I’m a 52-year-old woman living in Toronto, Ontario. Early in 2017, after decades of contemplation, I set about medically transitioning to my true gender: female.

I preceeded my transition with many years of research into the legalities and medical realities that such a journey would entail. While I undertook my transition in Canada, where I live, as a dual British-Canadian citizen, I broadened my research to include services that are provided to those transitioning both here and in the UK.

The challenges faced by transgender individuals in the UK are well documented, so I will not go into them here. However, what I will do in this blog is illustrate my experiences of navigating the medical and legal aspects of transition in Ontario, Canada, in order to demonstrate the stark difference between the two approaches.

Very early in 2017, I made an appointment with my GP for my annual physical. During this meeting, I revealed to the doctor that I was trans and that I wished to transition to female.

Fortunately for me, in March, 2016, the Province of Ontario (which provides government-run health care to all Ontarians akin to the NHS), made wholesale changes to the provision of trans health services. Healthcare services were devolved to a patient’s primary care practioner – either a GP or nurse practitioner.

Previously, those patients wishing to transition were referred to the province’s only Gender Identity Clinic, run out of the Centre for Addiction and Mental Health, in Toronto. The wait times for an initial appointment with this sole GIC regularly ran into months, if not years.

The provincial Ministry of Health (MoH), instead, now provides additional guidance to primary care practitioners to help them provide services to their trans patients.

During that first meeting in January, 2017, my GP requested two weeks to research best practices, as I would be her first male to female transitioning patient. I provided the doctor with guidance made available on the internet by the provincial MoH. Two weeks later, after the completion of bloodwork, I attended my next appointment. My GP prescribed an initial, low dose of hormones, a testosterone blocker, and a referral to an endocrinologist, known to have experience with trans patients.

Throughout this time, I also continued sessions with a trans-centric therapist, whose services I had enlisted the previous summer.


My first appointment and assessment with my endocrinologist occurred two months later, in April, 2017. After ascertaining that I was fit for hormone therapy, I was prescribed my first full dose of Estradiol, with follow-up monitoring.


In August, 2017, four months later, I presented as female in public for the first time – a terrifying and affirming moment for me! Then on 7 September, 2017, I decided to go “full-time”, with the exception of my workplace.

At around the same time, my GP filled out the paperwork necessary to change the gender marker on my brith certificate to the correct designation of Female. This corresponded with my changing of name so that, at once, I had official documentation with a correct gender marker and name on it. On 9 December, 2017, I officially became me!


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Next on the list was my new passport and driver’s licence. All told, the documentation changes took about three months. Crucially, my GP’s affirmation was the only written confirmation that the government required to make this happen.

With the assistance of my workplace’s Human Resources department, I came out to my coworkers on 17 April, 2018. I remain the only “out” transgender firefighter on the Toronto Fire Services, and am presently a fire station officer with 30 years experience.


That autumn, in September, 2018, I underwent facial feminization surgery in Montréal, Quebec. This specific surgery is not financed by the government health plan. Concurrent to this, I completed the surgical requirement of living one-year in my correct gender. I then applied to the MoH for approval for gender corrective surgery. This approval came from the government within two months, allowing me to move forward with the provincially-funded surgery process, in Montréal.


Four months later, in April, 2019, I was again in the good hands of the surgical team in Montréal.

The timeframe of my medical and legal transition was around two years from start to finish. This would not have been possible without the devolution of trans healthcare into primary care.

I felt like I was in the driver’s seat at all times, with my healthcare team assisting me in making the informed choices that were best for me. This reasonable timeline allowed my wife and I to go through transition and move on with our lives and careers with the shortest disruption possible.

Trans individuals faced with unnecessary gatekeeping are suffering. It is crucial for those opposing progress in trans healthcare to know that there is another way, it is already tried and tested and trans people are thriving.


If you have been affected by any of the topics raised in this blog post and you would like to speak to someone, please visit our Help Centre to access our team of gender specialists.




Sofie Lusiak, I’m a 52-year-old woman living in Toronto, Ontario. Early in 2017, after decades of contemplation, I set about medically transitioning to my true gender: female.


Photo by Ali Tawfiq on Unsplash