FROM: Ayn Wilcox, Executive Director – Klinic & Lee Heinrichs, Lead – Provincial Clinical Integration, Shared Health

On July 7, 2024, Manitoba Health, Seniors and Active Living announced important changes to how patients can access Gender Affirming Care in Manitoba. Province of Manitoba | News Releases | Manitoba Government Improving Access to Gender-Affirming Care Below are the key updates relevant to your practice. Please review them carefully.

Referral Process for Gender Affirming Procedures:

Referrals for hair removal, chest masculinization, breast augmentation, hysterectomy/oophorectomy and orchiectomy: Patients aged 18 and older no longer require two assessments from approved providers for referral for these procedures. Primary Care Providers (MD or NP) can now directly refer patients for these procedures. Providers can still refer to Klinic Community Health Centre (or an Approved Adult Transgender and Gender Diverse Health Care Provider outside of Klinic) if they do not feel they have the necessary knowledge base to initiate these referrals, or if a psychological assessment is deemed to be beneficial.

It will be important to confirm in the referral letter to the surgeon/dermatologist the diagnosis of Gender Dysphoria/Gender Incongruence, and how the individual meets the WPATH (World Professional Association of Transgender Health, Standards of Care vs 8) criteria for referral for the gender affirming procedure requested.

Referrals for Genital Reconstructive Surgeries and Facial Feminization: Referrals for these procedures now require only one letter of referral/recommendation by an approved Adult Transgender and Gender Diverse Health Care Provider. Referrals can be sent to Klinic Community Health Centre for assessment (or an Approved Adult Transgender and Gender Diverse Health Care Provider outside of Klinic).

Referrals for legal minors

Patients Aged 16-17: For individuals aged 16-17, referrals to Klinic are still required, and they must receive approval from providers on Klinic’s approved list.

Patients Aged 15 and Under: For patients aged 15 and under, referrals should be directed to the Gender Diversity and Affirming Action for Youth (GDAAY) program. For more information, please visit GDAAY – Shared Health

Provider Training and Support

In the coming months, Klinic will offer regular comprehensive training sessions for providers to ensure inclusive care for patients seeking Gender Affirming Care. Additionally, monthly Zoom-based community of practice sessions will be available to support providers in delivering safer and more inclusive care. Training dates and details will be shared through various channels.

For further guidance, please refer to the World Professional Association for Transgender Health Version 8 guidelines.

To become an Approved Adult Transgender and Gender Diverse Health Care Provider, please contact the Coordinator of the Klinic Trans Health program. Please visit, Health Care Providers – Trans Health Klinic – Klinic Community Health

Submitted by: Tamara Burnham, Collaborative Practice Lead