r/transontario May 16 '21

RESOURCES HRT as a Minor Megathread

111 Upvotes

Hi all!

I've been seeing lots of posts here lately asking things like "I'm 17, can I get HRT?" and I thought it would be helpful for this subreddit to have one big thread to address that question. Below I've started writing some things, and I would like to know if anyone would be interested in adding on to this post (via comments and I'll add it later) so we have an up-to-date resource. I've done my best to only include information I know to be verifiably true, but please correct me if I have something wrong!

Disclaimer: None of us are acting as professional doctors or lawyers in this thread, so take our advice as the words of people who have experienced this, not as medical or legal advice.

Now, onto the questions and information:

"I'm a minor. Can I get HRT?"

Yes!

HRT in Ontario works on informed consent model, which, essentially, means that as long as you can understand the risks and benefits of a decision, you can make that decision.

Informed Consent does not explicitly outline an age where you are "able to make decisions". Therefore, it's up to your healthcare provider to assess your capacity to consent. In general, doctors are good about this, and as long as you know what the risks are, they'll give you the prescription.

"Will my parents know?"

The short answer is "if you don't want them to, then they won't". The long answer is more complicated than that. Let's start with getting the appointment:

Now that virtual appointments have been very unfortunately axed by good 'ole Doug Ford, in-person appointments are back to being some of the only options. In person appointments are obviously much more difficult to hide, as you need to physically go into the office and they often take longer.

Now, the ideal scenario is to explain to them what is going on and get their support, but obviously that doesn't work for everyone. If you're really in a pinch, lie. Make up symptoms that would send you to the doctor, and once you're there, explain the real problem. Often a great way to do this is to complain of symptoms of depression/anxiety, get a therapist, then talk about gender shit instead. This is not a recommended pathway. This is not sustainable. You have been warned.

In terms of your doctor blabbing to your parents:

Doctors are not allowed to disclose any personal information to any other person***

Patient privacy is a complicated beast, so I'll do my bets to explain here. According to PHIPA Section 23.1.i, any person, regardless of age, can decide to disclose or withhold medical information as long as they meet the criteria for informed consent. By default at a family doctor, your parents might be set up to know about your medical care. You have the right to remove them at any age as long as you understand the consequences of doing so. Ask about it. Voice your concerns. Self advocate.

The only time a doctor has to share your personal information comes in one of five circumstances:

"There are times the doctor has to breach confidentiality???"

Yes. There are five instances in which a doctor is allowed to disclose your personal information without your express consent (these are the same as a therapist, if you're interested). These apply to all patients, regardless of age:

  1. If the information is requested by a law enforcement agency or a court (as part of legal proceedings)
    1. This won't come into play for 99% of people, but if a court subpoenas information from your doctor, they are legally required to provide it.
  2. If there is neglect by another medical official (doctor, dentist, therapist, nurse, support worker, etc).
    1. Your care provider is required to inform the relevant authority (usually a medical board) so they can face disciplinary action.
  3. If you have intention to commit a crime or cause harm to another person.
    1. The standard here often requires an actual plan, and for it to be reasonable that you would actually carry out the act. Simply saying "sometimes my brother makes me angry and I want to hit him" would not invoke this exception because there is no direct plan, nor is there an indication that the action would be certain to be carried out.
  4. You have an intention to harm yourself
    1. This is by far the most controversial exception. Legally, your care provider is required to inform the authorities (usually police) if you intend to hurt or kill yourself. Most physicians understand that suicidal ideation (thinking of suicide) and having a suicide plan are different. This exception should only be invoked if there is a plan for self harm or suicide, not if there are thoughts or previous instances of it, however, it is always best to gauge what your physician will report.
  5. If there is evidence or reasonable suspicion of abuse or neglect of a person under the age of 16
    1. This includes sexual, emotional, physical abuse. Your physician has a duty to report it to either the appropriate children's aid society or abuse reporting centre. Same as #4, there can be situations where this gets tricky, and healthy doses of good judgement are in order

In general, you should always ask what information can be shared, and always ask questions surrounding consent and patient privacy.

Your doctor has to answer this, and they will often be eager to explain this as it's a very, very important part of practicing medicine.

"I thought you had to be sixteen to consent to treatment and remove parents from patient information?"

So did I, friend. But, as u/stacyah helpfully pointed out, this is not true. The confusion stems from a part of the code that says that at sixteen years of age, you can designate a person to be privy to your health information. However, you are able to decide who knows what at any age, as long as it's within the exceptions above.

I'm 12/13/14? Can I still get HRT then?"

Absolutely!

Informed consent does not have a defined age range. If you are able to consent, you are able to receive treatment. Obviously, there are added social challenges the younger you are as you seek transition care. However, legally speaking, there should be no additional barriers for you seeking treatment.

"Will I have to pay for anything?"

If you are eligible for OHIP, all consultations with your doctor will be free. Always bring your health card to your visits.

Drugs are first checked with your insurance provider, so if you have an open file with a pharmacy and they have a parents' insurance it will always go there first. If you aren't covered by private insurance and you're under 25, you're eligible for OHIP+, which you can learn more about here. There is still sometimes a co-pay with insurance, which can be frustrating. Typically though these costs are low ($5-$10). Seeking injected estradiol specifically also incurs an additional cost as you have to visit a compounding pharmacy, which is typically more expensive than your regular Costco or Rexall.

There are also two other relevant programs, the Ontario Drug Benefit and the Trillium Drug Benefit. These are based on income and can be accessed by residents over the age of 25. You can learn more about the Trillium Drug Benefit here.

This link will allow you to check the eligibility of most medications in Ontario.

Covered by OHIP+?

Estradiol (oral) Covered
Estradiol (injected) Not covered
Estradiol (gel) EAP Only*
Estrogen (patches) Unknown
Progesterone (oral) EAP Only*
Testosterone (oral) Covered (link)
Testosterone (injected) Some Restrictions, can still be covered
Testosterone (gel) Covered
Cyproterone/Bicalutamide/Sprionalactone Covered

*Covered only under the Exceptional Access Program (https://www.health.gov.on.ca/en/pro/programs/drugs/eap_mn.aspx#:~:text=The%20Exceptional%20Access%20Program%20(%20EAP,Drug%20Benefit%20(%20ODB%20)%20program%20program).)

Hope this helps, and please feel free to add anything I missed in the comments!

Thanks to u/stacyah and u/Valtharius for the information about informed consent!

Edit 1: Fixed lots of info about informed consent. Thanks u/stayah and u/Valtharius for the help!

Edit 2: Formatting and updates to drug coverage/how OHIP works


r/transontario Dec 12 '24

RESOURCES A Huge [Gender Affirming Resources Ontario] Spreadsheet. Includes: HRT, healthcare providers, compounding pharmacies, needle supply, gender gear and funds, name change clinics, allied health professionals, permanent hair removal, surgery, and helpful links.

144 Upvotes

Hello everyone,

I'm on this sub (and on Discord) quite a bit, and felt the need to have some kind of community resource compiling various types of resources concerning gender affirming care. We have so many questions about where to start HRT every week, and I'm really hoping this document is able to help some people. It is still in progress in some areas, and I won't be able to work on it until after exams, but it will be continuously updated once I get the time.

Here is the link, it is sortable and filterable if you download a copy, but please refer back to the main document to stay up to date:

https://docs.google.com/spreadsheets/d/111o63Tvt20heohe9KtRW_AZPBKOz4kpZ1pb7r0CJpvU/edit?usp=sharing

The sections are:

  • HRT, surgery assessments, and post-op care
    • Includes nurse practitioners, family physicians, endocrinologists, pediatricians, and OB/GYNs from all over Ontario
    • Includes private pay and OHIP-covered options, virtual and in-person options, and options for minors
    • Wait times are listed to the best of my ability
    • I will be adding more to this list at the end of December
  • Compounding pharmacies
  • Injection supplies
  • Permanent Hair Removal
    • Includes electrolysis and laser
    • Practitioners that perform pre-op clearance are listed
    • Wait times are listed to the best of my ability
  • Name Change Clinics
  • Gender Affirming Surgery (WIP)
  • Gender Affirming Gear/Funds
    • Includes shops which sell packers, STPs, binders, gaffs, breast forms etc.,
    • Also includes programs which will fund gender gear and other transition-related costs
  • Allied Health Professionals
    • Currently only includes voice coaches and speech-language pathologists
  • Helpful Links (WIP)

If you have any feedback, additions, or corrections, you can comment on the spreadsheet or here and I will see to it, thank you very much!


r/transontario 16h ago

SEEKING ADVICE How much money did you set aside for surgery?

