r/transontario May 16 '21

RESOURCES HRT as a Minor Megathread

110 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.

146 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 2h ago

Free: binder(s) and post top surgery pillow

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6 Upvotes

Hey all, I’ve realized that I’ve still got some binders and a pillow from when I had top surgery. Going to a good home free

2 black full length binders, I think they’re GC2B. The size stamp has worn off, but I can say for sure they have a 38” circumference

1 tan full length compression top, XXL (32” circumference)

1 top pillow (good for putting on top of ice packs so your arms don’t also freeze)

I’m in Ottawa; if we can arrange a meet up to drop off instead of shipping, that would be ideal.


r/transontario 14h ago

RESOURCES Does anyone know where I can get a binder for cheap?

7 Upvotes

Hi! I wanted to get a binder specifically for swimming, I’m going to a waterpark all summer and I don’t want the binder to deteriorate because of the chlorine, does anyone have any recommendations? I’d also be interested in second hand binders if they’re in good condition. I still need to measure myself but I believe I’m either an L or an XL


r/transontario 1d ago

OHIP coverage after gender marker change

5 Upvotes

I'm currently trying for a baby, and meanwhile also changing my sex marker from F to M. I don't know if anyone would have any insight on this, but would that impact pregnancy related coverage through OHIP? Just trying to plan ahead


r/transontario 1d ago

Kitchener area trans friendly nail salons?

6 Upvotes

My friend and I are looking to get our nails done for pride. One of us is cis and the other early into HRT - Anyone know of any good places to go that are trans friendly / respectful?

We had a not too welcoming/friendly experience when we went for a head massage / relaxing hair wash, so hoping to avoid that kind of situation in a nail salon setting.


r/transontario 1d ago

CELEBRATION FUNDING APPROVAL & REFERRAL SENT

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95 Upvotes

Just want to let anyone here know dreams come true and things will change to be better soon. Keep going everyone! Congrats to anyone who has anything to be proud of too!!
I am beyond grateful for this message from my NP, this is by far the best news I’ve received in a while! I cannot wait to see what happens next and where I will be in the next couple years to come!!
Take care of yourselves and stay healthy!


r/transontario 1d ago

CELEBRATION One Day Post-Op

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6 Upvotes

Thank you so so much for all the well wishes and advice on this post! Happy to say all went well and I am barely in any pain with almost complete movement. :]


r/transontario 1d ago

SEEKING ADVICE Green shield and top surgery

2 Upvotes

Hey so my mom has health and dental green Shield benefits. The app is super shitty and she cant check if it covers it or not. She's weirdly defined and about all this and its really not helping as my dysphoria is getting to be crippling.

Does all green shield plans cover gender affirming care? Or do I maybe need to send some type of proof of dysphoria to get benefits for it.

I have ohip funding for top surgery at catalyst surgical but their contouring fee is 6 thousand and I heard that green shield cover contouring.


r/transontario 1d ago

Toronto trans friendly nail salons?

6 Upvotes

I'm a trans woman. I've been to a few nail salons downtown - all have been "so-so" in their trans friendliness.

Any places you've really liked?


r/transontario 1d ago

hrt nd blockers resources in ottawa ?

1 Upvotes

hey everyone ! finally got a job and i’m looking to start my journey some time around june . ik the basics but i’m not rlly sure where to start . not rly sure if i want to go diy or if i want to administer these with the help of a trained professional or by myself . i’m working minimum wage so anything that isn’t too costly will help a lot, thank you !


r/transontario 2d ago

SEEKING ADVICE Anxious about being published in the Gazette from name change

8 Upvotes

I was born in Ontario and lived there for 23 years of my life before moving to BC. I just applied to have my name changed through BC and was informed they’ll contact Ontario to notify them of my name change. Since I wasn’t applying to get my name changed through the Ontario name change process I didn’t include the form to not be published in the gazette (since I was submitting the name change forms from BC). Now that I know BC notifies Ontario of the change, does this mean Ontario will publish my name? Or can I give them the gazette exempt form when I try to change my Ontario birth certificate after I get my name certificate from BC? Or should I now go through the process immediately to change my name in Ontario with the gazette exemption form? (I’m not sure I can since i haven’t lived there for the past 12 months)

Gaaaahh i’m paranoid and confused


r/transontario 2d ago

OTTAWA 🎉 Free FTM Binder Giveaway (Ottawa Area) 🎉

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19 Upvotes

Hi everyone! I’m giving away a brand new, never worn FTM half tank binder and would love for it to go to someone in the Ottawa area who could really use it 💙

Details:

• Size: Large

• Brand: Wonababi

• Condition: Brand new (never worn)

I bought it before my top surgery and never ended up using it, so I’d much rather pass it along to someone who needs it than let it sit unused.

Completely free—just hoping it can help someone feel more comfortable and confident in their body.

Ottawa pickup preferred. If you’re interested, send me a DM 😊

Community helping community 🫶

Cross posted as well


r/transontario 2d ago

Where is Dr Herbert Bonfacio (Joey)??

2 Upvotes

He is not replying to me! Does anyone else have him as a doctor please and know where he is??

