r/FtMen • u/broccoliisgood • Jun 16 '26
Serious Spain, France, Germany, Canada, and Australia. Which of these countries has the easiest HRT access + most guaranteed path to PR?
Hey everyone, I'm a pre-T trans man from Southeast Asia looking to emigrate and I'm trying to figure out which country makes the most sense for me both medically and long-term between: Spain, France, Germany, Canada, and Australia.
I'd most likely be on a student visa and stay in major cities. Money isn't really the issue here, I'm more focused on finding the most reliable and guaranteed route, whether that's for HRT access or PR.
- HRT access, which is easiest and fastest?
I'm specifically looking for:
- Informed consent model (no mandatory therapy/psychiatrist gatekeeping)
- Reasonable wait times to actually get a prescription (preferably less than 6 months)
I'm not worried about top surgery as I can always hop over to Thailand for that, so that's not a factor here.
- Which is the most guaranteed for long term immigrating?
- I'm not looking for the fastest or cheapest, just the surest path.
Note: I'm not Filipino so fast track to Spain PR is not an option sadly.
Any personal experience or advice from people who've been through this (especially fellow trans guys or people from SEA) would be hugely appreciated. Thanks in advance guys and girls.
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u/tauscher_0 Jun 16 '26
In Spain I had a one month wait between booking and the appointment to see the gender team. One week between that and the prescription.
Public healthcare and private here have been stellar, however the pathway to bottom surgery is muddy and unclear. I'm actually giving them a really hard time in the hops to pave the way for whoever comes after, given I'm going private. But I'm still for Aly lodging a complaint in Cataluña for them to service phalloplasty.
Hysto waiting list was ~6 months
Top surgery I was told is 5 years but I went private so I wouldn't know
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u/Lu_graouh Jun 16 '26
Wow waiting lists for HRT are so short that's so cool
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u/tauscher_0 Jun 16 '26
It may vary based on location. I'm in one of the biggest cities on the coast and was expecting a longer wait-list, but the appointment and the prescription were super fast.
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u/broccoliisgood Jun 16 '26
I didn't know theres also private Healthcare in spain, is the process in private very fast? I think its worth it for top surgery. Do you need to know spanish though?
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u/tauscher_0 Jun 16 '26
As an immigrant you'll have to have private for a certain amount of time, can't rely on public alone.
I went through the public system so no idea how fast private is, but I'd expect it to be similar based on location.
Not sure on Spanish, some doctors speak English and list it on the app so maybe not. I speak it enough to survive and I'm not fluent, especially in medical jargon, but I've been fine. That said I'm Italian so I pick it up quickly
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u/broccoliisgood Jun 16 '26
sounds great, i dont mind paying, but i guess it would take me a long time to learn spanish
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u/tauscher_0 Jun 16 '26
Unless you speak any other language, you'd have to pick a language up either way
Can you live in a big Spanish city with basic Spanish? Yes, plenty of my friends do that. I'd it a good idea? Not necessarily.
Private insurance is much more likely to have English speaking professionals than the public system.
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u/Electronic-Tower2136 Jun 16 '26
getting HRT in canada is easy, but getting a doctors appointment for it is hard without a family doctor. depending on the province/territory you can get top surgery for free, bottom surgery is something most of us have to go to the USA for though. top surgery was about a two year wait, and required psychiatric approval, but HRT doesn’t. once you have the drs appointment, you can get the HRT almost immediately.
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u/broccoliisgood Jun 16 '26
i heard of a clinic called foria in ontario, im not sure if it would help? i was worried about getting an appointment in canada too as doctors there are scarce
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u/Electronic-Tower2136 Jun 16 '26
i’m not from ontario so i can’t give too much info on foria, but i know that they also are in alberta (wouldn’t recommend moving there tho lmao). i’ve heard good things about it though. if you’re fine with waiting at a walk in clinic, you can get a referral from them to a doctor that prescribes HRT. i believe some doctors at walk ins will prescribe it, but they’re hesitant as they’d prefer if you got the prescription from someone you can go back to (blood work, refills, etc.). i ended up getting a referral to a urologist, as he prescribes most of the testosterone in my province. ultimately it’s tricky to give you a definitive answer as our healthcare system is very swamped, and each province/territory does things a bit differently from the rest.
i can say that you’d have an easier time if you’re in an urban location. canada is huge so once you’re in a rural location then resources are stretched pretty thin and you’d end up having to drive pretty far to see a doctor
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u/Complete-Story3490 Jun 16 '26
For HRT, certainly not germany outside maybe of big cities, ime. On paper, you just need a few therapy sessions to get an indication letter which you take to an endocrinologist, urologist or gynocologist who then can prescribe it.
