Important win in the coverage of gender affirming surgeries in Manitoba


Manitoba Health has been ordered by the Manitoba Health Appeal Board (the “Board”) to cover the costs of facial feminization surgery for a transgender woman. Prior to this decision, requests for coverage of facial feminization surgeries, and several other gender affirming procedures, have been considered elective cosmetic surgery and automatically denied by the Insured Benefits Branch.

In its August 11 ruling, the Board unanimously agreed with the woman, that the requested surgeries were medically necessary and key in tackling her gender dysphoria.

The Board found that Manitoba Health erred when it did not consider the woman’s individual case and instead relied “on a blanket position that facial feminization surgery is not medically required.” Without an express exclusion to the surgeries under the Excluded Services Regulation, the Board stated that Manitoba Health “ought to take the time to consider each proposed surgery on a case by case basis to determine if for that individual, surgery is medically required.”

The Board also recognized that the regulations and Manitoba Health’s internal policies applicable to the treatment of trans people “may be getting somewhat dated” and encouraged Manitoba Health to “clarify for all concerned what will and will not be covered…”

Not only is this a first in Manitoba, it also appears to be the first time in Canada that an administrative tribunal has ordered coverage of this type of procedure when it has not been expressly included within an insured benefits scheme.

Counsel Allison Fenske of the Public Interest Law Centre, an office of Legal Aid Manitoba, represented the woman in her successful appeal. Ms Fenske also represents Trans Manitoba in a pending series of systemic human rights complaints around gender affirming health care in Manitoba.

You can read the Manitoba Health Appeal Board decision here.

You can view media coverage of this story here: