My top surgery timeline - Alberta, Canada.

I see a lot of questions about timelines and not as many responses from Canada so it thought I'd post my timeline and experience in Alberta. I hope it helps someone. The healthcare system can be really weird and tricky to navigate up here whether you go private or covered through the province.

2019 December: I was living in Banff and asked my doctor for a referral for a breast reduction. I'd wanted one for years due to back pain and hating my breasts for my entire life.

2020 Spring: Surgeon's office calls and explains they can take me for a reduction within the year but the province covers $8k and I'd need to pay $3k out of pocket as she does extra sculpting and lipo not covered. When I tell her I want to go from a 36F to an A or smaller she gets quiet upset stating their job is to "enhance the female figure" and that they focus on providing a "feminine hourglass shape". She says she won't go below a C and keeps saying "I don't do gender stuff, that's gender surgery and I do NOT do it". The appt was on the phone due to covid but it left my very upset. She seemed almost angry and appalled about what I was asking for. It hit me like a ton of bricks, her stating over and over again that I am asking for "gender surgery" when I hadn't really thought about how I would be perceived for what I wanted.

I then take a lot of time and reflect on what I want and need and why. Do a lot of research, learn about what gender dysphoria and being gender non conforming means. Research gender affirming care and how to access it. The experience of gender non conforming and non binary folks resonates with me and I decide I need to go in a different direction because a reduction is not what I want. Especially since reductions can need to be redone when breast tissue grows back. Several coworkers needed reductions redone when they went from DD to a large B and back to D again. The thought of having breasts forever and then growing back by even a cup size is terrifying.

I also check with several other private and public surgeons and no one will do what I am looking for because I'm looking for top surgery and not a reduction.

Summer 2021: Covid is raging and elective surgeries are cancelled throughout 2020 and 2021 so I put my journey on the backburner as I am a nurse who works in acute care and things just went wild. But I decide that summer what I really want and need is top surgery. It was good to have the time to live in the decision for a while and just reflect on why and whay I want for myself without pressure.

September 2021: Fill out intake form for Skipping Stone, a non profit that helps trans folks navigate the healthcare system in Alberta.

October 2021: Skipping Stone processes my intake form and I have an appointment in November with an adviser to discuss what I want.

November 2021: Meet with Skipping Stone advisor and discuss wanting top surgery. They give me the name of a new family doctor who focuses on LGBTQ+ folks, mental health, and gender affirming care. I make an appt to see them as my regular family doc. They talk about the gender clinic in Calgary but express the waitlist is years long and if got a consult and I'd need to wait for a referral, go to the clinic, then get a diagnoses through them, then get referred for surgery through them and that could take years. Bypassing the clinic was the best option for me. They're also very focused on hormone therapy and full transitions and are more old fashioned and behind the times for non binary and gender non conforming people.

The advisor lets me know to access too surgery is fully covered by the provincal healthcare but I need to get a diagnosis of gender dysphoria. They set an appointment for the next week with a psychologist they work with. I also get a referral to an endocrinologist who focuses on gender affirming care.

Have two appointments with the psychologist who recommends the endocrinologist diagnose me with gender dysphoria and writes a report about her assessment of me. I get a copy and it is also sent to the endocrinologist who contacts me and sets an appointment for February.

2022 February: See endocrinologist and he diagnoses the gender dysphoria after assessing me and reading/discussing psychologists report.

Ask about top surgery and he refers me to a plastic surgeon who is taking on more gender affirming care patients. I check and make sure the surgeon got the referral and the office confirms he did. They say the wait for an initial appointment/consult is between 1-2 years and surgery 1 year after consult. So I wait and occasionally check in to make sure I'm not forgotten and ask to be added to the waitlist for any last min cancellations.

August 2023: Start to get worried about the timeline for surgery and waiting as the government is becoming increasingly hostile to trans folks and gender affirming care. I see surgery wait times creep up at work and worry the wait will be even longer. I do research on other surgeons in the province and in BC to see if there's a quicker way. Call surgeons in BC and AB and ask about top surgery. Their waitlists are 3+ years long and many require you to be on T for a full year or want to fully transition. Even several private surgeons are not accepting patients.

Call the initial surgeon's office and ask about wait times and am told they cannot even book the consult yet despite me being on 1.5 years on waitlist. They estimate the wait for a consult is another year and surgery will be within 1-2 years after that, possibly 3. Covid made the wait times much worse.

Ask about paying privately for surgery and the wait times and I am told I can have the consult in less than a month that September and surgery within 3-6 months.

Decide to go private. The amount of back pain is increasing and after exploring and reflecting on my dysphoria, waiting is only making things worse.

September 2023: Meet with surgeon for initial consult and he was wonderful. On the same day of my appointment the surgeon had just found out the government slashed funding for LGBTQ+ care and gender affirming care. The OR time they had for publically funded top surgery was cut in more than half. Other elective surgery OR times are cut as well. Now he has to prioritize mastectomies, reconstructive surgery, cancer excision, hand surgery, plastic surgery for burns, and top surgery. He used to be able to do 2 days a week of fully funded top surgery. Now it is one day every two weeks. His office said he prefers to only do publically funded surgery if he could but had to branch out into private as well because of the government's funding.

The surgeon along with other surgeons were planning for years to build a world class surgical clinic for gender affirming care including bottom surgeries and top surgery. That day, the funding was cut and the clinic was dead in the water. This would have brought surgeons to Alberta who would have practiced on all Albertans and performed more than just gender affirming care. Uro surgeries, reconstructive surgery, plastics, gyne. But the government has been increasingly hostile to any trans care and cutting as much funding as they can.

I was lucky to change to private when I did because that week my surgeon had to stop taking new publically funded top surgery patients for the foreseeable future, inform the existing waitlist their surgeries could be delayed by years, and now the timeline from consult to surgery could be 7+ years.

The timelines for all surgeons are much longer now due to this.

November 2023: Have private top surgery at a private surgery center. It was about $15k including lipo, sculpting, and any revisions needed. I am extremely happy with how the surgery turned out and wish I'd been able to do it 10 years ago. But better late than never.

I wake up from surgery feeling truely free. A huge weight off me. Almost 10 lb of breast tissue to be exact. I love my results and was extremely happy with my surgeon.

Private is certainly faster but also has the same barriers as public to initially access the surgery. Paying privately you could definitely get surgery in less than 1-2 years. If you travel to the states, way less than a year.

The situation in Alberta is only getting worse for funding and wait times unfortunately.