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Exclusive documents reveal that doctors in Nova Scotia greenlit five surgeries to create artificial vaginas for patients listed as under 19 years old.

Melanie Bennet, True North.
Jul 7
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Source: Nova Scotia Health Authority, Instagram. July 23, 2024

Exclusive documents reveal that doctors in Nova Scotia greenlit five surgeries to create artificial vaginas for patients listed as under 19 years old. Citing privacy laws, the provincial health authority refused to reveal whether any of the patients were minors but acknowledged that Nova Scotia Health funds transgender genital surgeries for minors as of this year, “as per policy and procedures.”

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Federal officials and Canadian medical organizations have long assured the public that bottom surgery, a euphemism for irreversible genital procedures like vaginoplasties, or the surgical reshaping of penis tissue into an artificial vaginal opening, are not performed on minors. However, newly released documents from Nova Scotia’s public health system show otherwise.

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The Citizen’s Alliance of Nova Scotia provided True North with demographic data obtained through freedom of information requests. The data shows age breakdowns of both surgical and non-surgical gender-related interventions. The group has been requesting information from the provincial government on behalf of concerned mental health therapists fearful of professional repercussions should they be identified. The documents include internal emails, policy memos, and detailed statistical breakdowns.

The findings reveal that minors in Nova Scotia are receiving irreversible transgender medical treatments, including puberty blockers, cross-sex hormones, and in some cases, genital surgeries. The number of transgender treatments for all ages in Nova Scotia are trending upward at a time when other jurisdictions, such as the United Kingdom and several European countries, are retreating from such interventions due to mounting evidence of harm and a lack of long-term data to back claims made by transgender activists and proponents in the medical community that such procedures lower the risk of suicide.

The 2023–2024 annual report from Nova Scotia’s the province’s health insurance program (MSI) reveals that five procedures to create a neo-vaginal canal were approved for patients under the age of 19. Additional procedures, including the removal of the penis and testicles, appear in the same age bracket but the actual figure remains suppressed under Section 20(1) of Nova Scotia’s FOIPOP Act, which exempts disclosure when the number of patients is fewer than five.

True North sent several emails to Nova Scotia Health asking if any of the patients in the under-19 column were minors, and to verify the age of those listed. Stacy Burgess, Executive Director of Clinical Care at Nova Scotia Health, would not specify any ages but admitted that genital surgeries continue to be funded by the province. Nova Scotia Health’s policy states that minors over the age of 16 can request exemptions for such surgeries under certain conditions. These revelations contradict public-facing guidance from Health Canada and several provincial health authorities, which explicitly state that bottom surgeries are not available to individuals under 18.

 

Puberty blockers, particularly leuprolide (the generic version of Lupron), are being prescribed to children under the age of 15. Teens aged 16 to 18 are being given testosterone and estradiol, often in combination with anti-androgens like spironolactone or cyproterone.

This pharmaceutical regimen initiates irreversible physiological changes, including infertility and altered sexual development. The documents show a sharp increase in leuprolide and testosterone prescribed to young girls in 2024. The same dataset confirms that hormonal interventions are trending upwards for young girls in Nova Scotia’s health system.

The costs associated with this care are significant. Nova Scotia budgeted $1.7 million for gender related health care in 2023–24 alone. That figure does not represent a fixed cap, as internal memos state that departments are encouraged to “adjust forecasts upward” if demand increases.

 

Between 2021 and 2024, the province spent just over $2 million on 187 all ages mastectomies, a medical term for breast amputation. This figure includes hospital costs, physician fees, out-of-province costs like airfare, accommodations, and post-operative care. The province also allocates public funds for binders and prosthetic genital devices as part of its transgender health equipment budget.

The administrative infrastructure overseeing this system is profoundly ideological. In recent years, Nova Scotia health authorities have implemented sweeping policy changes that removed longstanding medical safeguards. The requirement that patients live as the opposite sex for 12 months before surgery was eliminated. The mandate for psychosocial assessments before starting treatment was scrapped. The standard of requiring two independent referral letters for surgical intervention was reduced to just one.

Gender Affirming Care Reform – Nova Scotia.pdf

These changes were based on the World Professional Association for Transgender Health Standards of Care v8, a document that has come under global scrutiny for promoting early medical transition with limited evidence. In internal emails, Stacy Burgess, Executive Director of Clinical Care at Nova Scotia Health, admitted in May 2024 that she had only “skim read” WPATH v8 and hadn’t noticed anything of concern. This statement came two months after the release of the WPATH Files, an investigative exposé which documented internal dissent among the authors and raised alarms about the reliability of the organization’s standards.

WPATH Files author, Mia Hughes, recently wrote in the National Post that Nova Scotia is dangerously out of step with nearly every jurisdiction that has seriously reviewed the evidence. “Every jurisdiction that has scrutinized this medical protocol has come to the same conclusion—there is no reliable proof of benefit, and the risks are too serious to allow the experiment to continue,” Hughes wrote.

While countries like Sweden, Finland, the UK, and even Alberta have pulled back from youth medical transition, Nova Scotia is forging ahead, expanding services while ignoring growing calls for caution. Hughes describes WPATH as an “activist association posing as a medical authority,” and criticizes the provinces for relying on its guidance instead of commissioning independent reviews.

Behind the rapid expansion of transgender medicine in Nova Scotia lies a network of activist, political, and medical policy actors. This revolving door between activism and administration has allowed ideology to advance through Nova Scotia’s health system, bypassing public scrutiny, medical debate, and evidence-based caution.

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