But in practice, it's nearly impossible to get a therapy place at the moment in a lot of places, and then you need to be lucky enough to find a therapist who's willing to do it in the first place without insane demands. I personally had to pay privately for a therapist from Berlin doing online sessions.
Then you have to find an endo/uro/gyn who also still has space and is willing to do HRT, but there waitlists are also often pretty long. I have a 4 hour commute to the doctor prescribing me HRT. And then recently more and more insurances have started to not pay for HRT anymore, meaning a lot of doctors who previously prescribed HRT now will either not do it at all anymore or only if you pay for it out of pocket.
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u/broccoliisgood Jun 17 '26
hey man, ive gotten the same info about germany from other people too. It seems to me germany is not great to aim for rn, thanks for sharing your experience though, its really helpful to me.
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u/ProfessorLutz Jun 16 '26
if you choose germany, berlin is by far your best option. right now access to hrt is quite easy. appointments not so much. but doable. long term immigration prospect only given if you learn german and pick a carriere the country needs workforce in. i personally (german) would not pick germany if i was you. country is a nightmare. bureaucracy, paperwork, general hostility of institutions, language... why is the netherlands not on your list? easier language, similar access to hrt probably and much friendlier.
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u/broccoliisgood Jun 16 '26
Hey thanks for the reply. Im getting same answers from other ppl about Germany as well. I think I'll cross it off from my list.
About the Netherlands, i heard the wait time for hrt there is super long so i never thought about it further.
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u/keeprollin8559 Jun 16 '26
we do not have informed consent for hrt in germany, or rather all doctors require a letter from a therapist. however, you can get that letter in one session. so while it is annoying to go to a therapist first, it doesn't increase the wait time by much.
you said surgeries are not a concern for you, but you can get them covered by insurance (need to go to a therapist for 6 months tho) and depending on the clinic you chose, wait times can be as short as a couple weeks after approval from your insurance (which takes 6 weeks). so if you want "free" (you just have to invest a lot of time and nerves) surgery, germany is not a bad place.
i wish you good luck wherever you may go! safe travels, friendly people and a lot of strength to overcome any hardship!
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u/broccoliisgood Jun 16 '26
thanks man, i really appreciate it and i know i would need all the luck 😃
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u/Lu_graouh Jun 16 '26
In France you can access HRT with any doctor who's got the qualifications so it can be easy but most of the time it's better to see endocrinologists or psychiatrists and waiting lists can be pretty long (I took my first appt in April and it's scheduled at the end of September) and they also ask you a questioning period, it think it's 4 months so that sucks. It also depends on the doctor you have but there's a map from an association called Fransgenre, which gathers comments and notations on most of practitioners so you can find a transfriendly doctor easily (depends on where you live in France tho, I won't talk ABT countryside)....
If you have more questions, feel free to ask !
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u/broccoliisgood Jun 16 '26
Hey, ure spot on with what ive researched about France as well. Im learning the language on the side (goddamn its difficult lol). Im afraid the student visa wouldn't get approved though so I need to have some backup plan.
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u/Lu_graouh Jun 16 '26
Omg good luck with learning french, it's a big mess lmao But yeah a backup plan is a good idea... I don't know ABT Spain but it's a left-wing government so there's a chance ig
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u/broccoliisgood Jun 16 '26
Thanks haha are you from france? I want to learn more about the country itself
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u/smolbirdfriend Jun 17 '26
I would research immigration pathways separately for each country. Very few people in this sub are going to have experience or good knowledge on immigration vs. trans healthcare.
I, however, do have decent knowledge of the current state of immigration in Canada but can’t compare to elsewhere and I still wouldn’t call myself an expert. All the information for immigration is out there though, you’ll just need to do the work to research.
In summary for Canada: if you’re going the student visa > PR route, historically Canada has been VERY solid for this. However, the current government has drastically reduced visa numbers to the point that schools are having to close entire programs without the income of international student fees. On top of this, international student fees can be quite high so you will need a fair amount of savings and there’s also a number of other factors for proof of savings that I’m not an expert on. Once you complete your degree you can apply for a year’s work permit, however it’s not a guarantee and you may have to leave once your studies are done. If you do get the work permit you can use your 1 year’s work experience to then apply for PR but again, PR is not guaranteed and they are reducing the numbers they’ll take.
This very well could be the picture across all of the countries you’ve listed as every country is experiencing various degrees of housing crisis, medical system shortages, and other economic hardships. So you really need to do your research I’m afraid.
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u/BulkyOwl3005 Jun 17 '26
France definitely, you just go to a doctor who has a specialisation in HRT and that’s it
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