Medical professionals adding voice to outcry over trans rights

BARRHEAD – It didn’t take long for medical professionals to speak out after Premier Danielle Smith announced upcoming policy changes to the way transgender and gender diverse (TGD) youth will be able to access gender-affirming care.

In the immediate aftermath of Smith’s Jan. 31 and Feb. 1 announcements, the Canadian Pediatric Society (CPS), alongside the Alberta Medical Association’s (AMA) Section of Child and Adolescent Psychiatry and the AMA Section of Pediatrics all put out statements condemning the decision. In a Feb. 1 statement, AMA’s paediatrics section said, “The doctor-patient relationship is inviolable and sacrosanct. Full stop.”

Smith’s proposed policies would ban access to hormone therapies for youth aged 15 and under and restrict access for youth aged 16-17, which she referred to as mature youth. It would ban all gender-affirming surgery for anyone 18 and under, as well as require parental permission or notification if youth wish to use different names or pronouns in schools, depending on their age.

Caitlin Clarke, a Barrhead-based pharmacist who works in Whitecourt, expressed her disappointment in the decision.

“The moves the government of Alberta has made are completely ideology based,” said Clarke in a Feb. 2 interview. “They go directly against science and statistics, it’s basically ideological war on trans kids who are vulnerable and just looking for a loving place to land.”

According to CPS, statistics show that TGD youth are more likely to be at risk for adverse health outcomes, including depression, anxiety, eating disorders, self-harm and suicide. One of the easiest ways to mitigate those risks is through what it calls inclusive and non-judgemental interactions with the health care system.

During a Feb. 1 press conference, Smith said the policies were being implemented to make sure children weren’t making choices that would have a negative impact on their future medical health without fully understanding the possible repercussions.

“We’re aiming to be supportive of children’s rights. We want to make sure that children do not prematurely make decisions that are going to be irreversible and affect their ability to have sex and affect their ability to have children,” said Smith.

Smith and the medical community agree on part of her statement — sexual reassignment surgery isn’t an option for anyone under 18 in Canada, and the process requires heavy amounts of psychological consultation for adults.

Meanwhile, CPS reported puberty blockers have no adverse effects on a person’s future health and can help prevent the development of secondary sexual characteristics that can make a later medical transition riskier and more difficult.

“It’s not just the physical changes we’re worried about, but the emotional damage from developing those secondary sexual characteristics,” said Clarke. “People who are assigned female sex at birth can go through puberty anywhere from nine years of age until 18. A large majority of them will have started puberty by the time they would be allowed to start puberty blockers at the age of 16.”

Besides the development of breast tissue, which can create issues with increased sensitivity even after top surgery and hip development, Clarke pointed out that many assigned female at birth (AFAB) individuals will have already started menstruation.

“It would be absolutely disturbing for someone not born in the right body,” said Clarke.

For TGD individuals who are assigned male at birth (AMAB), puberty brings about changes that aren’t reversible later in life. Testosterone promotes the development of an Adam’s apple, can lead to early onset hair loss, and deepens the voice, which can’t be undone.

“Puberty blockers press pause on those things. They have absolutely no long-term side effects when it comes to sexual development. If we have a person who is gender diverse, or queer, or questioning, who is unsure if they’re living in the right body, we can use blockers to press pause,” said Clarke. “If they later decide through counselling or whatever to continue in their body, we can remove the blockers and puberty continues normally.”

In CPS’s letter, the society strongly urged the province to reconsider the announced policy changes.

“They will all have direct and real negative impacts on the physical and mental health of Alberta’s children and youth,” wrote Dr. Sam Wong, Dr. Jeff Critch, Dr. Ellie Vyver, and Dr. Raphael Sharon, all executives with medical societies in the country. “Gender-affirming medical care for youth should be a decision between the patient, their parents, and their medical care team, without intrusion by government.”

“The health and safety of TGD youth is too important.”