The Canadian province of Alberta has said it will pay for almost 50 final genital reassignment surgeries before ceasing funding for the operations.
Last week, officials announced that the province will no longer fund the medical procedures, citing issues of cost.
Around 16 people in the province undergo the procedure each year at a total cost of $700,000, (£385,271).
The operations cost anywhere between $18,000 and $70,000 and take place in Montreal.
Yesterday at question period at the Alberta legislature, Health Minister Ron Liepert said that 26 residents currently in line to undergo surgery will have their procedures covered by the province and that 20 more people on the verge of being approved will be covered.
According to the Edmonton Journal, he said: “It would not be right for us to now say, ‘Well, you’ve spent all this money, we’re now going to change the rules.
“It seems to me to be unfair to have someone believe that a certain surgery was going to take place, dug into their pockets for hormonal drugs that were prescribed by the medical community, and somehow we don’t follow through on it.”
However, he confirmed the budget cut would go ahead, saying: “Unless we get a handle on expenditures, we won’t have a publicly funded health-care system.”
Mr Liepert added that the operations were not the only medical services being cut.
Jamie-Lynn Garvin, 47, is one of the Alberta residents whose funding for male-to-female gender reassignment surgery has not yet been approved.
She told the Calgary Herald: “It’s a matter of life and death.”
Ms Garvin cannot afford to pay for her surgery on her own.
“This is what I am, who I am and I’m not crazy,” she said. “We need to let the government know that programmes – and not just this one – within the healthcare system, they can’t be cut. They are necessities. That’s why they’re there. Even if it helps one person, it’s worth it.”