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Nova Scotia 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. Nova Scotia covers the cost through its public health plan.

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

A person 16 or older can apply to change the sex marker on a Nova Scotia birth registration. They write a statement that they identify with the requested gender. A new birth certificate can show the change.

Nova Scotia — change your sex indicator if you are 16 or older

A male who identifies as a woman can be housed in a women's federal prison, even if his body is male and his identification still says male, unless a health or safety problem cannot be resolved. A federal count of 99 gender-diverse prisoners, from December 2017 to March 2020, found that 62 percent were males who identify as women. At the end of that count, 67 percent of that group were still in men's prisons. The federal women's prison in Nova Scotia is Nova Institution for Women in Truro.

CSC Commissioner's Directive 100 (in effect 9 May 2022); CSC research report R-442