An Alberta doctor has raised concerns over Premier Danielle Smith’s gender policies, stating that they will hinder the province’s ability to attract trans specialists. Dr. Kate Greenaway, a trans health-care specialist and medical director of the Foria Clinic, is among a growing number of medical professionals calling for the UCP (United Conservative Party) to reject the proposed legislation. Greenaway argues that restricting healthcare options for trans and non-binary youth will create a culture of fear and discrimination that will deter specialists from practicing in the province. She emphasizes the importance of specialists forming close relationships with the trans community, which would be hindered by the proposed policies.
One of the contradictions identified by doctors lies in Premier Smith’s claim that the policies aim to prevent children from making irreversible decisions about their bodies. Pediatrician Dr. Tehseen Ladha disputes this, stating that hormone-blockers or pubertal-blockers, which are reversible, are being incorrectly portrayed as irreversible decisions. The Canadian Paediatric Society (CPS) supports this view, indicating that natural puberty resumes once the medication is stopped and that long-term fertility is not affected. These medications have been used for decades to treat various medical conditions and are known to have mild and minor side effects. Dr. Greenaway underscores the significance of puberty-blockers, as they provide trans youth with time to make complex decisions about their future without the distress and emotional harm that puberty often brings to this population.
Greenaway argues that limiting such interventions to 16-year-old patients, who have likely already undergone or completed puberty, effectively removes them as a treatment option. She criticizes Premier Smith’s idea that preserving youths’ future choice can be achieved by limiting the use of puberty blockers. Greenaway emphasizes that this approach fails to understand the medical necessity of supporting trans and non-binary youth and contradicts the evidence that shows the positive impact of these interventions on mental health and well-being, as well as reducing the risk of self-harm and suicide.
The Alberta Medical Association (AMA), the Canadian Paediatric Society (CPS), and the Social Workers Association of Alberta have all expressed their opposition to Premier Smith’s proposed policies. The AMA’s pediatrics section asserts that medical decisions for minors should involve the patient, their parents, and their physician or healthcare team. Dr. Ladha highlights that while the policies claim to protect parents’ rights, they actually restrict them by taking away their ability to endorse or give permission for puberty blockers for their children. Parental rights, therefore, are being removed from the hands of medical professionals who possess the necessary expertise in utilizing such therapies.
In response to criticism and concerns raised, Premier Smith has urged Albertans not to politicize the topic of trans youth. However, Dr. Greenaway argues that this is precisely what Smith has done, asserting that it is inappropriate for the government to initiate a public debate about trans people’s bodies, especially when discussing youth. Greenaway believes that these discussions can be painful and harmful, particularly if they create a perception that it is acceptable to discuss a 14-year-old’s body in such a manner in the media.
It remains unclear how the policies will be enacted, with some being implemented through regulation and ministerial orders, and others possibly requiring legislation. Premier Smith has not detailed the penalties for doctors who go against the policies and provide care outside of the prescribed guidelines.
Both Dr. Ladha and Dr. Greenaway anticipate that some doctors will continue to provide necessary gender-affirming care, irrespective of the rules if strict legislation opposing the policies is not enacted. They maintain that these doctors will prioritize what is best for transgender youth and their families, basing their decisions on scientific evidence and literature, rather than being swayed by policies that lack scientific support and have not involved consultation with stakeholders.
The province’s Minister of Health’s office has stated that they are consulting with medical professionals to ensure that minors requiring puberty blockers or hormone therapy for medical reasons, unrelated to gender reassignment, will still have access to the necessary medical care. The AMA and CPS have confirmed that they were not consulted on the matter. Dr. Ladha and Dr. Greenaway say they are unaware of any consultations taking place within the medical community.
In addition, the UCP is reviewing evidence-based guidelines and treatment recommendations from other countries such as Finland, Sweden, Denmark, Norway, and the UK regarding youth gender transition.
The concerns raised by medical professionals highlight the contradictions and potential risks associated with the proposed UCP gender policies. As the debate continues, it remains to be seen how these policies will be implemented and what impact they will have on the healthcare options available to trans and non-binary youth in Alberta.
