Fraser Place says gender confirmation surgery will finally allow her to feel comfortable in her body. But the 26-year-old Montrealer says that feeling of comfort feels far away.
Recently, GrS Montreal, the only clinic in Quebec offering fully subsidized gender confirmation surgeries, announced that a change in provincial funding would delay wait times — possibly by years.
This news outlet felt that his future was in question.
“It’s very complicated,” he said in a recent interview, “knowing that it will probably extend into the rest of my 20s and even into my early 30s.”
What’s more frustrating for space and transgender advocates, however, is that the delay only affects Quebecers. Wait times for out-of-province patients — about 65 percent of the private clinic’s clientele — have remained largely the same and, in some cases, shortened.
Jacob Franklin, co-director of the Transpaint Alliance, said people should be outraged about the situation, an advocacy group for transgender and non-binary patients.
“A clinic in our own city, in our own province, is able to better serve non-Quebecers because their funding systems are adequate,” he said in a recent interview.
GrS Montreal offers a lifeline to transgender people in Quebec and the rest of Canada, especially in the Atlantic region, where many clinics lack the capacity to perform complex procedures. New Brunswick, for example, has many patients seeking surgery following GrS.
Recently, the clinic announced that funding cuts from the Quebec Department of Health will force it to perform fewer surgeries and shorten wait times — but only for Quebec residents, a decision that leaves patients with little choice but to wait or pay out-of-pocket for procedures that can cost up to $100,000.
About 35 percent of the clinic’s patients are Quebecers, about 40 percent are Ontarians, 13 percent are from the Maritimes, 11 percent are from Western Canada, and about one percent are from outside the country.
GrS has the potential to “double or even triple” the number of surgeries it performs annually for Quebecers, but the province has tight caps on its budget for the clinic, says GrS owner and medical director Michel Gagner. Every year, when the budget for Quebecers runs out, the clinic continues to offer surgery to people elsewhere in Canada, which is funded by their provincial health care plans.
This limitation, combined with high demand, contributes to long wait times [for Quebecers]he said.
GrS Montreal’s website says it performs approximately 1,600 surgeries each year. Gagner did not want to give exact figures.
Quebec’s budget should be doubled, clinic owner says
In the 2024-25 fiscal year, the wait time for breast removal surgery, known as a mastectomy, was 18 months for Quebec residents. It’s been at least two years now. The waiting time for out-of-province patients in 2024-25 was 13 months. It’s been six months now.
The delay in 2024-25 for a female genital reconstruction procedure — known as a vaginoplasty — was about 20 months for Quebecers, and now it’s 34 months. The wait time for this procedure was the same for out-of-province residents in 2024-25, but is now 18 months – almost twice as short.
The latest estimates for Quebecers indicate a three-year wait for surgery to remove the testicles, called an orchiectomy, and a three-year wait for masculinization of the testicles using existing genital tissue, called medioplasty.
“Those two, three-year wait times are really devastating for trans patients,” Franklin said. “We’ve had people reach out to us in crisis about the news.”
Gagner, for his part, said the clinic “received many messages expressing concern, sadness and distress.”
When Place heard the news, he said, “It felt like my world was coming to an end.”
Place, originally from Ottawa, is awaiting a phalloplasty, a procedure the clinic says creates a penis “functionally and aesthetically similar to biological male genitalia.” For phalloplasty, the clinic said it could not provide a clear timeline, noting that the process depends on individual factors, including lasering the hair from the patient’s face for skin grafting.
Place submitted her paperwork for surgery more than a year ago and is scheduled to see a surgeon in April. And while he doesn’t have a surgery date yet, he knows it will take longer than he anticipated.
More than 1,200 Quebec patients were waiting for surgery at the clinic by the end of 2025, Gagner said, adding that the clinic has seen a significant increase in demand in the past few years. If the province doesn’t increase its budget for the clinic next fiscal year, Gagner said, it will continue to fall behind. He warned that the wait time for a vaginoplasty could reach four years and three years for a mastectomy.
Quebec, meanwhile, insists it has not cut GrS’s budget. Funding for the 2024-25 fiscal year was “exceptionally high” at $9 million, Marie-Pierre Blair, a health department spokeswoman, said in an email. That year’s budget was increased to “continue the planned surgical schedule.”
But that envelope has been reduced to $7.3 million for 2025-26, she confirmed. It was “always clear” that the increase in 2024-25 was a one-time amount, adding that provincial funding to the clinic had tripled since 2018-19. Financial resources are limited and difficult choices must be made, the spokesman said. Funding in the 2023-2024 budget was $8 million.
Gagner says provincial funding will need to double to $14 million to $15 million to meet the demand to reset wait times and adequately meet the needs of the population.
For many transgender patients in their 20s and 30s, paying out of pocket can be prohibitive, Franklin said, adding that they need to stop other major projects to pay for health care.
“You borrow, you don’t save. You don’t save for a house or get married. You don’t do those important and expensive things.”
An agreement between the Université de Montréal Hospital Centre, the Quebec Department of Health, and GrS Montréal gives the private clinic exclusive responsibility for public funding of gender confirmation surgeries in the province until 2028.
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