Gender-Affirming Care in Canada

Healthcare in Canada is organized at the provincial level.

Organization

Healthcare in Canada is organized at the provincial level. Each province has its own reimbursement rules and waiting times for transgender healthcare. Major centers are located in Toronto (CAMH), Montreal, and Vancouver.

Guidelines

Canadian clinicians predominantly follow the WPATH Standards of Care Version 8 (2022). There is also a Canadian Pediatric Society position statement on care for young people.

Public debate

Since 2023, provincial debates — including in Alberta, Saskatchewan, and New Brunswick — have focused on age limits, parental consent, and the role of schools in the social transition of minors. A critical voice in this debate is Canadian Gender Report, a group of parents and professionals. In British Columbia, a tribunal fined a doctor who refused to prescribe a puberty blocker on conscientious-objection grounds; an analysis of that ruling is available on trans-nederland.nl.

Conversion therapy ban

Since January 2022, conversion therapy has been a criminal offense throughout Canada. The law prohibits practices intended to change or suppress a person's sexual orientation or gender identity. During consideration of this conversion therapy ban, critics raised concerns about whether exploratory psychotherapy for young people with gender dysphoria could consequently come under pressure; see gender exploratory therapy.

Alberta

Alberta went the furthest. In late 2024, the province passed a law banning puberty blockers and hormones for young people under sixteen and prohibiting surgeries on minors. In 2025, a judge temporarily suspended the law following a case brought by advocacy organizations and several families. The province responded with a new law invoking the notwithstanding clause, a provision in the Canadian Constitution that allows a legislature to shield a law from review under some fundamental rights for five years.

Schools and parents

In Saskatchewan and New Brunswick, the debate focused on schools. In 2023, Saskatchewan established that students under sixteen need parental consent to use a different name or different pronouns at school, also invoking the notwithstanding clause. New Brunswick introduced a similar rule in 2023, which a new government repealed in late 2024. For more on Quebec, see the article on gender-affirming care in Quebec. In that province, the Réseau éducation, sexe et identité network was launched in early 2024, bringing together citizens, parents, and professionals from healthcare and education to share their concerns about gender identity in schools and healthcare.

Research from Canada

Canada also plays a role in scientific research. The CAMH clinic for children and adolescents in Toronto, for a long time one of the best-known in the world, closed in 2015 following criticism of its treatment approach. Researchers at McMaster University, the birthplace of evidence-based medicine, published systematic reviews on puberty blockers and hormones in 2025 and rated the certainty of the evidence as very low. See systematic reviews in gender-affirming care.