About Foria Clinic
What is the backstory of Foria Clinic?
Foria’s roots are in Connect-Clinic, an Ontario-based clinic that pioneered virtual gender-affirming care. In December 2022, Connect had to stop services following the Government of Ontario’s changes to virtual care billing codes, making its operations unsustainable. These changes left 1,500 patients without access to critical life-affirming care and nearly 2,000 prospective patients on its waitlist. PurposeMed has worked with Connect’s Medical Director, Dr. Kate Greenaway, to build a new home for the clinic and its patients. That home is Foria.
Is virtual gender-affirming care as safe as in person?
Virtual gender-affirming care provides you with the safety of meeting an experienced nurse practitioner from your location. For some people, in-person care might be a better choice, and if so, your nurse practitioner will discuss this with you.
Where is Foria available?
Foria is currently available in the Canadian provinces of Ontario and Alberta. Patients must be physically in Ontario or Alberta at the time of their virtual consult. (Updated September 2023)
When will Foria come to other provinces?
Foria has launched in Ontario and Alberta, with plans to expand thoughtfully to other provinces.
How it works
What kind of services are offered by Foria?
Foria provides virtual consultations for health and wellness support, gender-affirming hormone therapy, surgical referrals, letters for gender marker change and more to trans, non-binary and gender-diverse people.
How do I access Foria’s services?
How does virtual care work with Foria?
You'll need the following to access your virtual appointment:
A supported computer or mobile device with a web browser, camera, good quality speakers, and microphone
An internet (wi-fi) or a phone data plan (for connections via mobile device)
A strong internet connection
An email account. You will receive an email 5 minutes before the appointment, with a link and code to join the visit.
How often will I meet with a provider?
What is the wait time to access Foria’s services?
Eligible patients are typically able to book an appointment within 1 week, and as far as three months in advance. (Last updated September 2023)
There is no waitlist to join Foria - if you meet our eligibility criteria below, you are welcome to book an appointment right away.
If cost is a barrier to you, we are currently working on a financial assistance program and will release more information as soon as it's available. If you are interested in this program, please opt-in for updates here.
Who is eligible for Foria?
We are currently offering services to residents of Ontario and Alberta who are 16 years and older. We are planning to expand age eligibility in the future.
What if the service isn’t right for me?
There may be some reasons such as other health conditions that would make it safer for you to receive ongoing care from an in-person or specialist service. Your clinician will discuss this with you at your first appointment.
Please note: Because we will still provide a detailed assessment prior to referring you on, the fee for this service will not be refundable.
Do you serve people who are under 18 years old?
We are currently offering services to individuals 16 years and older, and we are working to expand age eligibility in the future.
What if I don’t have a provincial health card or identification?
You do not need a provincial health card to access our services, but you do need a government-issued ID (federal or provincial). You must also be physically located in the province of Ontario or Alberta at the time of your appointment.
Here are a list of valid identification cards you can use:
Health card issued by a Province or Territory in Canada
Valid Driver’s Licence or Temporary Driver’s Licence (issued by Ontario or other jurisdiction)
Ontario Photo Card
Birth Certificate from a Canadian province or territory
Government-issued Employee Identification Card
Ontario Outdoors Card
BYID (age of majority card)
Certificate of Indian Status
Valid Passport – Canadian or other country
Certificate of Canadian Citizenship
Canadian Immigration Identification Card
Permanent Resident Card
Old Age Security Identification Card
Canadian Armed Forces Identification Card
Royal Canadian Mounted Police/Provincial/Municipal Police Identification
Firearms Possession and Acquisition Licence
Do I need a referral to access Foria’s services?
No, you do not need a referral to access Foria.
Do I need to have a family doctor to access services?
No, you do not need a family doctor to access Foria’s services.
Costs & accessibility
Why is this a paid service?
With the current limitations of the public healthcare system on virtual care, Foria’s nurse practitioners are not covered by OHIP or other provincial health systems. This makes them unable to fully bill those health systems for the services provided, meaning those systems won't cover their salaries. PurposeMed will pay Foria’s clinician and staff salaries and benefits, allowing them to focus on providing the highest quality care to patients. Unfortunately, this means our services are out-of-pocket for patients at this time.
When will I be charged for my consultation?
You will be charged at the time of booking your appointment using our booking system.
What are the fees for this service, and how was this decided?
What’s included in the fee?
