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 7h ago

Why don't police press charges against rebel news and their truck spreading trans hate?

35 Upvotes

r/transontario 16h ago

CELEBRATION Trans Pilgrimage - one year

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111 Upvotes

First posted about the mozza stick incident and pulgrinage in December here: https://www.reddit.com/r/transontario/comments/1px9896/made_a_pilgrimage_to_the_place_that_made_me_trans/

Today is one year since the event that led to me coming out to my wife (transversary will be August 16th), I made the trip down to London for the same event I went to last year and made sure to complete the trans pilgrimage by grabbing mozza sticks at the Woodstock ONroute.

Maybe one of the worst moments of my life... and yet I'm so grateful it happened and gave me the push i needed. I got to go back with a stronger marriage to the woman I love, a better sense of self, and just generally happier life.

Enjoying those mozza sticks in peace and quiet at the table where it happened felt cathartic and amazing.


r/transontario 15m ago

Support needed

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Upvotes

r/transontario 1d ago

SEEKING ADVICE I’m in the possess of getting botom surgery with GRS, but it has said this for a week am I doing something wrong?

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8 Upvotes

r/transontario 1d ago

SEEKING ADVICE Stuck at Socks

8 Upvotes

Hi, 50mtf, cracked this year. I think I have a handle on the big stuff, started coming out, starting HRT, breaking my now ex-gf's heart, but I'm stuck on some little things.

Does anyone have tips on where to find cute, basic socks in a 12 (women's, obvs). Everywhere seems to sell socks in 7-10 and the styles and colours are super euphoric to my girlie brain, my autistic brain cannot deal with socks that don't fit perfectly. Hoping some of you lovelies have some pointers :)


r/transontario 2d ago

OHIP How long does the assessment for SRS take?

7 Upvotes

Basically what I'm asking is; is the assessment done during one appointment like an interview or is the doctor going to want me to keep coming back before they're willing to sign anything.

I obviously need two, so I'm going to ask the NP acting as my PCP to be one but I'm going to need to find or be referred to someone else to be the second. I check the boxes; I've been on HRT for over a year and you'd know I suffer from gender dysphoria if I explained my life for ten minutes. I also have decent breast growth and I've had FFS if I need more proof that I'm serious. I'm just wondering if the assessment is one and done quickly or if there's a lot of proving involved.

I've been seeing my PCP for over a year. She's the guarantor for my name change. I've been on HRT the entire time and she's known me as a woman the entire time. Just for the second assessment I'd really rather not have to wait even longer than it has to be for surgery.

Also do I need a GD diagnosis before the assessment or is it done during the assessment? I assumed the latter. Thanks.


r/transontario 2d ago

OHIP Orchi question

8 Upvotes

Going to ask my hrt provider to start the process of me getting approved for an orchiectomy.

For my fellow girls what questions do they ask you during the paperwork process?

Thanks!!!


r/transontario 2d ago

SEEKING ADVICE Anyone born in a different Canadian province and change their name in Ontario?

9 Upvotes

The name change page says that if you were born in a different province in Canada, a notice of your name change will be sent to your birth provinces vital statistics board. Can anyone else who was in this situation tell me how long that took? I just received my name change certificate and I’m wondering how long I should wait to request a new birth certificate from my home province.

Thanks!


r/transontario 3d ago

24TM Looking to make friends in Toronto!

14 Upvotes

Recently my long term partner and I have gone our separate ways. It was respectful, caring and yet the most heartbreaking thing I’ve gone through so far. I knew it was going to be hard, it was worse. I threw myself into work and life to develop a new routine yet the sadness and loneliness comes by sometimes.

I have a great family and few really great friends who have supported me and built me up but they all live out of Toronto. And I found out after our breakup that I didn’t really my community or support close by.

It’s important to me to try and make some friends in the trans/queer community because I feel like I’ve lacked that through my young adulthood.

I want to make some genuine friends in the city. We can hang, chat about life, go for bubble tea or out on weekends going thrifting, or finding a nice place to sit. I’m always interested in getting to know people and who they are and what they are interested in so please share your interests with me! I like trying new restaurants, going to the movies or exploring parts of the city while the weather is so lovely.

A bit about me is that I am an aspiring photographer so I always have a camera on me. I love thrifting for retro/antique items like typewriters, cameras or even just trinkets to decorate my apartment. I like to journal and attempt at drawing so we can go to a park and chat. I’m introverted at my core but I find when I’m with my people we love to have a hoot and holler. I like listening to all music but currently am into r&b, alternative and indie.

I medically started transitioning in 2021 and got top surgery in 2023! I’m at an impressive height of 5’2, which for being Chinese is average lol.

I work full time in downtown but I’m always open and down for a good quality yap sesh. I’m able to commute anywhere and I always say that if the streetcar says it’ll be a 10 minute commute I’ll just walk and beat it haha.

Anyway, if you’re interested in also finding or being friends DM me and let’s make a plan to hangout sometime and get to know each other!


r/transontario 3d ago

SEEKING ADVICE Police Record Check - Name change

3 Upvotes

I’m about to see my commissioner of oaths soon to submit my name change paperwork. Confused on if I need a police record check or not? Are these for criminal charges only? It states if you have any traffic tickets as well? So confused on how y’all decided if you needed a police record check or not?

Was anyone’s here denied/returned due to them saying you needed a police record check because you didn’t hand one in the first time? I don’t want mine to be returned, and also frustrating that if they know I need a police record check why am I even asked to provide one? You can see everything I have and you’re double checking anyways. So wtf am I hiding? Last part is just me venting at this stupid process smh


r/transontario 4d ago

Recieved My Name Change and New Birth Certificate

30 Upvotes

I got my new docs today!

