You can choose to change your name and update documents like your identification or medical records.

The Skipping Stone ID Amendment Guide can help guide you through this process. Organizations like Student Legal Services of Edmonton and Skipping Stone in Calgary also offer support with name and document changes. These programs are called Trans ID Clinics.

Voice therapy or coaching can help you adjust the way you speak to better align with your gender identity. This can make you feel more confident in your expression. There are many affirming voice services and resources available for people in Alberta:

• Voice Clinic in Edmonton
• Calgary Voice Program
• Skipping Stone Foundation
• TransVoice Teacher Directory
• Trans Care BC: Changing your speech

Some of these programs have waitlists, need referrals, or cost money. Talk to your healthcare provider about specific recommendations or concerns that you might have finding a program.

There are different ways to remove facial or body hair. These can be temporary or permanent. You might need to experiment to find the best method for you.

• Temporary hair removal can include shaving, waxing, and threading.
• Long-term or permanent hair removal can include electrolysis and laser treatments.
• Medically necessary hair removal is done before surgery for some procedures.

Learn more about hair removal for gender affirmation.

Using gender-affirming gear can be affordable and less invasive than surgery. People may use gender-affirming gear to feel more comfortable in their body and clothing and to be seen by others in a way more aligned with their gender.

• Binding involves using tight clothing, tape, or compression garments to create a flatter chest.
• Packing involves wearing a prosthetic penis or padding in your underwear or lower garments. People may also use prosthetics or padding during sex or to be able to stand while peeing.
• Tucking involves positioning the penis and testicles to hide them.
• Padding involves using undergarments to create the appearance of larger breasts, hips, or buttocks. Padding offers a comfortable, affordable, and painless alternative to surgical options.

Learn more about binding, packing, tucking, and padding and where to find gender-affirming gear in Alberta.

Talking to a counsellor or therapist can give you emotional support, help with gender exploration, and address some of the challenges you may face in your journey. This can be helpful at all stages of your journey. Find someone you can connect with who understands your needs. Find gender-affirming providers through:

• Psychologists’ Association of Alberta
• Trans Wellness Initiative Providers
• Trans Affirming Network (filter by category: counselling and mental health)

Connecting with others who understand your experience, whether in person or online, can provide a sense of belonging and reduce feelings of isolation.

Community resources can include practical supports, in-person and virtual support groups, Indigenous and two-spirit resources, and guidance or connections around sports, recreation, and arts. Community resources are also available for parents, caregivers, and family members.

Talk to your healthcare provider about programs and services near you, or visit 211 Alberta.

Hormone therapy can be used to re-balance your body’s hormone levels in a way that feels more aligned or affirming of your gender. Hormone therapy can also promote the development of affirming body characteristics (like growing breasts or growing facial hair) as well as reduce characteristics that are not affirming or are causing dysphoria.

Your options for hormone therapy will depend on various factors that are unique to you. Many people choose to start this process by making an appointment with their primary care provider. In most cases, your primary care provider should be able to support and get a plan in place to prescribe hormone therapy if you make that decision. Your primary healthcare provider will need to have a conversation with you to make sure hormone therapy is safe and that it fits with your gender-affirming care plan.

Ultimately, the decision to start hormone therapy is yours. Your healthcare provider’s role is to encourage, guide, and assist you in making fully informed decisions. Before starting hormone therapy, it is important that you understand your treatment. Consider asking the following:

• “What effects might I expect from treatment?”
• “How long will medicines take to work on my body?”
• “What ongoing monitoring or tests are needed?”
• “Are there different ways to take hormones?”
• “What are the risks associated with treatment?”
• “Are there any expected side effects of treatment?”

It is important to consider the impact that certain medical options can have on your fertility. Changes from hormone therapy on your fertility can be permanent so it is important to talk to your healthcare provider about this.

For adults, hormone therapy can be broadly split into 2 types: estrogen-based therapy and testosterone-based therapy.

Estrogen-based therapy

Estrogen-based therapy often combines estrogen hormones and testosterone-blocking hormones. It can contribute to changes like:

Estrogen-based therapy can increase your risk for some health conditions, including:

• blood clots
• pulmonary embolism (blood clot in the lung)
• stroke
• heart attack
• gallstones

Talk with your healthcare team about these risks and what to watch for.

Testosterone-based therapy

Testosterone-based therapy can contribute to changes like:

Testosterone-based therapy can increase your risk for some health conditions, including:

• increased red blood cells (polycythemia)
• sleep apnea
• scalp hair loss (balding)
• changes to cholesterol, which may increase your risk for heart attack or stroke
• liver inflammation

Talk with your healthcare team about these risks and what to watch for.