Included in all appointment fees are the following:
A review of your medical history
Monitoring of your health including vitals and blood work
Sexual health monitoring and check-ins
Management of secondary effects
Is there a financial assistance program for those who can’t afford the price?
We are currently working on a financial assistance program and will release more information as soon as its available. If you are interested in this program, please opt-in to updates when you fill out your intake. (Last updated September 2023)
How do I pay for services?
Credit card payments are completed via our secure online payment processor.
How will Foria ensure my confidentiality is protected?
Foria Clinic is committed to protecting your confidentiality and privacy. The clinic adheres to strict privacy policies and complies with all relevant Canadian healthcare regulations, including the Personal Health Information Protection Act (PHIPA). For any digital communications regarding health information, Foria uses secure and encrypted platforms to ensure that your information is safeguarded.
How does Foria store my medical information?
Foria Clinic stores your medical information using a secure electronic medical record (EMR) system. This system is designed to safeguard the confidentiality and integrity of your information. The clinic adheres to Canadian healthcare data storage regulations and employs security measures such as encryption and access controls to protect your records.
Will my other healthcare providers know that I accessed Foria's services?
Your other healthcare providers will only know that you accessed Foria’s services if you choose to share this information with them or if you provide Foria with consent to communicate with them. It’s often beneficial for your healthcare providers to have a complete picture of the care you’re receiving, but Foria respects your privacy and will not share your information without your explicit authorization, except in cases where it is legally required.
How can I access my health records with Foria?
At Foria Clinic, you can request access to your health records by contacting the clinic directly at firstname.lastname@example.org. There will be a $30 fee to have your records sent to you.
The clinic will provide you with information on the process and any forms that may be necessary to fill out. It’s important to know that Canadian healthcare regulations also support patients' rights to access their own medical records, and Foria is committed to facilitating this in a timely manner.
Is your video platform secure?
Yes, Foria Clinic utilizes a secure video platform for virtual consultations through our electronic medical record (EMR) system. The platform employs encryption and other security measures to ensure that your privacy is protected during video calls. This is in line with Canadian healthcare regulations, which mandate the use of secure and confidential communication methods in healthcare settings.
What is testosterone?
Testosterone (which some people call “T”) is a drug used in gender-affirming care. T produces changes to your body that can help reflect your gender identity. These include a deeper voice, facial hair, and more muscle mass. It also has psychological effects - it can change your sex drive and mood.
Who is testosterone HT for?
Testosterone is a hormone that’s taken by people who want to have masculinizing effects, and can also be taken by intersex people.
What are the effects and timelines for testosterone HT?
For detailed information about the effects and timelines of testosterone HT, please visit our Testosterone resource page.
Do I require an up to date lab tests to receive a testosterone prescription?
Yes, up-to-date lab tests are required before receiving a testosterone prescription. These tests help your clinician assess your current hormone levels and other health indicators, which are essential for determining the appropriate dosage and monitoring for potential side effects. Your healthcare provider at Foria Clinic will guide you through the necessary steps and explain the importance of lab tests in managing your hormone therapy safely and effectively.
How can I take testosterone?
Testosterone can be administered in several ways, including injections and topical gels. Injections can be delivered into the muscle or subcutaneously. They're taken every one to two weeks. Topicals are applied directly to the skin once per day. The method of administration that is best for you will depend on various factors including your health, lifestyle, and preferences, and should be determined in consultation with your Foria clinician.
Can I microdose testosterone?
Testosterone can be given in a range of doses. How each person responds to their dose will depend on their genetics and their response to the treatment. If you would prefer to try a lower dose, you can review this option with your clinician. Changes may be slower at low doses, but testosterone effects may be the same.
Are the effects permanent?
Some changes from T, like your mood or body composition, are temporary. This means that if you stop treatment they will eventually reverse.
Other changes like facial hair, bottom growth and a deeper voice are permanent. This means you can stop treatment and they will remain.
Some people choose to stop T after reaching permanent changes that they’re happy with, while others will continue for the rest of their lives. You can decide whatever works best for you and your body – and remember, you can adjust your treatment at any time.
Note: If you have had your ovaries surgically removed, then going off hormones is not recommended.
What are estrogen and androgen blockers?
Estrogen and androgen blockers are a type of gender-affirming care. These medications have feminizing effects, and a treatment regimen usually consists of both. Androgen blockers suppress your body’s natural testosterone and estrogen is a hormone. If you’ve had bottom surgery then you won’t need to take androgen blockers. This is because testosterone is mostly produced in the testicles, which are removed during surgery.
