty, phalloplasty & metoidioplasty


Foria does not offer assessments for vaginoplasty/vulvoplasty, phalloplasty or metoidioplasty in Alberta at this time. This is because bottom surgeries are only performed out of province at GRS Montreal and have a different approval process.

If you live in Alberta and would like to get bottom surgery, here’s how the assessment and approval process works with other providers:

Step 1

First assessment

This must be done by a family doctor, nurse practitioner, endocrinologist or psychiatrist at a provincially recognized clinic.

Step 2

Second assessment

This must be done by a physician at a provincially recognized clinic

Step 3

Application

Physician (first or second assessor) submits an application for coverage.

Step 4

Approval

Approval is sent to the assessor who submitted the application.

Step 5

Referral

Physician writes referral to your surgeon.

FAQ

What happens during my assessment?

During your assessment, you’ll be asked about your gender history, your health history and your medication history. For most transition-related surgeries, you’ll need a diagnosis of gender dysphoria. Even though some people don’t identify with this label, it’s still required by surgeons and Alberta Health (if you’re applying for coverage).

You’ll also be asked how the surgery will impact your life, where you’d get surgery and what your recovery plan is. Because of this, it’s a good idea to do some research in advance. For example, bottom surgeries are performed out of province so you’d need to make some travel plans. Bottom surgeries covered by Alberta Health are performed at GRS Montreal.

Who does my assessment?

Foria provides assessments for top (breast or chest) surgery, orchiectomy and hysterectomy. These only require one assessment. We do not provide assessments for bottom surgeries.

Foria’s assessments are done by our Alberta-based physicians. When you select your assessment appointment, you can choose which assessor you would prefer.

For minor surgeries that aren’t covered by Alberta Health, like hair transplants, your surgeon may do the assessment themselves. For these procedures, you can reach out to your surgeon and ask what their protocol is.

What surgeries are covered by Alberta Health?

Alberta Health will cover some but not all transition-related surgeries. The procedures that can be funded are:

  • Vaginoplasty (includes orchiectomy, clitoroplasty, and labiaplasty)

  • Phalloplasty (includes vaginectomy, urethroplasty, glansplasty, and penile and testicular implants)

  • Metoidioplasty (includes vaginectomy, urethroplasty and testicular implants)

  • Hysterectomy (removal of the uterus)

  • Salpingo-oophorectomy (removal of the tubes and ovaries)

  • Orchiectomy (removal of the testicles)

  • Mastectomy/chest reconstruction (includes removal of breast tissue, excess skin, proper positioning of nipple and areola, and chest contouring)

  • Breast augmentation (after 12 months of continuous hormone therapy with little to no breast growth)

What surgeries are not covered by Alberta Health?

There are some transition-related surgeries that Alberta Health doesn’t cover. There are also some costs related to surgery that you’ll have to pay yourself. These are:

  • Breast augmentation (for people who don't meet criteria above)

  • Facial masculinization

  • Facial feminization

  • Electrolysis

  • Laser hair removal

  • Hair transplants

  • Tracheal shave

  • Voice modification surgery

  • Body contouring (e.g. liposuction, BBL)

  • Chin, nose, cheek, or buttock implants

  • Travel and accommodation costs related to surgery*

  • Supplies related to post-surgery care

* If you are getting surgery at GRS Montreal, the clinic will cover your hotel and food costs for three day

What are the criteria for getting approved?

If you’re applying for Alberta Health funding for surgery, you’ll need to meet these criteria:

  • You have a diagnosis of gender dysphoria. This can be a previous diagnosis or the clinician can make the diagnosis in your appointment, based on your history.

  • Other health conditions (like diabetes) are treated and/or under good control.

  • You do not have a mental health condition that is symptomatic or likely to become so.*

  • You’ve considered the alternatives to surgery, like binding for chest surgery.

  • Surgery could help you achieve the goals you have.

  • You understand the risks and benefits of surgery and can give consent.

  • You’ve been on hormones for at least a year (for bottom surgeries and breast augmentation).

  • You have had one year of “real-life experience” of your gender.*+

  • You have a good support network and a stable lifestyle.

  • Your gender identity has remained stable over time.*+

  • You’re over the age of 18.

* These are outdated requirements that do not reflect the lived experience of trans, non-binary and gender-diverse people. However, they are unfortunately still part of the approval process in Alberta. If you have any questions about specific approval criteria, we suggest reaching out to your assessor ahead of time.

+ These are only required for bottom (genital) surgeries that take place out of province. These surgeries are vaginoplasty, vulvoplasty, phalloplasty and metoidioplasty.

Ready to get started?

We're here to support you

Book appointment


Have health costs that aren't covered? Connect Fund can help.


Connect Fund is a non-profit organization partnered with Foria that provides financial assistance for 2SLGBTQ+ healthcare costs.

Any community member with healthcare costs that are not covered by provincial health insurance can apply – this includes surgeries, travel and accommodation for surgeries, and counselling.

Learn more