'Doctors aren't always right': Alberta goes ahead with controversial transgender policies in 3 new bills

The Alberta government has tabled three bills that will change, among other things, how transgender youth and athletes are treated in the province.

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Premier Danielle Smith first introduced various policies aimed at transgender youth in January, saying they are designed to "protect the rights of kids" to make medical decisions as adults.

While the policies have seen support from some Albertans, they also sparked backlash from academics, doctors, legal experts and LGBTQ2S+ advocates.

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On Thursday, Smith introduced the details on those policies and defended them.

Transgender health care

The Health Statutes Amendment Act, 2024, makes changes to the Health Professions Act, including:

• Banning sex-reassignment surgeries on minors;
• Banning puberty blockers and hormone therapies for transgender youth 15 years old and under;
• Introducing new definitions for 'gender dysphoria', 'sex-reassignment surgery', 'minor', and 'gender incongruence';
• Granting the health minister authority to identify surgeries considered sex-reassignment surgery; and
• Granting the health minister authority to identify which drugs can be used to treat transgender youth.

Health-care professionals have previously pointed out that sex-reassignment surgery is not being performed on minors in Alberta, with the exception of top surgery in rare cases.

Experts have also said that puberty-blockers are safe, reversible and give kids more time to explore gender identity without more invasive measures.

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"Doctors were given a lot of latitude to prescribe opioids and now we have a Fentanyl crisis," Smith said in defence of the new legislation.

"I would say doctors aren't always right."

Smith could not answer questions about how many Alberta youth were being given hormone therapy, or how many under-age gender-affirming top surgeries have been done in the province.

Instead, she reiterated that she is following similar moves made by other countries like the U.K. and Denmark.

"When you identify something that's a problem, you have to put a legislative framework in place to address it," Smith said. "We have identified that there are some problems, and so this is what we're trying to do."

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Minors, aged 16 and 17, will be allowed to access puberty-blockers and other hormone therapies with parental, physician and psychologist approval.

The bill does not legislate penalties for doctors who break the rules, and medical professionals will continue to be overseen by regulatory colleges.

If it passes, the ban on surgery will come into force immediately. The ban on puberty blockers and hormone therapies would come into effect in the winter.

Youth who have begun hormone therapies before the laws come into effect will be allowed to continue.

Pronouns and sexual education

The Education Amendment Act outlines new rules around pronouns and sexual education in schools.

If passed, the bill will:

• Require parents to be notified if a student 15 years old or under requests to use a different name or pronoun at school;
• Prevent teachers from using a student's preferred name or pronoun until a parent has given consent;
• Require parents opt-in to sexual education; and
• Require all teaching resources on human sexuality to be approved by the minister of education.

The province says if telling parents about a pronoun change is expected to "result in emotional or psychological harm to the student,' school boards are responsible for giving that student "assistance" before the notification.

Regulations will apply to public, separate, charter, francophone and independent schools. It would come into effect next fall if passed.

Smith would not say if Alberta, like Saskatchewan, would be willing to invoke the notwithstanding clause to enforce the policies.

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"The charter allows for limits on rights that are reasonable in a free and democratic society. We think what we're putting forward is reasonable," Smith said when asked.

Sporting restrictions

The new Fairness in Safety in Sport Act will create rules around how transgender women and girls can participate in sports.

If passed, only women and girls assigned female at birth will be allowed to compete in female sporting divisions.

Those rules will apply to school authorities, post-secondaries and provincial sporting organizations as defined by the act.

Minister of Tourism and Sport Joseph Schow said eligibility will be determined using the registration of sex at birth, because it's legal for Albertans to change the sex on their birth certificate.

Organizations will be required to report the following to the provincial government:

• Any complaints related to athlete eligibility and how they were handled; and
• Any requests to create mixed-gender or mix-sex leagues, classes or divisions.

The bill includes legal protection for provincial ministers and staff, sporting organizations and athletes in following the rules in the act.

When asked about the need for this legislation, Schow said the province doesn't keep track of how many transgender athletes there are in Alberta, and he could not say how many are competing in women's sports.

If passed, that legislation is expected to come into force next fall.  

Reaction

Alberta NDP leader Naheed Nenshi, issued a statement in response to the legislation, where he called into question the province's priorities.

"As a politician I will tell you that I have been in every corner of this province these last four months," the statement read. "We’ve talked to Albertans of every background and I will tell you that punching down on trans kids does not appear in the top 50 of the things Albertans are concerned about."

 "I think she's going to ruin the lives of a lot of young gender-diverse people," said Dr. Jake Donaldson, who works with many LGBTQ2S+ patients.

Donaldson pointed at the puberty-blockers ban as particularly harmful, as it will force transgender youth to go through puberty and develop secondary-sex characteristics that don't match their gender.

"They're going to have to spend the rest of their lives living in that body as potential targets of transphobic hate," he added. "It really is going to ruin the lives of a lot of people."

Smith invited three transgender people to speak in support of the various bills on Thursday, including the founder of De-Trans Alliance Canada Kellie-Lynn Pirie, who shared her own regret about transitioning.

Donaldson said current research suggests her story is a rare one.

"The best done studies have really suggested rates of 'detransition' are somewhere in the realm of one to three, maybe four per cent," he said. "That is a risk that we address with every family when we're weighing these decisions with youth and their families.

"That has to be weighed over and against the risk of doing nothing … the risks associated with that are much, much higher."

Donaldson cited a recent study published in the scientific journal Science, which found that U.S. states with laws restricting rights for transgender and non-binary people saw "significant increases" of suicide attempts within those groups after that legislation was enacted.

Egale Canada and Skipping Stone Foundation cited the same study in a press release where the groups said they would be taking legal action against the provincial government over the announced legislation.

Kristopher Wells, Canada research chair for the public understanding of sexual and gender minority youth, called it a "sad day" and echoed that the province will undoubtedly face legal challenges.

"Gender identity is a protected ground against discrimination in every human rights act in the country, and these policies, this legislation, is clearly discriminatory," Wells said.

"It is not rooted in evidence. It is rooted in fear mongering, rhetoric, propaganda, and transphobia," Rowan Morris, founder of Trans Rights Yeg, said of the new legislation. 

"We know that gender-diverse people experience predominant rates of poverty, mental health issues, and all of this is due to emboldened homophobia and transphobia," Morris said. "This does not just exist in the halls of these buildings. These are real lives they are affecting."

Morris said a protest is planned for Saturday at 3 p.m. at the legislature.