Montreal,  April 23rd, 2001

Allison Diane Daniels,

We are pleased to send you a detailed information package on gender reassignement surgery male to female.

After reading the content you may wonder why the price quoted for the procedure (s) is lower than in the U.S.A.  Here is why, we own the hospital where the procedures are done.  The cost for one hospitalization day at our hospital is around $ 400.00 canadian compared to U.S. $ 1200.00 to 1500.00 in the U.S.A..  For 4 to 5 days of hospitalization in the U.S.A., you spend U.S. $ 5000.00 to 6000.00 extra on hospital overhead which you do not have to pay for with " GRS in Montreal."  Our modern and safe hospital care is personnalized and our staff has a high experience with transgender patients.  Low overhead combined to favorable exchange rate are responsible for the low cost of procedures with GRS in Montreal. 

In choosing Montreal you do not settle for less.  On the contrary you pay for state of the art procedures and unsurpassed results based on a vast experience with transgender surgery.  Also with the residence, you benifit from a unique care concept which is not available anywhere else in the world.

We and our staff would like to thank you for your interest in our surgical services and please do not hesitate to contact us if you need anymore information


To be eligible for G.R.S., one must, first of all, answer to the criteria of the " Standards of Care of the Harry Benjamin International Gender Dysphoria Association, Inc". 

  That is: "Hormonal sex reassignment recommended by a clinical behavioral scientist.

  Full-time living in the social role of female sex at least 12 months.
Two recommendations for G.R.S. made by two clinical behavioral scientists.  One of the two recommendations must be made by a person possessing a doctoral degree e.g. PhD, Ed.D., D.Sc., D.S.W., Psy. D., or M.D. in a clinical behavioral science granted by an institution of education accredited by a national or regional accredited board.  The clinical behavioral scientist making the primary recommendation in favor of S.R.S. shall have known the patient in a psychotherapeutic relationship for at least six months prior to making said recommendation". 

The patient has the responsibility to see that the behavioral scientists have the necessary qualifications mentioned above and that they are clearly stated in the recommendation.  Also most important is the fact that one of these recommendations has been made by a scientist who has followed the patient for at least six months.

The medical history and the two recommendations for G.R.S. must be well detailed and must arrive at my office before a date can be set for the surgery.  Also, I wish a report from the Doctor who is supervising the hormonal therapy as to the type of hormones being administered, the dosage and the duration of the treatment.  Please also send me a recent photograph of yourself.


It is preferable to meet with the patient a few months prior to surgery.  However, if the patient lives very far from Montreal, it is possible to meet a few days prior to surgery.  If the latter is the case, the patient's file must be complete :  the two recommendations, the laboratory reports and the medical history must be at my office before the visit.  If a document is missing, the surgery could be cancelled.


As this is a major surgical procedure, under general anaesthesia, the patient must pass the following exams about two months before the date of the surgery and the results of these exams must be sent to my office about three weeks prior to the date set for the surgery.  Without these test results, there will be no surgery.  PLEASE WAIT TO HAVE A DATE OF SURGERY BEFORE HAVING YOUR PRE-OPERATIVE TESTS DONE.
Following is a list of the obligatory tests:

- CBC (complete blood count)
- BUN (blood urea nitrogen)
- Glucose (blood sugar)
- Urine analysis
- Chest X ray (the report only)
- E.K.G. (over 40 years of age)
- H.I.V.