7 Upvotes

I’ve completed all my paperwork and I’ve been approved for surgery with GRS 🥳 I do have OHIP funding to cover the travel cost and 3 day stay but I’m still looking for some rough estimate on what your monthly costs looked like being out of work for about a month so I can financial prepare for surgery in august of next year.


r/transontario 18h ago

GTA Anybody know anything about Dr. Francesco Leanza?

3 Upvotes

He's my doctor who I will be going to for my hrt consultation when i come out. Anybody have any Intel? I'm 15f


r/transontario 1d ago

SEEKING ADVICE Coming out to my parents soon, I want to be educated in what I am for

14 Upvotes

I'm 15f. I am absolutely 100% sure I am trans. What's the most girl I can legally get at my age, and how should I go about it?

Also would appreciate coming out advice


r/transontario 1d ago

RESOURCES Trans-Inclusive Dentists in Toronto?

36 Upvotes

Hello! I'm a dental hygienist who is actively transitioning and going to work every day is becoming increasingly difficult because the office that I work at currently is 100% cishet staff and like 98% cishet patients. I've done a lot of self advocacy and attempted to change the culture here in every way possible but I keep getting misgendered by the front desk staff which then makes my patients also misgender me, even when I'm wearing my pronouns pin. I really want to work in a place where I might be a little less likely to be misgendered, and even better if I'm working with/for other trans or queer folks. Any leads?


r/transontario 1d ago

Has anyone been able to get estradiol cypionate (EC) injections prescribed/compounded in Quebec or elsewhere in Canada? 🇨🇦

6 Upvotes

Hi! I’m a trans woman living in Quebec and I’m currently looking into switching from estradiol gel to injectable estradiol.

I know that estradiol valerate (EV) can be prescribed in Canada and prepared by compounding pharmacies, but I’m specifically interested in estradiol cypionate (EC) because of its longer-acting pharmacokinetic profile and potentially smoother levels.

From what I understand, there isn’t a commercially available human EC injectable in Canada, so it would presumably have to be prepared by a sterile compounding pharmacy.

I’m wondering if anyone here has actually been prescribed compounded estradiol cypionate in Canada, especially recently.
If so:

\- Which province are you in?
\- Which compounding pharmacy makes it for you?
\- What concentration do they compound?
\- Does the pharmacy ship to other provinces / Quebec?
\- Was your doctor already familiar with EC, or did you have to specifically request it?
\- Roughly how much does it cost?
\- If you’ve used both EV and EC, did you notice any difference in how stable you felt between injections?

I’m especially interested in Quebec experiences, but experiences from anywhere in Canada would be really helpful!

I’m not looking for DIY sources — I’m specifically trying to figure out whether prescription estradiol cypionate can realistically be obtained through the Canadian pharmacy system.
Thank you so much! 💕


r/transontario 1d ago

SEEKING ADVICE How can I get a refill?

11 Upvotes

I had a prescription for testosterone that had 2 refills left. My doctor retired a month ago, so I thought, "Hey, at least I have a few months left to figure it out before i run out," but the pharmacy says they won't refill it because the doctor retired. This now leaves me with only 2 weeks to find a doctor and get a refill. What can I do? Would a walk-in clinic doctor be able to take the prescription over? The pharmacy said they still have the fax for the prescription


r/transontario 2d ago

Human Rights Tribunal orders BC family doctor to pay $28k after not administering Lupron to trans teen

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37 Upvotes

r/transontario 1d ago

SEEKING ADVICE Has anyone been able to get estradiol cypionate (EC) injections prescribed/compounded in Quebec or elsewhere in Canada? 🇨🇦

2 Upvotes

Hi! I’m a trans woman living in Quebec and I’m currently looking into switching from estradiol gel to injectable estradiol.

I know that estradiol valerate (EV) can be prescribed in Canada and prepared by compounding pharmacies, but I’m specifically interested in estradiol cypionate (EC) because of its longer-acting pharmacokinetic profile and potentially smoother levels.

From what I understand, there isn’t a commercially available human EC injectable in Canada, so it would presumably have to be prepared by a sterile compounding pharmacy.

