Adult choices

Grown-up gender reforms from Alberta's Danielle Smith

Photo by Guillaume Jaillet on Unsplash

Canada’s province of Alberta has announced plans to restrict medicalised gender change for minors, arguing that children must be protected from making irreversible decisions signing away reproductive rights and future sexual pleasure.

“As adults, we have an obligation to ensure for kids that they preserve all of those important choices until they’re adults, until they’re able to make those decisions with the maturity that goes along with that,” Alberta’s Premier Danielle Smith, of the United Conservative Party, said during a news conference on Thursday, following her seven-minute video address unveiling a package of interlocking gender reforms.

Under the rubric of “preserving choices for children and youth”, publicly funded patients in Alberta will have to wait until they are age 16 before starting puberty blockers or cross-sex hormones (existing prescriptions for gender dysphoria can continue). At ages 16 and 17, patients with capacity to give informed consent can begin these hormonal interventions if they have “parental, physician and psychologist approval.” All gender surgery under 18 will be prohibited.

Paediatric transition involves lifelong medicalisation with risks including sterilisation and sexual dysfunction. Social contagion online and via peer groups is suspected to be a factor in the unprecedented numbers of chiefly female teenagers disowning their birth sex and seeking life-altering medical interventions.

“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.”—Alberta’s Danielle Smith, video message, 1 February 2024

Allies offside

Alberta’s initiative was quickly condemned by the federal government under the Liberal Party Prime Minister Justin Trudeau, who styles himself as the champion of “2SLGBTQI+ Canadians.”

Federal Health Minister Mark Holland said he was “deeply disturbed” by Alberta’s proposed policy, which he claimed “places kids at risk [because] problems around sexual identity” were a leading cause of youth suicide.

“So, affirming gender, making sure that kids and families have the healthcare they need on extremely sensitive issues, is so very important,” Mr Holland said.

Alberta-based Liberal MP Randy Boissonnault, a founding member of the Canadian Pride Caucus, said “this is our NATO moment as an LGBTQ2S+ community. An attack on one of our communities is an attack on us all, and I need allies and champions to stand up.”

The opposition Conservative Party—whose national convention last year adopted a resolution to prohibit paediatric gender transition—had a lead of 17 percentage points over the Liberals in a recent poll. This is a federal election year.

Video: Alberta’s Premier Danielle Smith pitches her new gender policy

Package deal

The Alberta premier’s package of policies, to be implemented in the northern autumn, includes—

• a pilot counselling program for young people who identify as trans and for their families

• more health services for transitioned adults

• a requirement for parental consent before children aged 15 and under can alter names or pronouns at school

• tighter controls and more transparency over classroom instruction in sex and gender

• plans to protect fairness and safety in female sport from male-bodied players

“No Canadian politician with the power to make change has made such a sweeping proclamation on everything from protecting children, to parental rights, to fairness for women in sports,” Linda Blade, a Canadian sport performance coach and campaigner for women and children, told GCN.

She said Premier Smith’s intervention was “a seismic shift in the direction of sanity.”

“It will come to be seen as the moment Canadian leaders understood that proponents of gender identity have taken things way too far in all aspects of the dogma, and that a re-emergence of safeguarding of the citizen, based upon the reality of biological sex, is critical as a counterbalance in life and in law,” Dr Blade said.

Dr Blade’s Edmonton Strathcona electoral district in Alberta that sponsored last year’s national Conservative Party resolution upholding the right of women to single-sex spaces and female-only sport. A district in British Columbia put up the resolution “to protect children by prohibiting life-altering medicinal or surgical interventions to treat gender confusion or dysphoria”. (Note: An earlier version of this article stated incorrectly that it was Edmonton Strathcona behind the resolution to end paediatric transition—BL)

Gay men and women often told me [when I was researching my article] they fear that same-sex-attracted kids, especially effeminate boys and tomboy girls who are gender nonconforming, will be transitioned during a normal phase of childhood and before sexual maturation—and that gender ideology can mask and even abet homophobia.

As one detransitioned man, now in a gay relationship, put it, ‘I was a gay man pumped up to look like a woman and dated a lesbian who was pumped up to look like a man. If that’s not conversion therapy, I don’t know what is’.”—Pamela Paul, opinion article, The New York Times, 2 February 2024

Eyes on Europe

Alberta’s premier told Thursday’s media conference that her government had been monitoring the shift away from gender medicalisation in Europe and the global medical debate about youth gender dysphoria treatment.

“We’ve been watching internationally as the UK has made [treatment] policy changes, as well as Denmark, Norway, Finland, Sweden,” Ms Smith said.

“There really is a lot of divergence in the medical community about when the right time is for these [medical interventions] and in the absence of providing guideposts, it really is going to be just up to the individual doctor, and we just don’t think that that’s the environment that we should be having here.

“We think it’s important that we set some guidelines, so that those who are going through this journey know the decision points where they can commence hormone treatment and where they can commence surgery.”

