The Canadian Medical Association (CMA) has
a legal challenge to Alberta’s recent ban on puberty blockers and cross-sex hormones for youth under 16 who identify as transgender. The CMA argues that Alberta’s
, enacted in December last year, violates physicians’ Charter right to freedom of conscience. This raises a pertinent question: If a doctor is compelled by conscience to subject vulnerable youth to unproven treatments despite growing evidence of harm, should governments intervene to protect patients?
It is troubling that Canada’s most prominent medical body would oppose a law grounded in precisely the kind of evidence-based caution other nations are embracing. Countries like
,
, and
have all conducted years-long investigations into the practices in their paediatric gender clinics and, after finding that potential benefits of puberty blockers were inconclusive or that the risks outweigh the benefits, have reverted to a cautious psychotherapeutic approach to helping gender-distressed youth.
The CMA, by contrast, calls Alberta’s move an “unprecedented government intrusion” into the doctor-patient relationship, claiming it forces doctors to choose between obeying the law and doing what they think is best for their patients. Yet it is becoming increasingly clear that, regardless of their good intentions, doctors who continue to prescribe these interventions could be inflicting
on the young people they seek to help in the form of infertility, reduced bone density, disrupted psychosocial development, and impaired sexual function.
The decision to build the case on freedom of conscience is a curious one. Conscience rights are meant to protect doctors’ right to refrain from providing treatments that violate their moral or ethical beliefs — such as in cases related to abortion or medical assistance in dying — not to grant them the right to perform interventions that lack solid evidence or violate medical ethics.
The CMA invoking conscience to justify harmful and unproven treatments turns the principle on its head. An Ontario court has
that physicians’ conscience rights do not protect them from the requirement of making referrals to MAID practitioners. If conscience rights cannot protect a physician from taking an action that goes against a core belief, it’s unclear why such rights would empower them to perform what Finland refers to as an “
.”
Comments made to the media by CMA president Joss Reimer reveal an astonishingly poor understanding of the field of gender medicine. She
that “ideological influence” does not help vulnerable patients, when in truth, the current approach to paediatric gender medicine in most Canadian provinces is a textbook case of ideology-based practice.
The entire field is built upon research out of the Netherlands that has been shown to be
, and the diagnosis of gender dysphoria is shaped by
intended to reduce stigma and distress.
What’s more, the Canadian Pediatric Society bases its recommendations on the field’s standards of care which are set by the
World Professional Association for Transgender Health (WPATH). In a
legal challenge to Alabama’s youth gender medicine ban, WPATH was forced to disclose over two million internal emails that
the organization blocked independent systematic reviews that showed low-quality evidence, consulted “social justice lawyers” when drafting its medical guidelines, and, at the Biden administration’s request, removed almost all lower age limits from its adolescent chapter to avoid undermining state-level legal battles.
Reimer also stated, without irony, that medical decisions should be based on “the best science.” Yet the best science — specifically the systematic reviews from Sweden, Finland, England, and a
— has all concluded the evidence base for paediatric medical transition is of very low certainty. Alberta’s Bill 26 reflects that consensus. The CMA’s position contradicts it.
This isn’t the first legal challenge to Alberta’s legislation. Late last year,
— originally a gay rights charity that expanded into trans advocacy in the early 2000s — teamed up with the
and five families
. That move is surprising given early research conducted by leading figures in gender medicine, Psychologist/Sexologist Kenneth Zucker and Psychiatrist Susan Bradley, found that most children with early-onset gender dysphoria would grow up to be
or
if left untreated, and same-sex attracted teens are
in the
adolescent patients
who began flooding gender clinics
in the 2010s and among
That a gay rights group would back medical interventions that have the potential to sterilize homosexual adolescents is a tragic reversal of purpose.
In an
, Dr. Jake Donaldson, one of three Alberta doctors who filed the challenge alongside the CMA, inadvertently highlighted the questionable rationale for these extreme medical interventions. He believes that puberty blockers and cross-sex hormones help gender-distressed youth blend in better as members of the opposite sex, which makes them “safer and happier.” But even if that were true — and there is no high-quality evidence to suggest that it is — this approach only offers a superficial, short-term fix that ignores the deeper psychological struggles of these youth. And it can come at such immense long-term cost in the form of
,
, and
.
“Medicine is a calling,” explained the CMA president in her
. “Doctors pursue it because they are compelled to care for and promote the well-being of patients.”
Yet noble intentions are no safeguard against harm. History is littered with medical scandals. At the centre of each one, there were well-intentioned doctors who left a trail of devastation in their quest to help patients. The doctors who prescribed
didn’t do so with the intention of causing major birth defects; the obstetricians who sent expectant mothers for
didn’t deliberately set out to cause childhood leukemia, and Walter Freeman
his prefrontal lobotomies were a humane alternative to the deplorable conditions in insane asylums.
At this point, there is little doubt that paediatric gender medicine is destined to take its place in history alongside these medical catastrophes. Therefore, Alberta is not acting unreasonably; it is acting responsibly. By restricting unproven and irreversible treatments for minors, the province has commendably joined a global wave of governments re-asserting evidence and ethical principles in the face of medical groupthink. It is the CMA — not the Alberta government — that must reckon with its conscience.
Mia Hughes specializes in researching pediatric gender medicine, psychiatric epidemics, social contagion and the intersection of trans rights and women’s rights. She is the author of “The WPATH Files,” a senior fellow at the Macdonald-Laurier Institute, and director of Genspect Canada.
National Post
