Transgender/Gender-Affirming Health

What are the steps in the transition process in Nova Scotia?

Pride Health has produced a great set of guidelines that outlines all of the steps of the hormonal transition process, surgical options, and legal transition in Nova Scotia, as of 2020.

HSHC can help with any aspect of a person’s transition, including the MSI approval process and surgical arrangements.

If you’re not sure where to start, we can help!

What kind of transgender support does HSHC offer?

The HSHC can help with essentially all aspects of the transition process, such as:

  • Help with referrals (hormone readiness, surgical readiness)
  • Gender affirming hormones (letter of hormone readiness needed)
  • Help with MSI referral for surgery approval
  • Help with arranging surgery with Montreal (once it is MSI approved)
  • Post operative care
  • Emotional support
  • General sexual and reproductive health care

How do I book and prepare for an appointment at HSHC?

Booking an appointment with us is easy! Give us a call at 902.455.9656 ext. 0. You will need to speak to one of our medical administrators. They are always in the office Monday-Friday from 9:00 am – 4:00 pm (with the exception of holidays), but are not always in the office during our evening clinics (4:30 pm – 8:00 pm), so it is best to call during the day. We cannot book appointments over email or Facebook. You cannot book an appointment for someone else, even if they are your partner or child. We will need to speak with them directly. To book, we will need your full name as it appears on your health card, birth date, and phone number. You are also safe to share your pronouns and lived name with our admin while booking. We will always refer to you as you prefer!

If you are coming to start the process for gender affirming hormones and/or medical transition, you will be a placed on a waitlist, which typically is 3-10 months.

If you are moving to Nova Scotia from another province and are already on hormones, you can transfer your care to HSHC. Please note that there may be a considerable wait to access our services. You should call us as soon as possible to prevent an interruption in your care. You should also contact your original provider before leaving your province to maintain your prescription while you wait. We will need any relevant medical records from your previous provider, such as readiness letters, mental health assessments, recent bloodwork, prescription history, etc. You should arrange to access those records before booking with HSHC.

You will need a letter of readiness before being placed on our wait list to start hormones. If you do not have a letter of readiness and/or are unsure of how to get one, our admin can walk you through the process, or you can book an appointment to discuss it with one of our doctors. You will not need to go on the wait list for this appointment. If you do have your letter of readiness, you can bring it in person or fax it to us at least a week before your appointment. If you choose to fax it, please call us to confirm that we received it before your first appointment.

If you are looking for a readiness letter writer, you can find a directory of mental health professionals here: Queer and Trans Therapists NS Directory

The administrator will let you know when to expect the call to book your first appointment. The admin will typically book your first three appointments all at once. Make sure you bring your valid provincial health card with you to your appointment. Clients without health cards are subject to doctors and lab fees.

Do you have questions about the transition process? We can help! You are welcome to book an appointment with one of our doctors or nurses without being on the waitlist.

Other than that, just bring (and be) yourself! We look forward to meeting you.

Are you a youth? You do not need parental consent for any of our appointments. However, you must be 18 for us to provide gender-affirming hormone prescriptions. If you are under 18, you can access gender-affirming care through the IWK Trans Health Care Team. You can self refer to them by calling 902-464-4110 or toll free 1-855-922-1122.

Don’t have access to or lost your health card? You are entitled to your health card information! Call MSI toll-free at 1-800-563-8880 (in Nova Scotia) or at 902-496-7008 from Monday-Friday 8am-5pm. We require the number and the expiry date. Another tip: take a picture of your card! You will never lose it again!

What can I expect during my appointment at HSHC?

*COVID UPDATE: Some components of appointments are being moved to a telephone visit format. The administrator will explain these changes.*

If you are coming in for gender affirming hormones, this will involve 2 visits, all with the same doctor:

  • Pre-Visit: The admin team will mail you information, consent forms, a health history form, and a bloodwork requisition form.
  • Visit #1: Meet and greet, discuss transition goals, review health history, and a physical exam. You will not need to do anything you are not comfortable with. The purpose of this exam is to ensure you are healthy and well.
  • Visit #2: A review of your bloodwork results, you will sign consent forms to start your hormone therapy and get your prescriptions that day.
  • If you are starting on testosterone, you can book a follow up appointment with one of our nurses who will help teach you how to do your injection. You are welcome to bring a support person with you. We sell injection supplies on site for $52.50 for a weekly supply/year and $28.75 for a bi-weekly supply/year. Please note that we cannot sell injection supplies after 4:30 PM.
  • If you ever need help doing your own injection at home, check out the videos below of our nurse going through the steps of both IM and SubQ injections!
    • This instructional video is not meant as a substitute for professional medical advice. It is an extra resource for those already receiving hormone therapy care. Individuals are recommended to consult with a qualified medical professional before self administering any new medications.

What are the wait times for referrals, surgery, etc.?

  • Referrals for hormone and surgical WPATH readiness letters will depend on if you will be going to a private psychologist or through MSI.
    • If you are going through a private psychologist (if you have coverage or are paying out of pocket), you will likely get seen within a few months.
    • If you will be going through MSI (covered by provincial health care), wait times range from 6-18 months.
  • MSI approval for surgery: Once we have your letter(s) of surgical readiness, you can come to HSHC to fill out MSI approval documents. We will then forward this to MSI. It takes approximately 4-6 weeks to receive notification of approval from MSI. Once we have approval, we will contact you for a follow up appointment and begin planning for you to go to Montreal.
  • Referral to Montreal for surgery: Most gender-affirming surgeries are only available in Montreal. If you require a referral for surgery, HSHC can help with this. We fax off all required documents to Montreal. They will contact you from there. If you DO NOT receive a package from Montreal within one month, its very important that you call them. We can give you their phone number. Wait times for surgery are very variable, but often range from 6-18 months.

How do I change my name/gender marker?

Details on how to legally change your name are outlined on the Nova Scotia government website.

Gender marker changes: You will need to fill out a form for Vital Statistics which we can provide or you can access online. This form needs to be signed by one of our doctors. You will then bring this form to one of the Vital Statistics office locations, and they will begin processing your request.

Where can I go for support in the community?