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Alberta premier鈥檚 policy changes around trans youth could be harmful: doctors

Smith says the province will ban puberty blockers and hormone therapy for children 15 and younger
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Alberta Premier Danielle Smith answers questions at a news conference in Calgary on Thursday, February 1, 2024. Doctors are criticizing Alberta Premier Danielle Smith for her medically 鈥渇alse鈥 statements about transgender youth care and gender reassignment surgery. THE CANADIAN PRESS/Todd Korol

Doctors are criticizing Alberta Premier Danielle Smith for her medically 鈥渇alse鈥 statements about transgender youth care and gender reassignment surgery, saying her plan risks harming the vulnerable group.

In a video posted on X, the platform formerly known as Twitter, Smith said the province will ban puberty blockers and hormone therapy for children 15 and younger except for those who have already started those treatments. Those who are 16 and 17 can begin hormone treatment as long as they鈥檙e deemed mature enough and have parental, physician and psychologist approval.

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Top and bottom surgeries for people 17 and under will also not be permitted.

鈥淢aking permanent and irreversible decisions regarding one鈥檚 biological sex while still a youth can severely limit that child鈥檚 choices in the future. Prematurely encouraging or enabling children to alter their very biology or natural growth, no matter how well-intentioned and sincere, poses a risk to that child鈥檚 future that I, as premier, am not comfortable with permitting in our province,鈥 Smith said in the video posted Wednesday.

On Thursday, she said changes involving the new policies will be rolled out in the fall sitting in the form of legislation, regulation and policies. She did not rule out using the Charter鈥檚 notwithstanding clause to preserve them.

Dr. Tehseen Ladha, a pediatrician in Edmonton, said Smith is stoking fears by inferring as 鈥渄angerous鈥 the therapies that are offered after extensive consultations among pediatricians, mental health experts and endocrinologists, sometimes over several years.

鈥淔irstly, she doesn鈥檛 have the medical expertise to be able to make that decision about whether gender-affirming care is appropriate. Secondly, calling some of these things irreversible or harmful is simply false,鈥 Ladha said.

鈥淭hese therapies that we鈥檙e offering below the age of 18 are reversible. Hormone therapy is reversible. It鈥檚 being framed as something that is harmful, when in fact, in my clinical experience, it has been quite affirming and positive for youth and children dealing with these issues.鈥

No one in the province under age 18 has had bottom surgery so Smith seems to be creating an irrelevant issue, said Ladha, also an assistant professor at the University of Alberta.

Many teens have identified as the opposite gender since they were preschoolers and are not making a frivolous decision or being influenced by others if they seek medical help, said Ladha, adding she is wondering how trans youth, who already face higher suicide rates, will be affected by the province鈥檚 policies in the long run.

鈥淚 am very worried that parts of them will be integrated into legislation. For me, that sort of interference by a government is dangerous because it signals that the government can control your medical therapy or medical treatment.鈥

The policies regarding trans care are part of a broader range of regulations that Smith announced in the same video. They include a requirement for parental consent for students 15 and under who want to change their names or pronouns at school.

Doctors are upset that their views were not considered before Smith announced the policy out of the blue by a government that tussled with the Alberta Medical Association before reaching a four-year contract agreement in September 2022.

鈥淲e鈥檝e heard from medical professionals, all saying that they were not consulted when these policies were created, and that鈥檚 what makes me wonder if these are policies based on ideology, rather than evidence from the educational field, rather than scientific literature backing it up,鈥 Ladha said.

Dr. Sam Wong, medical director of the Canadian Paediatric Society, said Smith鈥檚 policies regarding trans youth have raised concerns among his colleagues across the country.

鈥淭here鈥檚 a degree of sadness. And it鈥檚 disheartening. I鈥檓 angry. That was my initial impression of the video when I was watching it,鈥 he said.

鈥淭ransgender patients who are youth and adolescents have suffered enough mental health issues as it is without being picked on by the government and being denied treatment,鈥 he said.

No trans youth have travelled to other provinces for bottom surgery, said Wong, a pediatrician at Stollery Children鈥檚 Hospital in Edmonton.

鈥淎cross Canada, there are strict guidelines, generally, on this particular surgery for pediatric patients. It鈥檚 pretty much prohibited.鈥

Camille Bains, The Canadian Press

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