Alberta Premier Danielle Smith stood behind her government’s recently announced policies regarding transgender youth, gender-affirming care, sex education and parental notification.
In a news conference Thursday, Smith said she believes the suite of policies and guidelines, announced on Wednesday afternoon through a video shared on social media, “struck the right balance.”
The policy includes a prohibition on gender-affirmation surgery (top and bottom surgeries) for Albertans under 18 years old. It also prohibits puberty blockers and hormone therapy for Alberta youth 15 and under, unless they’ve already started treatment.
“We are supporting kids in their right to make decisions about their own journey at a time when they’re mature enough to make those decisions,” Smith said Thursday.
“Age 16 is when they can begin with hormone therapies and age 18 is when they’ll be able to commence top and bottom surgery.
“We just think that’s the responsible way of approaching this issue so that kids are not precluded from all the future choices that come to them when they decide to make the decision that’s going to have potentially serious ramifications on their reproductive (health).
“So, we think this is preserving of choice.”
Smith said she looked to other jurisdictions while considering these rules. While she said Saturday that the UCP “consulted very broadly” on this issue, she has not said who or what groups or experts were consulted.
Still, on Thursday, the premier said she believes the majority of Albertans support this direction.
“I am confident that Albertans do not want children to make irreversible decisions that impact their reproductive health. I’m confident that they don’t think those are child decisions to make, 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, it doesn’t matter what perspective they come from. They want to make sure they’re walking the journey with their child every step of the way.”
She announced Alberta will pilot a project for additional counselling for trans kids and their parents. Smith also said Alberta was trying to attract one or more medical experts in the field of gender-affirming care for adults.
“I think it is supportive. And we want to make sure that in every step of that journey, that the kids feel supported by their families and supported by mental health support, if that’s what’s they need,” Smith said.
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“But that is I think that when you’re talking about irreversible decisions, that falls into the category of adult choices,” she added.
“We’re not stopping any covered service. We do about 100 transgender approvals for surgery every year and about a quarter of them are aged 18 to 25.”
Smith did not say if any patients were under 18.
She also pointed out that puberty blockers and hormone therapy are currently not covered by provincial health care.
Travers, a sociology professor at Simon Fraser University, said the Canadian standard is to not perform bottom surgery on patients under 18 anyway.
According to the World Professional Association for Transgender Health’s standards of care, an individual must be the age of majority in their country to be allowed to undergo gender-affirming surgery. Therefore, in Canada, the required age for genital reconstructive surgery is 18.
That wasn’t the part of Smith’s policy announcement that worries Travers.
“Denying them access to hormone blockers is incredibly dangerous because it’s forcing them to undergo a puberty that they are going to find intensely traumatic.
“For kids who are experiencing really severe gender dysphoria and who find the development of secondary sex characteristics deeply distressing … hormone blockers are a short-term solution that have no permanent impact,” Travers said.
“They just stop the development of secondary sex characteristics. They’re typically prescribed when young person reaches what they call ’10’ or ‘Stage 4,’ the beginning of the development of secondary sex characteristics, and hormone blockers just stop that.”
Kids who are prescribed hormone blockers are under the care of a licensed physician and often seen at children’s hospitals with gender clinics, they said.
Travers said they’ve interviewed more than 60 trans kids over the last several years and “a significant number” of them revealed that having access to hormone blockers saved their lives.
“Forcing them to go through puberty means, as adults, they will be more vulnerable to discrimination and violence.”
David Brennan, a professor of social work at the University of Toronto, said gender-affirming care saves lives.
“My research, and the research of my colleagues, consistently across the sciences, have shown that if you delay people having access to gender-affirming treatment and care, again, it increases and impacts the potential for suicidal thoughts and behaviours, as well as other mental health issues such as depression and anxiety.”
The UCP policies also address youth who want to change their name or pronouns in school. Smith said for children 15 and under, parental notification and parental consent will be required. For youth aged 16 and 17, parental notification will be required, but not parental consent.
“Unfortunately, when we’re talking about trans youth, who are often not safe in their homes or safe at school because of their gender identity or their trans identity, we are not building a better or safer place for them by … requiring parental consent for every change of a pronoun or name,” Brennan said. “That is a challenge and a problem.”
He said it could mean kids are being “outed” at home, where it may not be safe.
“Families are not always the safest place for queer or trans youth,” Brennan said. “They may be. But every parent wants to believe that they have the best interest of their children at heart, but that’s not always the case.”
When it comes to education in the classroom, Smith said any instruction that involves gender identity, sexual orientation or human sexuality will require parental notification and an “opt-in” approach to each lesson.
All third-party resources used for education in K-12 classes on the topics of gender identity, sexual orientation and human sexuality will need to be pre-approved by the ministry of education, Smith added.
The premier said new policies would also address transgender Albertans in sport. She said female Albertans should have the choice to compete in “women’s-only” events and that transgender athletes could compete in “co-ed or gender-neutral” events.
In her video address, Smith assured transgender children that they are loved and supported. She asked adults to “depoliticize” the debate around this issue.
Brennan said he was surprised at how much the UCP government involved itself in this issue.
“I understand that part of the agenda here is in Alberta — and other places, of course — is to be thinking about less involvement of government in people’s lives… but then here’s a situation where the government is actually saying: ‘We’re going to limit your freedoms and actually step into your lives and basically regulate and translate your bodies and your decisions. That is disturbing.
“I appreciate that Premier Smith is trying to be compassionate and thinking about this through a compassionate lens but I just think she’s missed the boat,” Brennan added. “They have missed the point.
“And they’ve not really provided any evidence to suggest that these policies are actually going to help gender non-conforming and trans folks in Alberta.”
Smith said discussion and consultation around implementing these policies will take place “over the coming months.”
“We’re looking at having those things that need to be legislated or put into regulation or policy, having that package ready for the fall.”