In her remarks, the premier stressed the need for kindness, inclusion and non-discrimination, as well as protecting the best interests of still-maturing young people and maintaining the strength of the child-parent bond.

“Making permanent and irreversible decisions regarding one’s biological sex, while still a youth, can severely limit that child’s choices in the future,” she said.

“Something that struck me with [Ms Smith’s video] speech was how much it sounded like a loving, authoritative parent was finally setting boundaries for her unruly children. It’s been a long time since it has felt like there are reasonable adults in charge in this country, and we need this if our Canadian ‘family’ is to survive and thrive. Tough love and firm spines will be necessary. And we can’t give in to the tantrums anymore, or they will never stop!”—Canadian lawyer and civil libertarian Lisa Bildy, tweet, 2 February 2024

Winning ways

Canadian Gender Report, a group of parents and professionals concerned about gender medicalisation, welcomed Ms Smith’s approach.

“The tone of her message was warm and compassionate as well as direct and truthful and we believe this bodes well for her government’s chances of making the new policy changes stick,” the group said in a post. (There has been speculation about a rights-based court challenge to Alberta’s foreshadowed legislative reforms.)

“These changes signal to children that the decision to change one’s physiology to achieve a gender ideal is an adult decision. Establishing clear boundaries with age limits is an important principle that recognises the risks that come with these medical interventions.

“In particular, there needs to be a clear distinction between adults and children so that clear assessment requirements can be established to safeguard young people who are prone to peer influence and social media harms.”

Chris Elston, a Canadian father who has taken his campaign against puberty blockers to the streets of North America, told GCN he believed the breakthrough in Alberta was “a result of many people creating awareness over the past few years.”

“Every conservative in the country is awake to this child abuse,” he told GCN.

Known as “Billboard Chris”, Mr Elston wears a sandwich board with a simple message, such as “Children cannot consent to puberty blockers” or “Children are never born in the wrong body.”

On street corners, in town squares or on campus, his approach is “having one conversation at a time to raise awareness about this medical scandal.”

In a 40-minute talk delivered in Calgary, Alberta, last November he declared, “There is no such thing as a ‘transgender child,’ they’re called girls and boys. And the positive message we should be sending is that they are beautiful just as they are—no drugs or scalpels needed.” (A tweeted video of the talk has 2.6 million views.)

“I understand a couple of Alberta politicians were in the audience that day,” he told GCN. “I spoke with some influential movers and shakers in Alberta, as well, but I wasn’t part of the planning for this [new gender policy].

“Some other Canadian provincial politicians and former MPs are finally working with me as well, so I’m confident more good news is coming.”

Another safeguarding group, Our Duty, characterised Ms Smith’s provincial proposals as offering “some protection from medical harm and indoctrination for children and vulnerable adolescents.”

“However, there are still significant changes needed before Alberta is truly safe for those susceptible to transgender ideation,” the group told GCN.

“We can see that we still have work to do toward educating people, especially politicians, about the threats to our youth and the perils of using language that plays into the hands of those pushing the transgender agenda.”

“Many who think there needs to be a more cautious approach [to gender medicalisation]—including well-meaning liberal parents, doctors and people who have undergone gender transition and subsequently regretted their procedures—have been attacked as anti-trans and intimidated into silencing their concerns.

“Detransitioners say that only conservative media outlets seem interested in telling their stories, which has left them open to attacks as hapless tools of the right, something that frustrated and dismayed every detransitioner I interviewed. These are people who were once the trans-identified kids that so many organizations say they’re trying to protect—but when they change their minds, they say, they feel abandoned.”—Pamela Paul, opinion article, The New York Times, 2 February 2024

News tip

After journalists suggested Alberta’s policy package was “a political stunt” pandering to “far-right wing voters”, Premier Smith said she believed the measures had broad popular support, and that the views of trans people varied.

There are prominent transsexuals internationally who hold that minors are simply not mature enough to undergo something as serious as medical transition. Canadian trans women Lois Cardinal and Tiffany Gillis were among those given a hearing during development of Alberta’s gender policy proposals.

Ms Smith urged journalists “to consult widely in the gay and transgender community, because once again, just like among doctors, there isn’t a single voice.”

“Issues involving kids’ reproductive health are not a political stunt.” she said.

“It is essential for us to show leadership and preserve kids’ choices… so that they haven’t prematurely made a decision that they can’t live with.

“I am confident that Albertans do not want children to make irreversible decisions that impact their reproductive health, I am confident that they do not think that those are ‘child decisions’ to make—[but rather] that those are ‘adult decisions’ to make.

“I am also confident that parents love their kids, and they want to know what’s going on with their kids—doesn’t matter what perspective they come from—they want to make sure that they’re walking the journey with their child every step of the way.

“And anyone who’s trying to put roadblocks in that child-parent relationship… I don’t think they have public support.”