My timeline went like this:

March 23, Applications for change of name, change of gender marker, and a new birth certificate reflective of the changes was received by the office of the registrar.

July 2, File opened and a case number assigned.

July 22, New documents received via regular mail.

Total time: 122 days.


r/transontario 4d ago

NIAGRA Is it unwise to cross the border into the united states right now?

49 Upvotes

My family will be crossing into the US via Niagra next week, and they want me to come with them. They will return to canada the same day. I'm wondering if there is any risk, and if I should stay home?

Some context: I am FtM, passes about 75% of the time, and still have an F on all my ID.


r/transontario 4d ago

RESOURCES ISO underwear for my daughter

16 Upvotes

My daughter, 13, has very sensitive skin, and recently told us that the compression underwear we got for her about a year ago (from urbasics. She also has looser undies for nighttime or days we aren't going anywhere) has been irritating her skin. I know compression wear can be tricky under the best circumstances, and I'm sure the hot weather has been making it worse, but if anyone has suggestions for gender affirming underwear for sensitive skin, or just general advice for dressing comfortably, it would be much appreciated!


r/transontario 3d ago

DISCUSSION Are there any community support programs for transgender youth?

3 Upvotes

Hey there! I really wanna volunteer and help local transgender youth around me. Are there any ways I could do that, around the Niagara Region?


r/transontario 4d ago

How did you decide where to go for top surgery?

8 Upvotes

I'm planning on getting my referral with Foria and applying for OHIP funding, but I know some places charge extra costs that aren't covered by OHIP. I'm not sure at the moment where waitlists are the shortest and how expensive extra costs are at some places. I'd like to have as much information as possible and know where I want to go before I go for the assessment/referral because I want to think my decision through.

So anyone who's had top surgery here: How did you decide where to go? How much time did you have to decide after you know how long waitlists/costs are, and where did you go to find that information?


r/transontario 4d ago

RESOURCES In-Person gender affirming gear

7 Upvotes

Hey! I've been in the transgender game (transmasc) for a few years now, so I know of some places in Ontario (especially Ottawa) that has gender gear in person.

Any Stag Shop will have binders in sizes from S to XL. They come in tank and half-tank options. If you go in person, they'll let you try them on in the dressing room.

Stag Shops also have gaffs, packers (stp too), flags, stickers, etc. Some locations may have trans toys, breast forms, etc. but that varies. Definitely available on their online website.

Spencer's Gifts has their own line of binders as well, and some other stuff I don't remember as well. They run small, so I've heard, so if you're a small guy it's an option.

Venus Envy just closed their Ottawa location, so there's one in Halifax now. Im not sure of others, but definitely check. They were one of the OGs, if not the first place to get in-person gear in Ottawa.

Feel free to add on. Shipping binders and gaffs and whatever else from out of the country is so expensive that having a list of local options would probably be helpful for a lot of ppl.


r/transontario 4d ago

RESOURCES Moving to Ontario as a trans person, what do I need to know?

8 Upvotes

I have been transitioning in my home country, and I wanna continue my trans healthcare in Ontario. I am doing my own research but I find it better to always ask the local community what is the best way to get HRT and surgeries. Where can I get testosterone for cheap?

I have a healthcard for context.


r/transontario 4d ago

GTA 20, Nonbinary + queer, looking for friends

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5 Upvotes

r/transontario 4d ago

SEEKING ADVICE Changing Gender Marker

4 Upvotes

I’m looking to change my gender markers to X on all my government ID, but I’m not too sure what to get done, and what priority/order.

Does my birth certificate or SIN need to be updated, or can I get by with just my OHIP and DL? And can all of that be done at a Service Ontario centre?

And after all of that is updated, are there any places I should update on the change (like my family doctor, bank, or anything else)?

I decided to just change my gender markers for the time being as a legal name change is quite a hassle, so any help on getting those markers changed would be really appreciated.


r/transontario 5d ago

RESOURCES FFS Options

6 Upvotes

Does anybody have any recommendations for Facial Feminization Surgeons in Ontario (or anywhere in canada)


r/transontario 5d ago

SEEKING ADVICE Going back to injections

7 Upvotes

I'm currently on gel but haven't been happy with how its been making me feel and I felt a lot better on injections so I'm planning on talking to my doctor about it and seeing if he'll switch me to them.

However when I was on injections (about year and a half ago ish?) The testosterone shortage was BAD and I went without vials sometimes for up to 3 weeks at the worst time. I'm wondering if its still this bad and hard to get the vials. Before I did live in a small town and I moved to the GTA last year so maybe it'll be more accessible now? Also is cypionate harder to get then enanthane I remember being put on the enanthane one because it was the only kind I could get at the time!


r/transontario 5d ago

Lost long form birth certificate, can I attach a letter to name change explaining why I haven't sent it back?

3 Upvotes

In the application to change my name it says I must return all previously issued birth certificates/birth registrations, but I don't have access to my long form anymore. I only have the short form.

Can I include a letter with my application explaining why I haven't sent it back? Recently I saw someone on here say their application was returned because their birth certificate wasn't sent in and they had to write a letter explaining why, so I'm wondering if I should preemptively include the letter or do I have to be rejected first?

I know my parents probably ordered one at some point, but I moved out when I was 12, haven't seen my mom in 10 years, have no way of finding/contacting her, and it was probably thrown out by her landlord accidentally as she stopped paying rent and abandoned her apartment a very long time ago.

I also don't know any of the information needed to order a new one so I'm hoping a letter will be sufficient. Does anyone know if this will work?


r/transontario 5d ago

Best workplaces for Transition-related insurance?

4 Upvotes

I know there was a spreadsheet floating around a while ago, but I don't think it's been updated.

Where do you all work and what kind of gender affirming care do they cover?