Research isn't the problem. Deciding the answer before you start is.
Here is what the researchers wrote in their federal grant summary, before collecting a single result: "They expect that top surgery will reduce the body's stress burden." And the payoff they name: the evidence "could strengthen support for access to gender-affirming care."
That's the hoped-for conclusion, written into the application. There are no results yet.
The conclusion is in the application
The study is "Gender-Affirming Chest Surgery and Allostatic Load in Transgender Men and Non-Binary Individuals." It studies double mastectomies for gender on healthy women and "allostatic load," the wear and tear long-term stress puts on the body, using blood tests and smartphone surveys before and after surgery.
Its summary also states, as settled, that "we know that top surgery improves mental health." The study is framed as the next step for something the researchers already believe works, not as an open question.
Good research asks a question it doesn't know the answer to. This one tells you the answer it expects.
What Ottawa paid for
In September 2026, the Canadian Institutes of Health Research (CIHR), the federal agency that funds health research, approved two four-year grants for gender surgery research in Toronto. Together they total $1,399,207.
Both came from CIHR's "Advancing 2S/LGBTQI+ Health Through Research" program, which funded 22 teams this year.
Grant 1: $700,000 to the University of Toronto (CIHR record)
- The double mastectomies for gender study above.
- Principal investigators: six, led by Massieh Moayedi. Women's College Hospital surgeon Dr. Kathleen Armstrong is one of them.
Grant 2: $699,207 to Women's College Hospital (CIHR record)
- Title: "Improving Gender-Affirming Surgical Care Through Digital Patient-Reported Outcomes: Implementing the GENDER-Q at Women's College Hospital."
- Principal investigator: Dr. Armstrong.
- What it does: patients seeking gender surgery fill out a questionnaire, the GENDER-Q, before their appointment, and the answers go into the hospital's electronic records.
What the surgeon said
In an Oct. 21 article in the trade publication Canadian Healthcare Technology, Dr. Armstrong called the funding:
> "an important commitment by the Canadian government to the health and rights of transgender people and the broader 2SLGBTQI+ community, at a time when we have seen other countries move away from these commitments."
She added that it will help "advocate for equitable access."
She's right that other countries are moving away. They did it after checking the evidence.
Where other countries stand
- England: The Cass Review (April 2024), an independent review for the NHS, found the evidence behind gender medicine for children and teens "remarkably weak." NHS England stopped routinely prescribing puberty blockers for gender dysphoria.
- Sweden: In 2022, the National Board of Health and Welfare said the risks of puberty blockers and cross-sex hormones for minors likely outweigh the benefits, and limited them to exceptional cases.
- Finland: National guidelines from COHERE Finland (2020) put talk therapy first for minors and said surgery is not for minors.
- United States: The HHS review (2025) rated the evidence for medical transition of minors "very low" certainty.
What about minors?
The CIHR grant records don't state an age range. We are not claiming these grants include minors. Here's what is documented:
- Women's College Hospital has no minimum age for surgery. The hospital told the National Post in 2023 that most of its patients are over 18.
- Dr. Armstrong was first author of a May 2026 study in BMJ Open of 35 girls aged 13 to 18 who were seeking or had already had double mastectomies.
What honest research would look like
Canada needs better evidence on gender surgery. That's exactly why the questions should be open: does removing healthy breasts improve long-term health, or not? What happens to the women who regret it? Who is followed up, and for how long?
Research that starts from the answer it hopes to find can't settle those questions. Canada should fund studies designed to find out, whatever the result, and order an independent evidence review like England, Sweden, Finland and the US already did.
Patients deserve evidence, not expectations.
Photo: Georgios Tzanakos / Wikimedia Commons, CC BY 3.0
- canada
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- government funding