Who can prescribe testosterone in Canada? Physicians, nurse practitioners, pharmacists and others

The federal rule: a controlled drug

Testosterone is listed in Schedule IV of the Controlled Drugs and Substances Act under item 23, anabolic steroids and their derivatives, subitem 40. Under the Act a prescription may be written only by a practitioner: a person registered and entitled under provincial law to practise medicine, dentistry or veterinary medicine, plus any other class the regulations add. Until 30 September 2026 the New Classes of Practitioners Regulations added midwives, nurse practitioners and podiatrists, each limited to what their province permits. Since 1 October 2026 the Controlled Substances Regulations, SOR/2025-242, replace Parts G and J of the Food and Drug Regulations; testosterone sits in Schedule 2, Part 3, item 1(39), and section 1(3) prescribes midwives, nurse practitioners and podiatrists as practitioners, subject to the limits in sections 153 and 154. Whether the drug is prescribed in person or online does not change who may sign the prescription. The legal status page covers buying and carrying testosterone; this page covers who may prescribe it.

Physicians

Any physician with a licence from a provincial college may prescribe testosterone, as a family doctor, an endocrinologist, a urologist or a physician working for an online service. None of the college documents read on 8 October 2026 restricts testosterone to a specialty, and the BC PharmaCare Special Authority criteria for testosterone injection, updated 21 April 2026, state "Practitioner exemptions: None," meaning any prescriber may apply for coverage. A negative cannot be proven from a search, so this is recorded as no restriction found rather than as a rule. Colleges do apply general prescribing standards; the Alberta virtual care standard is the only one read that names controlled medications, and it is summarized under telemedicine below.

Nurse practitioners, province by province

Federally, the New Classes of Practitioners Regulations, section 4(2), excluded anabolic steroids from nurse practitioner prescribing "except for subitem (40)," which is testosterone, so testosterone was the one anabolic steroid nurse practitioners could always prescribe. A Health Canada class exemption signed 29 November 2023 then allowed them to prescribe all anabolic steroids where provincial law permitted; Health Canada's page, updated 17 December 2025, states the exemption is revoked when the new regulations took effect on 1 October 2026. The Controlled Substances Regulations, section 153, require a nurse practitioner to be authorized by the provincial professional regulatory authority and contain no substance exclusion for nurse practitioners. The practical question is therefore provincial.

Several online TRT services state that a nurse practitioner, not a physician, does the assessment and prescribing; the providers table records what each one publishes about its clinician type and which provinces it lists.

Pharmacists

Pharmacists are not practitioners under the Act. Health Canada's class exemption page states that the regulations do not permit pharmacists to prescribe controlled substances, and the Ontario College of Pharmacists repeats on 2 October 2026 that "pharmacists are not practitioners." What changed on 1 October 2026 is continuation, not initiation. The Controlled Substances Regulations provide that "a pharmacist may extend a prescription if the new expiration date of the extended prescription is not later than two years after the day on which the pharmacist received the prescription," and Ontario pharmacists may now "extend (renew) or adapt prescriptions for controlled substances within two years of the date of receipt," with the condition that "only the original prescription issued by the practitioner can be renewed." The Canadian Pharmacists Association says extension, renewal, transfer and, where a province permits it, therapeutic substitution continue under the new regulations and that recognition of pharmacists as practitioners "is still an advocacy priority." Provincial uptake outside Ontario was not verified. Two provinces exclude controlled drugs from pharmacist prescribing outright: Alberta's Standard 11.11, as summarized in February 2022, prohibits prescribing drugs scheduled under the Act with or without additional prescribing authorization, and Quebec's prescriber table excludes "les stupéfiants, les drogues contrôlées et les substances ciblées" from pharmacists. How refills and part-fills work once a prescription exists is on the pharmacy prices page.

Midwives, podiatrists and naturopathic doctors

Section 154 of the Controlled Substances Regulations states that a midwife or podiatrist "must not possess or conduct any activity with respect to" item 1 of Part 3 of Schedule 2, the anabolic steroids including testosterone; the earlier regulations carried the same exclusion. Naturopathic doctors are not practitioners under the Act in any province. In British Columbia the standards, limits and conditions updated 30 June 2025 state that "naturopathic physicians do not have authority to prescribe narcotics and controlled drugs" and list "anabolic steroids (including testosterone)" as not authorized; the BC regulation under which that document was issued was repealed on 1 April 2026 and replaced, and the successor rules were not read. In Ontario, naturopathic doctors may prescribe only substances listed in the regulation under the Naturopathy Act, 2007, described in legal commentary as mainly vitamins, minerals, amino acids and botanicals plus topical bioidentical estrogen and progesterone; testosterone is not listed. Dentists and veterinarians are practitioners under the Act but prescribe only within their own practice.

