Nova Scotia

First N.S. gender-affirming top surgery program now in place with 2 dedicated surgeons

For the first time, Nova Scotia Health has a dedicated gender-affirming top surgery program with specifically trained surgeons who have a mandate to provide the care. Two surgeons have been recruited for the program in the last two years.

First surgeon recruited in 2023, followed by another in September

Nova Scotia now has a program for top surgery

6 days ago
Duration 1:31
Top surgery is gender-affirming chest masculinization or feminization. As Andrew Lam reports, it's the first time Nova Scotia has had a dedicated program with specially trained surgeons for this kind of health care.

For the first time, Nova Scotia Health has a program in place providing gender-affirming chest masculinization and feminization surgeries.

The health authority did not previously have a dedicated program for these kinds of procedures — commonly referred to as top surgery — with surgeons who have a mandate to provide the care, according to Nova Scotia Health.

Two surgeons specifically trained in top surgery have been recruited for the program, which began when the first surgeon came on board in July 2023. Dr. Nadim Joukhadar joined the program in September.

"I'd always ... wanted to give back to the LGBTQ+ community in some way," said Joukhadar, who is part of the 2SLGBTQ+ community himself.

Joukhadar is from Halifax and returned home after receiving specialty training and working in Toronto. He said it's gratifying to be able to provide care to people in the 2SLGBTQ+ community.

"I've never had something that's been more rewarding in my life in any field," he said. "I've never been happier at my work." 

Gap in care

Two years ago, advocates sounded the alarm when one of the only surgeons in the province performing top surgeries announced they would no longer accept new patients. 

That left a considerable gap in care, said Veronica Merryfield, founder of the Cape Breton Transgender Network.

A woman with glasses stands in front of Province House in Nova Scotia. She is wearing a jacket with a hood.
Veronica Merryfield is founder of the Cape Breton Transgender Network. (Andrew Lam/CBC)

Some patients are sent to Montreal for gender-affirming procedures. However, they need to pay upfront for travel and accommodation costs, with the province reimbursing them afterward, according to a Department of Health and Wellness web page. 

And for many people, it's not possible to pay those upfront costs, said Merryfield.

"Having surgeons in Nova Scotia takes away that barrier for a lot of folks," she said.

While she thinks the new top surgery program is a good thing overall, Merryfield said she'd like to see the province expand the gender-affirming procedures that are offered.

For example, treatments like voice feminizing surgery are not on Nova Scotia's list of publicly funded procedures, but are covered in the Yukon.

Gender-affirming surgeries can allow trans and non-binary people to be themselves, Merryfield said, adding that this type of health care is also accessed by cisgender people.

"It saves lives and it's as simple as that," she said.

ABOUT THE AUTHOR

Andrew Lam

Reporter/Associate Producer

Andrew Lam (they/she) is a Chinese-Canadian and trans reporter for CBC Nova Scotia. They are interested in 2SLGBTQIA+, labour and data-driven stories. Andrew also has a professional background in data analytics and visualization.

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