Alberta doctor says Smith's new gender policies based on 'ideology, lack 'medical expertise'

Doctors are criticizing Alberta Premier Danielle Smith for her medically "false" 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’re deemed mature enough and have parental, physician and psychologist approval.

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

"Making permanent and irreversible decisions regarding one's biological sex while still a youth can severely limit that child's 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's future that I, as premier, am not comfortable with permitting in our province," 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's notwithstanding clause to preserve them.

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

"Firstly, she doesn't 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," Ladha said.

"These therapies that we're offering below the age of 18 are reversible. Hormone therapy is reversible. It's 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."

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's policies in the long run.

"I 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."

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.

"We've heard from medical professionals, all saying that they were not consulted when these policies were created, and that's 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," Ladha said.

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

"There's a degree of sadness. And it's disheartening. I'm angry. That was my initial impression of the video when I was watching it," he said.

"Transgender 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," he said.

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

"Across Canada, there are strict guidelines, generally, on this particular surgery for pediatric patients. It's pretty much prohibited."

This report by The Canadian Press was first published Feb. 2, 2024.

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