Gender-affirming surgery (GAS)

Surgical assessments & referral letters (Ontario only)

Please note: Foria Clinic is currently able to offer surgical assessments and referral letters in the province of Ontario. We are working hard to expand this to other provinces.

How it works

Getting a surgery referral


Book consult

Start and complete your intake. We'll reach out with booking options as soon as new availabilities open for a surgical assessment.


Surgical assessment

The virtual assessment will include a review of your gender & medical history, and mental health. You will also review surgery options and their benefits & risks.


Funding approval

Foria will apply on your behalf, track the process, and make sure the Ministry of Health responds.
This process may take up to 6-8 months.


Receive your referral

Your Foria clinician will let you know when a response is received. If eligible, we will complete the referral to the surgeon of your choice.

For more detailed information on the Surgery Referral process, please visit:

Resource: Surgical Referrals

New & existing patients

Surgery consults

If gender-affirming surgery (GAS) is a desirable option for you, Foria’s team can provide you with a surgery assessment and, if eligible, a referral letter to the surgeon of your choice.

Surgical assessment & referral

During this consult, you will discuss your gender history, transition goals, and surgery expectations.

Education around the different surgery types, wait times, recovery, post-operative tasks and challenges as well as sexual implications will be provided.

What's included

  • 45 min virtual consult

  • Medical assessment

  • Funding application & tracking

  • One (1) surgery referral letter

Surgical assessments & referrals FAQ

For additional information and a complete list of questions & answers regarding Foria and our services, please visit our FAQs page.

What are surgical referral letters?

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 (this process may take 6-8 months) 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.