Advocates say P.E.I. near top in Canada for gender-affirming care, but better aftercare needed
'Once you receive services, it can be really hard to get proper aftercare'
At a time when large provinces such as Ontario and Alberta are not covering key procedures and therapies, advocates say Prince Edward Island has some of the best access to gender-affirming care in Canada.
"On P.E.I., we should actually be really proud," said Anastasia Preston, the trans community outreach co-ordinator at PEERS Alliance.
"On policy, we have the best health care in the country outside of the Yukon. So out of all the provinces, we have the best health care, which I think is a huge boon for P.E.I."
Health P.E.I. has worked closely with the trans community on the Island to improve access to care, Preston said.
"Where we run into problems often with gender-affirming care is aftercare," she said. "Once you receive services, it can be really hard to get proper aftercare."
Gender-affirming health care — an approach that affirms a trans person's gender identity instead of trying to change it — is endorsed by medical associations in Canada and around the world, including the Canadian Psychological Association and the Canadian Pediatric Society.
Affirming care ranges from social and psychological support, like using someone's chosen pronouns, to transition-related medical treatments, from puberty blockers and hormones to gender-affirming surgeries.
Provincial regulations
While P.E.I. and the Yukon are improving Canadians' access to gender-affirming care, other jurisdictions are limiting it.
In 2024, Alberta politicians passed Bill 26, which restricts anyone under the age of 16 from accessing gender-affirming health-care services, including hormone therapy.
Legislation like Bill 26 can have a negative effect on trans people, particularly trans youth, said John McIntyre, a lawyer and co-founder of McIntyre-Szabo, a boutique health law firm in Toronto.
"That would have a significant impact on their future and potential gender dysphoria in the future, and so it's stopping them from being able to make those decisions for themselves," McIntyre said.
Other jurisdictions, such as Ontario, typically don't help cover procedures like facial surgeries, meant to align the appearance of the face with a person's gender.
McIntrye said those kinds of surgeries have a significant impact on gender dysphoria since they affect how people present themselves on a day-to-day basis.
The path forward for P.E.I.
Over the years, P.E.I. has expanded its gender-affirming care policy to include coverage for things like hormone therapy and expanded surgical services, said Candice Rochford, a Charlottetown nurse practitioner who works in primary care.
The province also offers coverage for non-surgical services and procedures — including hair removal, hair replacement and access to speech and language pathology services — through the public system.
"Gender-affirming care isn't cosmetic. It is medically necessary," Rochford said.
"A person's decision or method to transition is really individualized… People don't always require medical transition or surgical transition, but things like facial appearance [and] voice can impact someone greatly."
When it comes to the kind of aftercare support available in the province, Health P.E.I. said the gender-affirming clinic provides some follow-up care after surgeries.
Typically the clinic discharges patients to a primary-care provider, but if patients don't have a doctor or nurse practitioner, the clinic will oversee their care until they recover.
While the trans community is happy P.E.I. has solid access to care, advocates like Preston say there is a need for more support following procedures and more education for health-care practitioners.
"I think that the P.E.I. health department is doing great work on this and that there's more work that we can do by listening to community and their needs."
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With files from Tony Davis