From the Frontier Centre for Public Policy

By David MacKinnon

In recent days, Premier Smith has endured criticism from many people about her recent announcements relating to treatments for what is often described as gender transition.

Instead, she deserves praise for decisions that are as important for how they were made as for the gender transition issues that concern her and her colleagues. Her actions on this matter demonstrate how public policy should be developed and explained.

The most important quality of the recent policy announcements by the Alberta government is that they are evidence based.

There is an emerging consensus outside Canada that the evidence supporting pharmacological and surgical procedures to change genders in minors is either very weak or nonexistent.

Sweden, Finland, the UK and Norway have restricted or forbidden the use of these treatments on minors, as have twenty-three American states. Ms. Smith referred to these in her press conference announcing the changes her government is making.

Leaders in other countries have done this after conducting detailed studies including one by the UK High Court of Justice and another by Dr. Hilary Cass, a former President of the Royal College of Pediatrics and Child Health in the United Kingdom

Dr. Cass is an independent expert commissioned to provide advice to the National Health Service on gender treatments. She concluded that “evidence on the appropriate management of children with gender incongruence is inconclusive both nationally and internationally’’.

The second reason the decisions taken by Alberta are important is that they were taken despite ideology advocated by the Government of Canada and the  unwillingness of federal officials including the Prime Minster to support their opposition to the Alberta policies with any evidence.

In his initial comments, the Prime Minister made no reference to any of the many studies that have been done describing the dangers of pharmacological and surgical procedures to change the gender of minor children.

He also displayed no understanding of the experiences of other countries on this matter. He did not refer to the Cass report and its seminal conclusions.

The comments by Federal Health Minister Mark Holland lacked any evidence the public could use. He also used offensive rhetoric.

Mr. Holland described the Alberta decisions as being behaviour that is “extremely dangerous to engage in …. which is, I think, playing politics about children’s lives.” He also referred to the “devastation that its going to bring”, referring to the Alberta changes.

Federal communications marked by a factual vacuum and excessive language are not going to help resolve serious differences of opinion on serious issues. They are also not condusive to good relations between the federal government and an important province.

The third and particularly significant reason the recent changes announced by the Alberta government are so important is that they will protect children.

Adolescence, a phase of child development that has been with us for thousands of years, is an important part of everyone’s life.

It is a vital part of what it means to be human. Delaying or blocking it is dangerous, something that many observers have noted but that the Prime Minister and the Minister of Health do not recognize.

Federal leaders need to inform themselves, particularly about the negative impact of puberty blockers on bone and brain development and the lifelong medical attention many transitioners will need because of the pharmacological and surgical procedures used on them to change genders.

The Prime Minister and the Minister of Health should also learn about the increasingly large number of transitioners who regret their transition and later seek to reverse it. Their situation is particularly tragic because many of the negative consequences of changing genders in children cannot be reversed.

Federal leaders also support hiding from parents the decisions children make in schools about the pronouns they use to describe their genders. This is another practice that many feel is harmful and divisive.

The federal perspective on this is unreasonable.

Our species survived over the centuries because the first priority for most parents is their children and most take good care of them.

There is no basis for a lack of trust in them and in the relatively few cases where parents do not provide appropriate care, the child protection laws come into play.

It is particularly important that federal leaders recognize the grave problems that puberty blockers and related surgeries often pose for children who are gays or lesbians.

These children sometimes display some of the attributes of the opposite sex as they grow, and these are often misinterpreted as gender dysphoria. They then get treated for a problem they don’t have, with serious lifelong consequences.

Unfortunately, this happens in many Canadian pediatric hospitals.

There is nothing wrong with these children. They should be allowed to develop and grow in their own way  and be who they are. That means no puberty blockers or surgeries to change them.

The fourth reason to respect the new directions on gender issues Ms. Smith and her colleagues have decided upon is the moderation displayed by the Alberta government in putting them forward and communicating with the public about them.

The language used has been understated. The changes are lawful in every respect including in relation to the Charter of Rights and Freedom and other legislation.

The evidence has been clearly presented in a way most citizens can readily understand and great care has been taken to deal with those who may have concerns thoughtfully, including allowing time for debate and discussion before the changes are made.

This is a good example of how governments should behave. Federal leaders should show some respect for the approaches taken by Ms. Smith and her colleagues as they dealt with a very complex issue.

The final reason for the importance of the Alberta approach is that it has avoided many of the problems associated with medical practice standards and regulation that are so evident in Canada and which have been a major cause of the difficulties our country faces on gender issues.

Provincial Colleges of Physicians and Surgeons and many regulators elsewhere regulate doctors based largely on prevailing practices by physicians rather than clinical outcomes.

This means that there have been many cases over the years, in Canada and elsewhere, where evidence to support medical procedures has been lacking. Current practices toward gender dysphoria in Canada and some US states are examples.

In these cases, if something is done often enough by enough doctors, that procedure becomes the standard and not clinical outcomes. This often leads to perverse outcomes that everyone ultimately regrets.

In the years to come, unless we change course soon and unless others follow the Alberta path, people will be wondering how the problems summarized in this article developed and why we damaged so many children by an approach defined more by ideology than factual reality.

David MacKinnon is a Senior Fellow at the Frontier Centre for Public Policy