Transition Related Surgery

As you all know, these are unprecedented times. Currently our Transition-Related Surgery (TRS) Program at Women’s College Hospital is focusing our efforts on catching up on the backlog of cancelled surgeries and consultations after our program was on hold for several months. We recognize that this is an incredibly difficult time and that there will be significant negative impacts on our trans, non-binary and gender diverse communities as a result of this situation.

We believe that TRS is an essential and life-saving service. We are also part of the health care system that must respond to our current situation by doing what we can to keep you, your family, and your loved ones safe. We will be in touch with you when we are able to schedule an appointment. Please refer to the wait times below as to when you can expect to receive a call. We appreciate your patience with delayed response times.

If you are currently on our waitlist for a Transition-Related Surgery, please note our current estimated wait times below:

  • Chest Masculinization and Breast Augmentation: 12 – 18 months – This is the wait time from referral to consultation.
  • Vaginoplasty: We are currently booking surgeries into 2025.

If you have questions about the referral process, please first review the “For Providers” tab below for detailed explanation of the elements required in a surgical referral.

If you are inquiring about the status of your referral, please first reach out to your referring physician. Upon receipt of any referral, we always send a response to your referring physician indicating that the referral has either been: accepted, declined or incomplete (requires further information). If your referring provider has not received such a response letter, please have them re-send the referral.

Transgender healthcare access issues are prominent in Canada and worldwide, with significant health gaps in access to skilled primary, emergency and specialty care services, which may include, for some individuals, access to medically necessary surgical services.

In response to a significant wait list for surgical referrals and lack of access to surgical services in publicly funded hospitals, Women’s College Hospital (WCH) has partnered with Sherbourne Health Centre including Rainbow Health Ontario (RHO), and the Centre for Addiction and Mental Health (CAMH), along with a group of committed individuals from the community, to form the Trans Health Expansion Partnership (THEx).

THEx supports the expansion of health services for trans individuals and communities across Ontario. Under the umbrella of THEx, the Transition Related Surgery Sub-committee led by WCH, is charged with the goal of creating an accessible, and quality surgical program.

WCH is dedicated to supporting the health and wellness of our transgender and gender diverse clients. The surgical team of the Transition-Related Surgery (TRS) Program includes specialists in plastic surgery, urology, gynecology and anesthesiology as well as nurse practitioners, nurses and other health care providers. This program represents the first public hospital-based surgical program in Canada focused on providing safe and timely access to transition-related surgical care.

At WCH, we are dedicated to offering the safest proven surgical options for TRS. Working in partnership with our patients, we bring expertise, experience and a commitment to the highest quality of care and patient experience.

If you have questions about the TRS Program, the team can be reached at 416-323-6148 or transitionrelatedsurgery@wchospital.ca.

Through training and recruitment of clinical staff with specialized expertise, we are building a comprehensive trans surgical program. At this time, the following surgeries are available at Women’s College Hospital.

  • Mastectomy with Chest contouring*
  • Breast Augmentation**
  • Hysterectomy
  • Bilateral salpingo-oopherectomy
  • Orchiectomy
  • Scrotectomy
  • Vaginoplasty
  • Vulvaplasty

*currently not covered by OHIP, there is a $1500 +HST cost for this procedure

**currently covered by OHIP following 12 months continuous hormone therapy with no breast growth defined as Tanner Stage 1

  • Hysterectomy
  • Bilateral salpingo-oopherectomy
  • Orchiectomy
  • Scrotectomy
  • Vaginoplasty
  • Vulvaplasty

*currently not covered by OHIP, there is a $1500 +HST cost for this procedure

**currently covered by OHIP following 12 months continuous hormone therapy with no breast growth defined as Tanner Stage 1

Yonah Krakowsky, MD FRCS(C), TRS Medical Director
Emery Potter, NP-PHC, BSCN, MN, TRS Program Nurse Practitioner
Nahir Anashara, Nurse Practitioner

Plastic Surgery

John Semple MD, MSc, FRCS(C), FACS 

Dr. John Semple is Head, Division of Plastic Surgery at Women’s College Hospital and Professor in the Department of Surgery, Faculty of Medicine at the University of Toronto.  Areas of specialty and interest include Breast Surgery, Breast reconstruction, Tissue engineering, Lymphedema, Mobile health technology and high-altitude meteorology and global waning in the Himalaya.

Mitchell Brown MD, MEd, FRCS(C) 

Dr. Mitchell Brown is a Professor of Surgery in the Department of Surgery at the University of Toronto.  Founder and co-course director of the Toronto Annual Breast Surgery Symposium and Breast Reconstruction Awareness (BRA)Day.  Dr. Brown specializes in aesthetic and reconstructive breast surgery, body contouring and facial aesthetic surgery.

Dr. Kathleen Armstrong

Dr. Kathleen Armstrong is an award winning teacher and expert in gender affirming top surgeries. She completed fellowship training with Dr. Hugh McLean at the McLean Clinic and performs over 250 top surgeries per year. She has extensive experience as an educator having participated in medical student and resident education for the last 10 years in various roles. In her role within the Division of Plastic, Reconstructive & Aesthetic Surgery at the University of Toronto, she trains medical students, residents and fellows in top surgery providing core lectures, office based and technical experience. She has a MSc in Health Services Research specializing in Health Economics. Her presentations have garnered various awards and she has published in multiple prestigious journals including CMAJ, JAMA and JAMA Surgery. As an Early Career Researcher at Women’s College Research Institute, she aligns her surgical and research interests to focus on gender affirming surgeries.

Urologic surgery

Ethan Grober MD, MEd, FRCS(C) 

Dr. Ethan Grober is the Division Head Urology and Assistant Professor at the University of Toronto, Department of Surgery.  Dr. Grober’s clinical activities focus on vasectomy reversal microsurgery, male reproductive and sexual medicine and testosterone deficiency.  His research interests include the assessment of technical competence and operative judgement, the integration and evaluation of new technologies in surgery and the validation of surgical simulation and laboratory-based surgical skills training.

Yonah Krakowsky, MD FRCS(C)

Dr. Yonah Krakowsky is the Division Head of Trans Surgery and a Surgeon-Educator at the University of Toronto.  His clinical and research interests are in peyronies disease, erectile dysfunction, female sexual medicine and increasing access for Trans Surgery in Canada.

Gynecology

Lisa Allen, MD, FRCS(C)