Procedures
Gender-Affirming Surgery
Affirming surgical care, led with experience and genuine understanding.
What gender-affirming surgery involves here
Gender-affirming surgery at The Self Institute covers chest and breast procedures. Top surgery reshapes the chest and is planned around the technique that suits the body and the goal — the options differ in where scars sit and how much sensation is retained. Gender-affirming breast augmentation adds volume, and the shared breast procedures shown on this page are performed here too.
Technique is the main decision, and it is driven by anatomy rather than preference alone: chest size, skin elasticity, and whether preserving nipple sensation matters more than minimising scarring. The guide under Top Surgery sets out each approach and what shapes the choice between them.
Funding is usually the first question rather than the last. OHIP covers gender-affirming surgery for eligible patients, and the referral and approval path is set out below. Dr. Armstrong is a Royal College–certified plastic and reconstructive surgeon with active surgical privileges at Women’s College Hospital, Toronto.
Our commitment
Our approach
Gender-affirming surgery is approached with the same precision and compassion that defines all of our care. Every plan starts by listening — understanding your goals and supporting you at each step — in a private, respectful experience where you feel seen, informed and cared for.
Affirming & respectful
Care delivered with dignity and without judgement — your identity and goals lead every conversation.
Surgical expertise
Reconstructive precision and accredited facilities, with techniques tailored to your individual goals.
Clear guidance
Honest information on options, timelines and recovery, so you can make confident, informed decisions.
The process
What to expect
Step 1
Consultation
Meet with Dr. Armstrong to discuss your goals, explore your options, and receive personalized recommendations and a detailed quote.
Step 2
Surgical planning
We confirm your procedure, select your surgery date, and provide guidance on the next steps.
Step 3
Pre-operative appointment
About one month before surgery, our RN reviews your medical history in detail and explains how to prepare for surgery, what to expect on the day, and how to manage your post-operative care.
Step 4
Surgery day
Your procedure is performed by Dr. Armstrong and her surgical team, with your safety and comfort closely monitored throughout.
Step 5
Recovery & follow-up
Dr. Armstrong and her team monitor your healing, answer your questions, and support you throughout your recovery.
Your investment
Planning for gender-affirming surgery
Every surgical plan is individual, and your exact quote is provided after your consultation. Starting prices are listed on our pricing page, and financing is available through our partner, Beautifi, should you wish to spread the cost over time. To begin, we invite you to book a consultation.
Funding
OHIP funding & referrals
Gender-affirming surgery can be funded by OHIP or paid for privately. The OHIP-funded pathway requires a valid referral, while no referral is required for the private pay pathway. Please note that once a pathway has been selected, it cannot be changed; therefore, we recommend carefully considering both options before proceeding.
OHIP-funded
You’ll need two things from an Ontario doctor: a referral and an OHIP prior-approval letter for your procedure. Your referring physician applies for funding on your behalf, completing Ontario’s Request for Prior Approval for Sex Reassignment Surgery. Once it’s approved, they receive an OHIP approval letter valid for 36 months (three years) — we need both that letter and the referral.
Your referral should include:
- Your legal name (and preferred name, if different), date of birth, full address and email.
- The procedure you’re seeking.
- Your OHIP approval letter for that procedure.
- Up-to-date height, weight and BMI.
If your doctor can’t complete the application, they can refer you to CAMH’s Adult Gender Identity Clinic, and Rainbow Health Ontario can help you find a 2SLGBTQ+-friendly provider near you.
Paying privately
- Referral waives the consult fee. A referral from your Ontario doctor waives the consultation fee; without one, you can register and pay it when we book.
- From another province? You’re welcome as a private pay patient — you pay upfront and submit a claim to your provincial health plan for reimbursement.
- Private insurance. We don’t bill insurers directly; you’ll receive a detailed receipt to submit with your claim. Most insurers require you to go through provincial coverage first, so review your plan’s gender-affirmation section.
Consultations are typically booked around 18–24 months after referral documents are received.
Questions & answers
Frequently asked questions
Further reading
Articles you may find helpful
Plastic & Reconstructive Surgeon
50 Burnhamthorpe Rd W, Suite 343, Mississauga, ON L5B 3C2