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Sherbourne Guidelines for Gender-Affirming Primary Care with Trans and Non-Binary Patients

Sherbourne Health has developed guidelines for gender-affirming primary care. They have information on assessing readiness, diagnosis, hormone therapy, blood work monitoring and links to the surgeries that are covered by OHIP. Also included are consent forms and EAP forms.

The full guidelines are linked above, and links to an interactive online version and a 7-page quick reference guide are also available at that link.

Rainbow Health Ontario

Rainbow Health Ontario (RHO) offers a range of supports for health care providers through an online learning platform. Create an account to access both foundational and more specialized courses. The three courses specific to primary care are:

RHO also offers a twice monthly Trans Health Mentorship Call, that can be accessed by enrolling through their learning platform linked above. This conference call acts as a community of practice for providing health care to trans patients. Health care providers can ask specific case-based questions or listen and learn from other professionals working with trans patients.

Project ECHO Sessions on Trans & Gender Diverse Healthcare

ECHO sessions are an interactive virtual education and capacity building initiative from CAMH and the University of Toronto. They have a set of sessions focused on gender-affirming care including: OHIP funded surgeries and referrals, providing post-op care, hormone replacement therapy, working with families and youth, and WPATH criteria.

The Path to Patient-Centered Care

This is a living resource to support providers in implanting the Informed Consent Model for gender-affirming care. This model “includes discussions of the patient’s expectations, decision-making process, understanding of risks and benefits, support structures, and general health, but does not involve an evaluation of their gender or whether they are ‘truly’ trans”. This is the model used by most gender-affirming care providers in Ontario, as it moves away from historical gatekeeping and works from a more comprehensive understanding of gender and transition.


eConsult is a secure web-based tool, hosted on OTNHub, that allows physicians or nurse practitioners timely access to specialist advice for all patients. Gender-affirming care advice is available on eConsult from a number of specialists across the province.

How to Submit an eConsult to a Transgender specialist or specialty group:

Physicians and nurse practitioners can bill OHIP using fee code K738 ($16 per eConsult) and specialists are compensated directly by the eConsult Centre of Excellence.

If you are interested in getting signed up to send eConsults, or if you are a physician providing gender-affirming care and would like to become an eConsult specialist, please contact Rebecca Wellbourn at

Hamilton Family Health Team

HFHT can provide internal support to any providers interested in learning more about gender-affirming care.

SOGI Nursing Website

This is a toolkit for nurses and nursing educators committed to providing resources and education around 2SLGBTQ+ issues in healthcare. The toolkit includes five self-directed lessons that explore working with people with a variety of sexual orientations and genders in various practice settings.

Trans Pap 101

A “how-to” video for healthcare students & providers on providing trans competent cervical cancer screening.

Jump to a chapter:

Lunch and Learn Facilitation Manual (Google Docs)

Created by the LGBTQ+ Interest Group at McMaster University’s Medical School, the Hamilton Trans Health Coalition, and staff physicians from McMaster’s Departments of Family Medicine and Obstetrics & Gynecology.