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B.C. 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. B.C. covers the cost through its public health plan.

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

A person born in B.C. can ask to change the sex on their birth record. They declare that they have taken on the gender identity that matches the new designation and intend to keep it. A minor needs a guardian's consent. Under 12, a doctor or psychologist must also sign a statement.

Vital Statistics Act, R.S.B.C. 1996, c. 479, s. 27

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 B.C. is Fraser Valley Institution in Abbotsford. Since 2015, B.C.'s own jails have housed people by the gender they identify with, rather than sex at birth. The main provincial women's jail is Alouette Correctional Centre for Women in Maple Ridge.

CSC Commissioner's Directive 100 (in effect 9 May 2022); BC Corrections research newsletter, issue 17; CSC research report R-442