Sweeping changes to gender-affirming care, announced this week by the Alberta government, are drawing widespread backlash and condemnation from doctors, nurses and medical organizations, and calls are growing to that the province reverse its decision.
Framing this as a measure to protect children, Premier Danielle Smith has positioned Alberta as the most restrictive Alberta in Canada and this week introduced a series of policies impacting transgender youth, including the banning the use of puberty-blocking drugs and hormone therapy in children under 16. for gender affirmation purposes.
While Smith also announced a ban on gender-affirming surgeries in children under 18, lower-level surgeries are already restricted to those over 18, and doctors say gender-affirming surgeries high level are very rarely performed on older adolescents.
“This is a direct attack on transgender youth,” said Dr. Ted Jablonski, a Calgary family physician specializing in transgender care. “It’s an attack on their medical care.”
Jablonski has been treating transgender people in Calgary for more than two decades.
“I feel like we’ve gone back in time,” he said.
“There is no medical evidence to impose restrictions. We have very good guidelines for managing trans youth.”
These guidelines include a detailed position statement published by the Canadian Pediatric Society and the standards of care published by the Global Professional Association for Transgender Health.
The pediatrics section of the Alberta Medical Association released a statement Thursday evening, calling on the provincial government to abandon its plan.
“Children and young people have the right to appropriate, timely medical care and should not be denied this,” the statement said.
“We urge the Prime Minister, in the strongest possible terms, to reconsider the proposed changes to the care of transgender young people.”
“Gender-affirming medical care for #youth should be a decision between the patient, their parents and their medical care team, without government intrusion. »
Read our letter to the Prime Minister of#Alberta @ABDanielleSmith : https://t.co/1lSJlMrntH @Albertadoctors @AHS_media
The Canadian Pediatric Society also condemned the project and asked the Prime Minister to reconsider it.
“We are deeply concerned that the implementation of these policies will not only undermine the human rights of transgender children and youth in Alberta, but will also result in significant negative health consequences, including increased risk of suicide and self-harm,” the group said in a statement. letter to Smith.
Facing a barrage of criticism, Smith defended his government’s plan at a news conference Thursday.
“We want to ensure that children do not prematurely make decisions that will be irreversible and affect their ability to have sex and have children, until they reach the age where they are fully responsible for these decisions… It’s 18 years,” she said.
Dr. Joe Raiche, a psychiatrist who works at the youth gender clinic at Alberta Children’s Hospital, called the policies “shocking” and “devastating.”
“This is causing enormous harm. This could have an irreparable impact on the lives of trans youth and their families,” he said, adding that no clinicians at the youth gender clinics in Calgary or Edmonton had not been consulted on this policy.
One of Raiche’s biggest concerns is the ban on anti-puberty drugs in children under 16.
“It would make Alberta the most restrictive gender-affirming care system in all of Canada,” he said in an interview with CBC News.
“The extent of the harm caused by someone going through puberty that doesn’t match their gender identity… is just cruel,” he said.
The Canadian Pediatric Society notes hormonal suppression is reversible and puberty continues once treatment is stopped.
“It gives young people and their families a chance to pause, reflect (and) explore, without their bodies undergoing devastating changes that could harm them in irreversible and irreparable ways,” Raiche said.
According to the company, gender-affirming hormones, which the province is also seeking to ban for children under 16, are considered partially reversible. These medications are prescribed to “promote the development of physical characteristics better suited to an individual’s experienced sex.”
Mental health problems
Doctors warn that the mental health consequences of these changes will be significant and long-lasting.
According to the Canadian Pediatric Society, transgender youth are at higher risk of mental health problems, including depression, anxiety, self-harm and suicide.
“Now we’re asking young people to endure more mental distress, more mental anguish,” Raiche said.
The AMA Pediatrics Section said the move would increase mental health needs and the burden on the health care system.
“The mental health of these children and young people will be significantly worse if they are deprived of care,” the statement said.
“These new medical restrictions single them out and reinforce the stigma.”
Statement from the AMA Pediatrics Section regarding the government’s proposal to restrict medical treatments available to pediatric patients who identify as transgender pic.twitter.com/KKFNacGA21
Dr. Jake Donaldson, a Calgary-based family physician who treats gender-diverse youth and adults, worries about his patients.
“Most studies, including here in Canada and here in Alberta, have shown that about 40 percent of gender diverse people will attempt suicide at some point if they are not in a supportive environment,” a- he declared in an interview on the CBC radio show. Alberta at noon.
“It really can be a life or death situation for some of these kids.”
Calling it an attack on human rights, the United Nurses of Alberta also blasted the policy, warning it amounts to political interference.
“Using the medical treatment of young people as a pretext to launch a politically motivated attack on gender-affirming health care would endanger the lives of young people, ultimately increase the costs of providing health care, and set a dangerous precedent which should worry us all,” the statement said.
“Political decisions aimed at blocking one type of medical treatment can easily lead to political decisions aimed at blocking others.”
“I don’t think our prime minister has a role in telling us what we should do medically,” he said.
According to Donaldson, this policy puts doctors in a position where they risk violating the Hippocratic Oath.
“I took an oath when I went through my medical training that I will not harm anyone,” he said.
“If I sit back and do nothing…and force them to go through a transition that doesn’t match their gender identity and live a life in a body that’s going to leave them as a target for hateful violence…that makes me breaks my heart. I don’t know if I can accept this.”