Evidence map›Paper›PMID 39123233›Full record

ArticleBMC health services research2024

The landscape of Medicare policies for gender-affirming surgeries in Canada: an environmental scan.

Dave Gwun, Brennan Snow, Emery Potter, Rachel Loewen Walker, Alexandra L Millman, Yonah Krakowsky, Gianni R Lorello, Janice Du Mont, Lucy C Barker, Percy Lezard and 3 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC health services research, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Review
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Dave Gwun *Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada. dave.gwun@mail.utoronto.ca.
Brennan Snow *Women's College Research Institute, Women's College Hospital, 76 Grenville Street, Toronto, ON, M5S 1B2, Canada.
Emery PotterWomen's College Research Institute, Women's College Hospital, 76 Grenville Street, Toronto, ON, M5S 1B2, Canada.
Rachel Loewen WalkerDepartment of Women's and Gender Studies and Political Studies, University of Saskatchewan, Saskatoon, SK, Canada.
Alexandra L MillmanDivision of Urology, Department of Surgery, University of Toronto, Toronto, ON, Canada.
Yonah KrakowskyDivision of Urology, Department of Surgery, University of Toronto, Toronto, ON, Canada.
Gianni R LorelloWomen's College Research Institute, Women's College Hospital, 76 Grenville Street, Toronto, ON, M5S 1B2, Canada.
Janice Du MontWomen's College Research Institute, Women's College Hospital, 76 Grenville Street, Toronto, ON, M5S 1B2, Canada.
Lucy C BarkerWomen's College Research Institute, Women's College Hospital, 76 Grenville Street, Toronto, ON, M5S 1B2, Canada.
Percy LezardDepartment of Indigenous Studies, Law and Social Justice, Wilfrid Laurier University, Waterloo, ON, Canada.
Marudan SivagurunathanWomen's College Research Institute, Women's College Hospital, 76 Grenville Street, Toronto, ON, M5S 1B2, Canada.
David R UrbachTransition Related Surgery Program, Women's College Hospital, Toronto, ON, Canada.
Kathleen ArmstrongWomen's College Research Institute, Women's College Hospital, 76 Grenville Street, Toronto, ON, M5S 1B2, Canada. kathleen.armstrong@wchospital.ca.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMany studies have described barriers to gender-affirming surgery (GAS) in Canada; however, few have explored why these barriers persist. To address this knowledge gap, we sought to describe documents related to public health insurance (Medicare) for GAS to identify the types of procedures covered, variations in coverage across provinces and territories, and changes in policy over time.

methodsWe conducted a descriptive cross-sectional study using an environmental scan approach. We queried 23 government websites, the Google search engine, and an online legal database between July 2022 and April 2024 to gather gray literature documents related to GAS and Medicare. Variables from relevant documents were compiled to create a present, at-glance overview of GAS Medicare coverage for all provinces and territories and a timeline of policy changes across Canada. 

resultsEight provinces and three territories had documents or websites related to GAS Medicare coverage (85%). We identified 15 GAS procedures that were covered variably across Canada. Yukon (n = 14) covered the most types of GAS, while Quebec and Saskatchewan covered the least (n = 6). Mastectomy and genital surgeries were covered across Canada, but other GAS were rarely covered. Five provinces and territories provided coverage for travel-related costs. Our GAS Medicare timeline showed differential expansion of GAS coverage in Canada over the last 25 years.

conclusionsWe provide previously unreported information regarding GAS Medicare coverage in Canada. We hope our findings will help patients and healthcare providers navigate a complicated public healthcare system. We also highlight barriers within GAS Medicare documents and make recommendations to alleviate those barriers.

Indexed as

Gender-Affirming SurgeryCanadaCross-Sectional StudiesFemaleHealth PolicyHumansInsurance CoverageMaleMedicareNational Health Programs2S-LGBTQ + healthAccess to careInsurance policyResource

Identifiers

PMID39123233
PMCPMC11316376

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.