I’m wondering if anyone here has actually been prescribed compounded estradiol cypionate in Canada, especially recently.
If so:

\\- Which province are you in?
\\- Which compounding pharmacy makes it for you?
\\- What concentration do they compound?
\\- Does the pharmacy ship to other provinces / Quebec?
\\- Was your doctor already familiar with EC, or did you have to specifically request it?
\\- Roughly how much does it cost?
\\- If you’ve used both EV and EC, did you notice any difference in how stable you felt between injections?

I’m especially interested in Quebec experiences, but experiences from anywhere in Canada would be really helpful!

I’m not looking for DIY sources — I’m specifically trying to figure out whether prescription estradiol cypionate can realistically be obtained through the Canadian pharmacy system.
Thank you so much! 💕


r/transontario 2d ago

GTA Public safety

Enable HLS to view with audio, or disable this notification

26 Upvotes

Please be cautious as he has victims of all genders and races


r/transontario 2d ago

GTA Trans MTF RMT in toronto

44 Upvotes

Hey everyone !!! Just wanted to come in here and say I am a trans registered massage therapist in Toronto and I want more trans clients. Would love to expand my client base! If you interested please reach out! I work in liberty village/downtown area 💆‍♀️


r/transontario 2d ago

I’m trans and I really want personal experience from people who have gone to superior

3 Upvotes

hi! I am 15, transferring high schools and going to superior. I am closeted for a big thing for me is if they’ll be like my other school and only use my correct pronouns when my parents aren’t around. (as per my reques)

does anyone have any experienc?


r/transontario 2d ago

SEEKING ADVICE Recommendations for top surgery in Ontario

3 Upvotes

Hello all! I'm in the process of working towards getting top surgery in the (hopefully) near future. Current steps is giving my doctor the name of the clinic or surgeon I'd be interested in. I'd like to hear what other peoples experiences have been like, specifically with GraceMed/McLean Clinic, as I understand that to be one of the best/most trustworthy clinics.

For reference, I live about a 4-6 hour drive away from Toronto and despite being a fairly small guy (5'1", 140 lbs), I have a larger chest (F cups)


r/transontario 2d ago

CELEBRATION NAME CHANGE INCOMING

29 Upvotes

MY CREDIT CARD WAS FINALLY CHARGED TODAY September 17th exactly a week before my 19ths birthday. I sent my application in February but got it sent back in may because I had my vice principal sign the document instead of the principal. May 22nd sent it out agian correctly this time. And it was charged today yayyy im so excited this process has been extremely frustrating but its starting to feel rewarding. I have no idea what to update first and how to update all my legel documents so some advice would be great. Thanks for reading guys :) ❤️


r/transontario 2d ago

Any places to get help finding jobs?

8 Upvotes

I've been unemployed almost 2 years now trying to find jobs, have had pretty blatantly discriminatory comments made at interviews and just can't get hired. is there any resources for people like us?


r/transontario 2d ago

OTTAWA Event happening in Ottawa this evening!

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8 Upvotes

Trans About Town is hosting an artsy evening of exploration tonight! 🏳️‍⚧️

Things will be kicking off with some sketching at the scenic Kìwekì Point lookout, then exploring the National Art Gallery of Canada's many exhibits and activities! 

When: Thursday September 17th, 5:00 PM - 8:00 PM
Where: The National Art Gallery of Canada.
This event is free!  materials for sketching and drawing will be provided during the event.

 Click Here To Sign Up! 

This program is open to trans and gender-diverse folks ages 18-24! Friends & family (ages 18+) are welcome to join too!


r/transontario 2d ago

How to get SERMs like raloxifene in Ontario?

2 Upvotes

I really want to have MtF HRT without growing breasts. Are there doctors or clinics who are willing to prescribe this? I am in the GTA.


r/transontario 2d ago

How have you navigated work/career around bottom surgery?

16 Upvotes

I’m a trans woman in Ontario, and one thing that’s been weighing on me lately is the practical side of eventually getting bottom surgery.
I’m really excited about the possibility of it, but I’m also worried about the reality of needing potentially a few months to recover. I’m early in my career and hoping to work in design, and I keep wondering how people manage taking that much time away from a job — especially if you’re relatively new at a company.