These medications produce changes to your body that can better reflect your gender identity and/or expression. Changes include breast growth, softer skin and changes to your body fat. They also have psychological effects - they can change your sex drive and mood.
Who is estrogen HT for?
Estrogen and/or androgen blockers are typically taken by people who want to have feminizing effects, and can also be taken by intersex people.
What are the effects and timelines for estrogen HT?
For detailed information about the effects and timelines of estrogen HT, please visit our Estrogen resource page.
Do I require an up to date lab tests to receive an estrogen/androgen blockers prescription?
Yes, up-to-date lab tests are required before receiving an estrogen/androgen blocker prescription. These tests help your clinician assess your current hormone levels and other health indicators, which are essential for determining the appropriate dosage and monitoring for potential side effects. Your healthcare provider at Foria Clinic will guide you through the necessary steps and explain the importance of lab tests in managing your hormone therapy safely and effectively.
How can I take estrogen/androgen blockers?
Androgen blockers are oral tablets, while estrogen can be administered in several ways. These include oral tablets, topical patches and injections. Oral tablets are taken by mouth, patches are applied to the skin, and injections are given into muscle or fat tissue. The choice of administration method depends on various factors including individual health considerations, lifestyle, and personal preferences. Your Foria clinician will work with you to determine the most appropriate method of estrogen administration for your specific situation.
Can I microdose estrogen?
Estrogen can be given in a range of doses. How each person responds to their dose depends on their genetics and response to the treatment. If you would prefer to try a lower dose, you can review this option with your clinician. Changes may be slower at low doses, but effects may be the same.
Are the effects permanent?
Some changes from hormones, like your mood or sex drive, are temporary. This means that if you stop treatment they will eventually reverse.
Other changes like breast growth are permanent. This means you can stop treatment and they will remain.
Some people choose to stop hormones after reaching permanent changes that they’re happy with, while others will continue for the rest of their lives. You can decide whatever works best for you and your body – and remember, you can adjust your treatment at any time.
Surgical assessments & referrals
What are surgical referral letters?
Foria currently offers surgical assessments for patients in Ontario only at this time. We are working on offering this service in Alberta as soon as possible. (Last updated September 2023)
Surgical assessments must be done before OHIP-funding for a gender-affirming surgery is requested. These assessments typically include a review of gender identity, medical history, mental health, and the necessity of surgery for the patient’s well-being.
During your surgical assessment, the nurse practitioner will review the types of surgery available, risks and benefits, and answer your questions.
How many surgical assessments are needed?
In Ontario, two surgical assessments are typically required for most types of gender-affirming surgeries. Chest masculinization or breast augmentation (for those that qualify) only require one assessment. Surgical assessments are conducted by healthcare professionals with expertise in gender-affirming care, including Foria clinicians.
I already have a surgical letter, can Foria provide me with a second one?
Yes, absolutely. If you already have one surgical assessment, a Foria clinician can provide the second.
How do I get a surgical referral letter from Foria?
First you will have your surgical assessment appointment(s) with your nurse practitioner who will submit a Prior Approval Form to get your surgery funding approved. Foria will track this process for you and make sure the Ministry of Health responds.
Once your Prior Approval Form has been reviewed and approved by the Ministry of Health, your nurse practitioner will let you know this has been received and they will complete the referral to the surgeon of your choice.
How much does it cost to get a surgical referral letter?
For specifics on surgical referral letter appointment costs, please visit our Surgery assessment & referral letters page.
How do I renew my prescription?
Once at a stable dosage, you can book a ‘Follow-up’ appointment when you are getting low on medication. You will then complete your lab tests and have a visit with a Foria clinician to review and renew your prescription.
How do I make changes to my prescription?
To make changes to your prescription, you can book a ‘Follow-up’ appointment to discuss desired changes with a Foria clinician. Your clinician may require up-to-date lab results in order to issue a new prescription.
Can my medication be delivered to me?
Yes, we have a partner pharmacy that offers free and discrete shipping to most patients in Ontario and Alberta. You can also get your prescription filled at any pharmacy of your choice.
Can I update my preferred pharmacy on file?
Absolutely, to update your preferred pharmacy just let your Foria clinician know during your appointment or send an email to email@example.com.
Ready to get started?
The expert team at Foria is here to understand your goals and support your gender affirmation however possible.