Claiming Tax Credits for Gender Affirming Care: Is it Possible?
- Sep Memarazad
- 3 hours ago
- 4 min read
How are tax credits and health costs connected?
Tax credits are the amounts that reduce the tax you actually owe rather than your taxable income. The Medical Expense Tax Credit (METC) lets taxpayers recoup a large portion of the out-of-pocket health costs that they have spent in the prior tax year. Since gender affirming procedures can be a necessary and life-saving treatment, they can qualify for the METC when the correct documents are filed.
What is a tax credit?
A tax credit is an amount that offsets the tax calculated on your return. Non-refundable credits (the vast majority, including the METC) can reduce your federal or provincial tax to $0, but will not create a cash refund beyond that.
Refundable credits, on the other hand, can generate a payment even if you paid no tax. Common non-refundable credits include the basic personal amount, disability amount, tuition credit, and the medical expense credit.
Who is eligible to receive tax credits?
Anyone who is a Canadian resident for tax purposes and files a T1 return can claim federal and provincial credits for which they meet the legislative criteria.
Newcomers get a prorated set of non-refundable credits for the part-year they were residents, as long as at least 90% of their World Income for the non-resident portion was Canadian-sourced.
What is the METC?
The METC is found in Income Tax Act s.118.2 and lets you claim eligible medical costs you paid for yourself, your spouse/common-law partner, and certain dependents.
You report them on line 33099 (self, spouse, minor children) or line 33199 (other dependents) when filing your taxes.
You may only claim the portion that exceeds the lesser of 3% of your net income or $2,759 for 2024. The federal credit rate is 15%; each province or territory gives an additional non-refundable credit (for example, 5.06% in B.C.).
The CRA’s detailed list of eligible expenses appears in Guide RC4065.
Additionally, each province and territory has a different list of authorized medical practitioners for the purposes of the medical expense tax credit. But all of them recognize surgeons as authorized practitioners.
Do gender-affirming procedures qualify as medical expenses?
Probably! CRA confirmed this in a 2012 Technical Interpretation, noting that sexual-reassignment surgery, facial feminization, chondrolaryngoplasty, and related travel expenses would “qualify as medical expenses” when performed on the advice of physicians treating gender dysphoria.
The CRA’s Income Tax Folio states that cosmetic procedures are disallowed only when “provided purely for cosmetic purposes”. If they are “necessary for medical or reconstructive purposes,” they remain eligible. The CRA’s consumer guide confirms this, saying cosmetic surgery costs “generally” cannot be claimed unless the surgery is medically required.
What are the requirements to claim METC for gender-affirming care?
A Licensed Provider
Amounts must be paid to a “medical practitioner” or a “licensed private hospital.” Under ITA s. 118.4(2)(a), a medical practitioner is “a person authorized to practice … pursuant to the laws of the jurisdiction in which the service is rendered,” whether in Canada or abroad. The CRA might ask for evidence of the surgeon’s license or hospital accreditation, especially if they are not located in Canada.
Medical Necessity
Since many gender affirming surgeries are performed by plastic surgeons, they are often thought to be purely cosmetic procedures. To prove they are medically necessary, you must show they were required to treat a diagnosed condition (gender dysphoria). Letters from a specialist or the operating surgeon explaining the diagnosis, the treatment plan, and why it is medically necessary should provide enough evidence to prove the necessity of the procedures. It is the taxpayer’s responsibility to prove the procedures were medically necessary.
Receipts and Proof of Payment
Original invoices and receipts can be used as proof of payment. For foreign expenses, convert costs to Canadian dollars at the Bank of Canada rate on the payment date. Guide RC4065 emphasizes that CRA may ask for these documents. It is advisable to keep the documents until you receive your Notice of Assessment and confirm that your claim has been approved.
Travel expenses
If substantially equivalent care was not available near home (>40 km), you may be eligible to also claim travel expenses. If the distance travelled is 80 km or more, reasonable meals and lodging can also be included. Flight receipts, mileage logs, and hotel bills can be submitted as supporting documents. If someone were accompanying you, a note from your physician is required explaining that an escort was medically required.
Note: This post explains the law in general. It is not intended to give you legal advice on your particular case; each person’s case is different, so you may need to get legal help. Information in this post is up to date as of December 2025.
Sources:
