Gender affirmation

Supporting your employees

Everyone experiences gender in their own unique way. Some may identify as being a woman, a man, both, neither, or anywhere along the gender spectrum. A person’s gender identity may be different from the gender associated with their sex.1

The sense of unease caused by the mismatch between one’s assigned gender and their gender identity is referred to as gender dysphoria.2 Gender affirmation care helps affirm one’s physical appearance with the gender they identify with.

Gender affirmation coverage*

As part of our DEI benefits offering, this coverage provides gender affirming procedures, surgeries, and treatment. This inclusive benefit can be part of your organization’s full spectrum DEI strategy, helping you attract and retain talent, and supporting your employees, in order to help them bring their most authentic selves to work.3


  • transition-related genital and chest/breast surgeries that are not covered by the provincial/territorial health plan
  • facial feminization/masculinization surgeries
  • body feminization/masculinization surgeries (such as tracheal shave, liposuction, lipofilling)
  • vocal cord surgery
  • electrolysis or laser hair removal
  • body hair or skin graft

The gender affirmation benefit is available to employees and their covered family members as part of their benefits plan*** if they are diagnosed with gender dysphoria by their physician. The diagnosis helps the benefit go to those who need it.

We know this can be a difficult time. To provide employees with support, we have a dedicated team who can help them with questions about their gender affirmation coverage and the claims process.

Expenses related to the reversal of gender affirmation treatments are not covered. Standard extended health care (EHC) exclusions apply.*** To learn more, sign in to the plan member site, click the ‘My benefits’ tab, then ‘View benefits booklet’.

Inclusive support

To further support your employees, consider providing a comprehensive DEI benefits plan design and holistic care so they have access to the resources that can help them bring their most authentic selves to work:

Travel within Canada is often required to access specialized gender affirming surgical procedures.5 Consider adding In-Canada Medical Travel benefits to cover employees’ long distance travel expenses related to health care.

Those experiencing gender dysphoria may also have symptoms of mental health conditions such as depression and anxiety.6 Consider including $2,000 to $4,000/year as the combined maximum for mental health practitioners, so employees have access to emotional and psychological support.

Review your plan’s drug coverage so that employees can have access to appropriate medication and hormone therapy.

At Manulife, embracing DEI sparks innovation and makes us better for our clients and customers. We continuously seek fresh perspectives to enhance our products and services, to help us deliver comprehensive benefits that meet the evolving needs of our diverse customer base.

Effective September 6, 2024, Gender Affirmation will be added to all EHC plans. If you have any questions or wish to opt out of this benefit (ASO & RA plans only), please contact your Manulife representative by August 1, 2024 (for opt-out requests).


* The purpose of gender affirmation coverage is related to masculinization or femininization, not elective cosmetic enhancement. All eligible services will require a diagnosis of gender dysphoria from a physician. The coverage is offered based on plan availability and is subject to conditions, limitations and exclusions.

** 2021 JAMA Network – a secondary analysis of data from the 2015 US Transgender Survey conducted across 50 states of 27, 715 transgender and gender diverse people. The exposure group included respondents who endorsed undergoing 1 or more types of gender-affirming surgery at least 2 years prior to submitting survey responses. The comparison group included respondents who endorsed a desire for 1 or more types of gender-affirming surgery but denied undergoing any gender-affirming surgeries. The data were analyzed between November 1, 2020, and January 3, 2021.

*** Effective September 6, 2024, Gender Affirmation will be added to all EHC plans.



1 “About Gender Identity and Gender Expression”, Government of Canada, 2021, <, anywhere-along-the-gender-spectrum.> 

2"Gender Dysphoria”, Cleveland Clinic, 2022, <>

3 “Survey finds 60% of employees say they’d leave current job for one with more inclusive benefits”, Benefits Canada, 2023, <>

4 “Mental health benefits associated with gender-affirming surgery”, 2021, <>

5 ”Gender-affirming health coverage by Canadian province, territory”, 2022, <>

6 ”Gender Dysphoria”, National Library of Medicine, 2023, <,of