First NS gender-affirming top surgery program now operational with 2 dedicated surgeons

For the first time, Nova Scotia Health has established a program that offers gender-affirming breast masculinization and feminization surgeries.

According to Nova Scotia Health, the health authority has not previously had a dedicated program for these types of procedures – commonly called top surgery – with surgeons mandated to provide the care.

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

“I always wanted to give back to the LGBTQ+ community in some way,” says Joukhadar, who is part of the 2SLBGTQ+ community herself.

Joukhadar is from Halifax and returned home after completing special training and working in Toronto. He said it is rewarding to be able to provide care to people in the 2SLGBTQ+ community.

“I've never had anything so fulfilling in my life in any field,” he said. “I've never been happier at work.”

Gap in healthcare

Two years ago, advocates sounded the alarm when one of the province's few surgeons performing top surgeries announced it would no longer accept new patients.

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

Some patients are sent to Montreal for gender-affirming procedures. However, they must pay in advance for travel and lodging expenses, after which the province will reimburse them, according to a Ministry of Health and Human Services web page.

And for many people, paying those costs up front isn't possible, Merryfield says.

“Having surgeons in Nova Scotia removes that barrier for a lot of people,” she said.

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

For example, treatments such as female stem surgery are not available in Nova Scotia list of publicly funded proceduresbut be covered by the Yukon.

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

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