Gender-affirming surgeries (also called transition-related surgeries) are various types of surgeries that can change the look and function of your body to be more reflective or affirming of your gender. Gender-affirming surgeries are sometimes called top surgeries (relating to the chest area) or bottom surgeries (relating to the genital area).

There are many considerations that may impact your decision to have surgery, including cost and setting realistic expectations.

• Cost: Some gender-affirming surgeries are covered by the Alberta Health Care Insurance Plan, which means the cost of the surgery itself will be covered. But you may need to consider other costs like time off work for surgery and recovery, medical supplies you may need after, expenses for a support person, and travel and accommodation depending on where the surgery is done. Some gender-affirming surgeries can be done privately, which require you to pay for the surgery. Learn more about funding for transition surgeries and EI sickness benefits.
• Setting realistic expectations: Although most people who decide to have gender-affirming surgery are happy with the outcome, it is important to set realistic expectations. It can be a long journey from deciding on surgery to being on the other side and happy with the results. Like any major surgery, there are limitations to consider and there is a recovery process that takes time. For example, some surgeries have different criteria to be able to have the operation, any major surgery will have some degree of scars, and each surgery will have different things you are not able to do for some time after the procedure. It is important to discuss the expectations for your surgery with your healthcare provider and surgeon.

Types of surgery

• Breast construction (also called breast augmentation or top surgery) is surgery that creates, enlarges, or shapes your breasts. The goal of this surgery would be to have breasts and nipples with sensation, a larger cup size, and minimal scarring. Breast implants generally last 10 to 15 years, often meaning that another surgery would need to happen later in life. Breast construction is typically done by a plastic surgeon as a day surgery, meaning that you do not usually stay in the hospital.
• Chest masculinization (mastectomy) is surgery that removes or reduces breast tissue and skin for a flatter chest. Chest masculinization surgery can also include a nipple graft, which may require changing the size or position of the nipple. Chest masculinization surgery is typically done by a plastic surgeon as a day surgery, meaning that you do not usually stay in the hospital.
• Hysterectomy is a surgery to remove the uterus. The cervix and fallopian tubes are also usually removed. After the surgery, you can no longer get pregnant or menstruate, and you no longer need regular Pap tests. Having a hysterectomy will change the levels of hormones you produce, and so some level of ongoing hormone therapy will be recommended. A hysterectomy is done by a gynecologist and is usually done as a day surgery. If you want a phalloplasty or metoidioplasty, you will first need a hysterectomy.
• Orchiectomy is a surgery to remove the testicles. It can be done with or without removing the scrotum. After an orchiectomy, you may be able to lower your hormone therapy dose, but some level of ongoing hormone therapy will be recommended. Some people stop their surgical journey after an orchiectomy. Others continue on to a vaginoplasty. This is based on each person’s gender-affirming goals. Orchiectomy surgeries are done by urologists.
• Metoidioplasty is a surgery that creates a 2 to 4 cm long penis out of your clitoris. Before surgery, you will have testosterone hormone therapy to enlarge your clitoris. It can take 2 to 3 years to get the most growth. The intended benefits of a metoidioplasty are preserving sexual sensation and allowing an erection without needing implants. A metoidioplasty can also include a procedure to lengthen your urethra, which would let you pee while standing. In Alberta, you will be referred to specialized plastic surgeons in Montreal for metoidioplasty. The metoidioplasty process usually takes 1 to 2 surgeries and needs 3 to 5 days in the hospital, with 6 to 8 weeks of recovery care.
• Phalloplasty is a surgery to create a longer and thicker penis with a glans (a head). Phalloplasty uses skin from your arm or your leg for part of the procedure. The intended benefits are to enable sexual sensation and let you get erections (with the assistance of an implant, if desired), have penetrative sexual intercourse (with an implant or external stiffening device), and pee standing up (when urethral lengthening is done). In Alberta, you will be referred to specialized plastic surgeons in Montreal for phalloplasty. The phalloplasty process usually takes 2 to 4 surgeries and needs 1 week in the hospital, with 3 to 6 months of post-operative care and recovery at home.
• Vaginoplasty is a surgery that creates a vulva and vagina with depth, allowing for receptive sexual intercourse. A vulvoplasty is another surgery option that creates a vulva with little to no vaginal depth. Both surgeries remove the penis, testicles, and scrotum. The tissue from the penis is usually inverted to create the inner walls of a vagina. The intended goal of a vaginoplasty is to create genitals with sexual sensation and a urethra that support peeing while sitting. After surgery, you may be able to reduce your hormone therapy. In Alberta, you will be referred to specialized plastic surgeons in Montreal for vaginoplasty.

Find more information about each type of surgery from Trans Care BC and the gender reassignment surgery program. You can also search for gender affirmation on MyHealth.Alberta.ca to find more information about specific gender-affirming surgeries.