April 20th, 2026

Dear members of the National Assembly and the Ministry of Health and Social Services,

Queer and transgender advocacy groups and community organizations across Quebec are raising alarm over rapidly increasing wait times for gender-affirming surgeries in the province.

In February 2026, GrS Montréal, the only clinic in the province that receives public funding to perform gender-affirming surgeries, issued a press release confirming the average delays for its most common surgeries have increased. These delays increased to nearly 36 months for its Quebec patients covered by the Régie de l’assurance maladie du Québec (RAMQ).

These delays have serious consequences for trans and nonbinary patients. Lack of gender-affirming care is associated with significant impacts on physical safety and mental health, including increased risk of suicidality. 

Although Quebec’s healthcare system as a whole faces long wait times, those for gender-affirming surgeries are unique because they are funded differently than other surgeries.

In Quebec, generally, surgeries deemed necessary are funded by the RAMQ. However, most gender-affirming surgeries are funded through a fixed budget allocated annually by the Ministry of Health and Social Services (MSSS) and approved by the Quebec National Assembly. This means that only a predetermined number of surgical procedures are funded each year, regardless of the number of patients requiring care, and that these surgeries can only be performed at a single clinic. 

These wait times are particularly striking, given that people from other Canadian provinces are able to undergo surgery at the same clinic within just 12 months. Funding for gender-affirming surgeries in those provinces is covered by their health insurance plans, even when patients receive care in Quebec.

The fact that the MSSS allocates funding for these procedures implicitly recognizes them as medically necessary. Yet, they remain outside the standard RAMQ surgical system.

This situation is related to the Regulation respecting the application of the Health Insurance Act (chapter A-29, r. 5), which restricts “surgical services provided for the purpose of transsexualism” by referring to administrative structures that no longer exist within the healthcare system, such as the “head of the clinical department responsible for transsexualism services at the Hôtel-Dieu de Montréal.”

The result is that transgender patients are treated differently from all other surgical patients in Quebec. For example, a cisgender person requiring a mastectomy can undergo the procedure through the public health system as soon as the necessary facilities are available. A transgender person who needs the same procedure cannot access it in the same way and will instead have to wait one, two, or three fiscal years for funding to be allocated for their surgery.

GrS Montréal has the staff and necessary infrastructure needed to perform two to three times more surgeries for Quebec patients every year, but is limited by the budget allocated by the MSSS, which is insufficient to meet the population’s needs and results in a waiting list which only gets longer.

This budget for the 2025–2026 fiscal year was reduced from $9 million to $7.3 million compared to the 2024–2025 budget, according to a freedom of information request filed by the Trans Patients’ Union in January 2026 (MSSS, DAI 25-26.328). This represents a decrease of $1.7 million, the largest in 15 years. It even represents a decrease compared to the 2023–2024 budget, which stood at $8 million. This runs counter to the trend observed since 2009, which was an average increase of $0.55 million per year, with the largest reduction to date—$0.27 million—in 2022, attributable to the effects of COVID-19.

The current situation is not an unavoidable consequence of demand: it is the result of discriminatory policy that can be changed.

Queer and transgender organization across Quebec call on their elected officials to:

1. To allocate sufficient funding to GrS Montréal, of $15 million, for the next fiscal year, so that wait times for patients in Quebec are the same as those for patients from other provinces.
2. To amend chapter A-29, r. 5 of the Regulation respecting the application of the Health Insurance Act, which refers to “surgical services provided for the purpose of transsexualism,” in order to better integrate this care into the public insurance plan.

Queer and transgender organizations across Quebec are urging the provincial government to act quickly to ensure equitable access to healthcare for transgender and non-binary people in the province.

Signed,