Ontario ON

Ontario has no law restricting puberty blockers, cross-sex hormones or surgeries for minors. Across Canada, Canadian Institute for Health Information data show double mastectomies on minors as young as 14. Ontario covers the cost through its public health plan.

National Post, 29 Sep 2023, reporting Canadian Institute for Health Information data

Anyone with an Ontario birth registration may apply to change the sex designation to M, F, or X. The adult application asks for a statutory declaration and a letter from a physician or psychologist. A driver's licence sex designation can be changed with an updated birth certificate.

ServiceOntario — change of sex designation on a birth registration

Provincial policy places an inmate in an institution matching self-identified gender or housing preference, unless a health or safety problem cannot be resolved. For a federal sentence of two years or more, placement after intake follows gender identity or expression, regardless of anatomy, unless a health or safety problem cannot be resolved. A federal research report looked at 99 offenders recorded as identifying as transgender. The largest group, 62 percent, were trans-identified males. Sixteen percent applied to move to an institution matching their gender identity, and 64 percent of those applications were approved.

CSC Commissioner's Directive 100 (in effect 9 May 2022)

CSC Research Report R-442 (2022), “Examination of gender diverse offenders”, covering offenders recorded from 27 December 2017 to 13 March 2020