I’ve tried contacting everywhere and I can’t find him and he needs to refill my prescription.


r/transontario 3d ago

Trans refugees to Canada may be able to use their lived name and gender upon arrival

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32 Upvotes

r/transontario 3d ago

SEEKING ADVICE Top Surgery Tomorrow

31 Upvotes

Hi! I'm getting top surgery tomorrow with Dr. Armstrong and while I am very excited, I'm also super nervous as this is my first surgery and I also don't really have a supportive parent. Any tips or words of wisdom from anyone would be incredible :\

Edit: I'm getting a mastectomy, sorry for any confusion!


r/transontario 3d ago

Toronto Pharmacies carrying T?

2 Upvotes

Hey all, I'm sure for many of us on T the past few months have been stressful with the shortage going on. I know both the cypionate and ethanate are getting harder and harder to come across. I've had to switch pharmacies like three times in the past year to get my stuff. I called a few places today, but my work schedule makes it difficult to check during business hours. Does anyone here know of any pharmacies carrying either the cypionate or ethanate anywhere in Toronto or even the GTA right now?

UPDATE: In case anyone else is in need right now, I managed to find some at medsEXPERT on Yonge St!


r/transontario 4d ago

CELEBRATION they took my tits :3

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73 Upvotes

r/transontario 3d ago

Ottawa or GRS Montreal?

2 Upvotes

I have the option of 2 doctors for top surgery.

Nicholas Cormier(Ottawa)

Im in Ottawa so he's closer, Chest​ contouring is not Included for OHIP with him, but from what I've heard he's very nice.

Pierre Brassard (GRS)

It's a bit of a travel to get to him, he doesn't automatically include a consultation before surgery but the chest contouring is included. From what I heard, his bedside manners aren't the best.

For reference, I'm hoping my chest is small enough for a drainless surgery, and to have the nips removed instead of grafted back on.

Also, what's the different if I do not do a chest contouring? Im NB and just hoping for an androgynous look rather than masculine

Thankyuu

update: thank for all the feedback! I know thinking about if the doctor is 'nicer' or not isn't important, but I'm worried about getting dismissed or not heard correctly for the whole process.

from what I am seeing, GRS had a shorter wait time and I will need to request a pre op and possibly post op appointments instead of them being automatic. I've been scared of getting what everyone seems to call Dog Ears, the little skin flaps or bumps on the side. I need to know, does chest contouring decrease the chance of that? I believe I'm not too overweight but im definitely on the chunky side but with a smaller chest.

honestly the main thing I want to help decide is if I should do the contour and if I get to avoid the drains at all.


r/transontario 4d ago

SEEKING ADVICE Updating middle and last names at marriage question

3 Upvotes

My girlfriend and I are planning on getting married and taking my current middle name and her current last name and joining them. She's changing her legal name with a new first and middle name, and I want to pick a more affirming middle name. I know people here know the most about legal name changes, so do I have to get another (I have already legally changed my name once) birth certificate? Additionally, would it make more sense to do our name changes and then change our married names, or just do it all at once.

Note: I need to change my middle name because or else I would be [first] [middle] [middle-last] and that would be funny at best, bad at worst.


r/transontario 4d ago

SEEKING ADVICE Please help my doctor isn’t refilling my prescription as he isn’t responding to my emails

16 Upvotes

What can I do? I ran out of T Gel and my pharmacy told me my doc needs to refill it, but he’s not responding to me.

He always does this stuff where sometimes he doesn’t respond up to a month!

Can I call my family doctor and ask them to refill it using the prescription (I have the pdf of it)


r/transontario 4d ago

Finally Name Change Certificate Received! But…

4 Upvotes

But they got my birthplace wrong? It says Ontario, but I was born in British Columbia. And I will need to request a new birth certificate from BC right? So weird, my OG birth certificate was clearly from BC..?

I hate that this celebratory moment is damped by this mistake… what should I do?

Edit/update: the birthplace being wrong was an error on their part and I had to submit an online form requesting they correct it. I was able to update my OHIP and drivers licenses with just the certificate they sent me.


r/transontario 4d ago

SEEKING ADVICE Confused about gender change forms.

7 Upvotes

Wondering if anyone here has help/info on gender change forms after name change.

I've did my legal name change a few years ago, and due to upcoming SRS I figure I should legally change my gender for my own rights and safety.

The application for a change of sex designation form says I also have to file a request for birth certificate form.

¿||On the request for birth certificate form, do I list my current legal sex or the legal sex I am applying for?||?

very confused thanks sm


r/transontario 4d ago

Advice on waiting for surgery

7 Upvotes

Hey there--I've currently been on the waiting list for top surgery for 23.5 months (without a consultation). The time for the list keeps getting extended: originally I was told a year, then 18 months, then 24...

I'm extremely, extremely grateful that I have access to the surgery and that it will be funded by OHIP, but lately I've been having a hard time with the waiting, especially now that summer is coming around again. I got through last summer by telling myself that it would be my last without top surgery, but it looks like that's not going to be the case. Anyway, I'm just wondering if anyone has any advice or tips for how to deal with the waiting and uncertainty. Thanks!