Online and telemedicine prescribing

The same practitioner rules apply online. The three college virtual care documents read on 8 October 2026 differ in what they add. The College of Physicians and Surgeons of Alberta standard, reissued 1 January 2022, clause 13, states that a physician "must not prescribe opioids or other controlled medications to patients unless" the physician examined the patient in person, has a longitudinal relationship with them, or is in direct communication with another regulated health professional who examined them; its glossary defines controlled medications to include all Type 1 and Type 2 drugs. The College of Physicians and Surgeons of British Columbia virtual care standard, version 9.3 revised 8 April 2026, has no controlled-substance wording; its conditions apply to opioids, opioid agonist treatment and psychotropic medications, and it asks registrants to "exercise caution when providing prescriptions or other treatment recommendations." The College of Physicians and Surgeons of Ontario virtual care policy, updated June 2022, does not mention controlled substances and states that in-person obligations, "including those pertaining to prescribing drugs," carry over. Nursing regulators' virtual care rules were not read. What each service publishes about whether a visit is by video, phone or questionnaire, and whether a blood test is required first, is in the how to check a TRT service page and the how hard is it to get TRT page.

Common questions

Can a family doctor prescribe testosterone in Canada?

Yes. Any physician licensed in a province is a practitioner under the Controlled Drugs and Substances Act and may prescribe testosterone. No provincial college document read on 8 October 2026 limits testosterone to endocrinologists or urologists, and the BC PharmaCare Special Authority criteria for testosterone injection list "Practitioner exemptions: None." A negative cannot be fully proven, so this is recorded as no restriction found.

Can a nurse practitioner prescribe testosterone?

Yes, where the provincial regulator authorizes it. Federally, the New Classes of Practitioners Regulations excluded most anabolic steroids from nurse practitioner prescribing but made an exception for testosterone, and the Controlled Substances Regulations in force since 1 October 2026 recognize nurse practitioners as practitioners when authorized by their provincial regulator, with no testosterone exclusion. British Columbia, Alberta, Saskatchewan, Manitoba, Ontario, Quebec and New Brunswick each have a regulator document permitting it, usually after a controlled-substances course.

Can a pharmacist prescribe testosterone?

Not as a new prescription. Health Canada states that the regulations do not permit pharmacists to prescribe controlled substances, and the Ontario College of Pharmacists repeats on 2 October 2026 that pharmacists are not practitioners. Since 1 October 2026 the Controlled Substances Regulations let a pharmacist extend a prescription for up to two years from the day it was received, and Ontario permits extending or adapting within that window; only the practitioner's original prescription can be extended. Alberta and Quebec exclude controlled drugs from pharmacist prescribing.

Can a naturopath prescribe testosterone?

No. In British Columbia the naturopathic regulator's standards, limits and conditions updated 30 June 2025 state that naturopathic physicians do not have authority to prescribe narcotics and controlled drugs and list anabolic steroids, including testosterone, as not authorized. In Ontario, naturopathic doctors may prescribe only the substances listed in regulation, mainly vitamins, minerals, amino acids and botanicals, and testosterone is not among them. Other provinces were not checked.

Can testosterone be prescribed online or by telemedicine?

Yes, within each college's virtual care rules. The Alberta standard says a physician must not prescribe opioids or other controlled medications unless the patient was examined in person, there is a longitudinal relationship, or another regulated professional who examined the patient is in direct communication. The British Columbia and Ontario virtual care documents contain no controlled-substance or testosterone wording; their usual prescribing obligations apply. What each online service publishes about its own process is on the providers page.

Can a midwife or podiatrist prescribe testosterone?

No. The Controlled Substances Regulations, section 154, state that a midwife or podiatrist must not possess or conduct any activity with respect to item 1 of Part 3 of Schedule 2, which is anabolic steroids including testosterone. The same exclusion existed in the New Classes of Practitioners Regulations before 1 October 2026.