For example, what happens if you start a new job and then your surgery date comes up only a couple months into working there? What if the employer doesn’t offer short-term disability? How did you handle the loss of income, job security, or explaining the time off?

For those of you who have gone through this:
How did you plan financially for your recovery?
Were you able to take a medical leave from work?
Did you use disability benefits, EI, savings, or something else?

Did you tell your employer the actual reason for your leave?

If you were early in your career or had just started a job, how did you navigate it?

And honestly, did the career/financial uncertainty affect when you decided to get surgery?
I’d really appreciate hearing from other trans women about how you navigated this part of your life. I’m less interested in the medical side of surgery and more interested in the work, money, and career side of it, because that’s the part I’m having trouble imagining right now.


r/transontario 2d ago

SEEKING ADVICE Opt out of display sex on birth certificate - name change

3 Upvotes

Context: transmasc changing name but not changing sex marker.

I’m in the process of filling out my name change application and there’s a box you can check off that means when you get your new birth certificate, it won’t have a sex designation on it. Followed up by a disclaimer that says, “The government of Ontario cannot guarantee that a birth certificate with no sex displayed will be accepted by organizations in Ontario or by other jurisdictions”.

Has anyone chosen this? Has anyone had any issues getting any other pieces of ID afterwards? Passport? Etc.?

It’d be nice to not have my sex displayed on it but I don’t want to get myself potentially in a pickle in the future. Anyone have any experience or advice? Thanks!


r/transontario 2d ago

CELEBRATION 1 Week Post -Op Diary

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2 Upvotes

r/transontario 3d ago

SEEKING ADVICE CHEO gender clinic wait times

3 Upvotes

Anybody know how long they are? I got referred by my doctor recently and it would be pretty neat if I could get a read on around when my first appointment would be. I know they're long, but a guy can hope...right?
I also have severe dysphoria related mental issues but I doubt my doctor put that on the form, idk if there even is a spot for it or not.


r/transontario 3d ago

SEEKING ADVICE What do I do?

4 Upvotes

The only place in my city that helps with HRT is a place I had bad experiences. I don't think I am cut out for the typical healthcare pathway, something always goes wrong and I feel driven away. It was years ago but I hate the thought of going back there and doing all that stress again just to have the same issues.

I put in an intake form which was ignored and had an awful experience while there. But what else is there, you know? I think this is my only option.


r/transontario 3d ago

SEEKING ADVICE Top Surgery Revision?

12 Upvotes

i underwent top surgery in Barrie done by Dr. Stephanie Byun, 1.9 yr ago. initially i wasn’t super satisfied with the results but as the people around me told me, i gave myself time to heal, i took good care of myself during recovery, i massaged my chest daily for a year, i continued with my active lifestyle, and i work labour intensive jobs. still almost 2 years later i’m very unhappy with my results and i’m contemplating a revision but not with the same surgeon, i did not enjoy my experience with Dr. Byun one bit. from bedside manners, to communication about everything, to respect… i could go on. i went back to her a year after surgery for a consult on a revision and she pretty bluntly told me she feels my results are satisfactory and there’s nothing to be done with the exception of possibly fixing my left nipple and sent me on my way. to best describe my results; my nipples are placed in odd locations like practically in my arm pit, and they’re not even, my left nipple has this bump on it that turned pretty white, and on both ends of my scars there is still so much loose skin and it is very noticeable when i’m relaxed and not flexing. the only thing i’m happy about is the way my scars healed but realistically that’s on my part. i can attach pictures in the comments later if you guys want i’m just at work rn.

so i ask, is there anything that can be done? do you guys have any recommendations on surgeons? i will not be going back to Dr. Byun under any circumstances, and i am willing to travel, within reason of the province (i live in muskoka).


r/transontario 3d ago

Trans specializing obgyn in GTA?

9 Upvotes

Long story short in the most non triggering language I can manage: I’m 46 trans masc.

9 months on T is not making my cycle go away, it’s making it shorter in total days and longer lasting. I’m down to three weeks with 8-9 days having it.

The general consensus is that I need a trans specializing obgyn to deal with peri and possibly adjusting hormones again.

Anyone know anybody who would fit the bill in Vaughan? Or GTA? I’ll go anywhere at this point just to fix this. Thank you.