Frontier Centre for Public Policy
Transition Troubles: Medical Risks and Regret Among Trans Teens
From the Frontier Centre for Public Policy
By Lee Harding
Do teens going through cross-gender hormones and surgeries know what they’re doing? A leak of internal conversations by the World Professional Association for Transgender Health shows even some doctors administering the procedures have serious doubts.
The U.S. advocacy organization Environmental Progress, led by president and founder Michael Shellenberger, made the leaks public.
“The WPATH Files show that what is called ‘gender medicine’ is neither science nor medicine,” Shellenberger said in a press release.
A short list of excerpts highlighted many telling comments.
Child psychologist Dianne Berg, who co-authored the child chapter of the 8th edition of WPATH Standards of Care, said young girls don’t understand what it means to get male hormones.
“[It is] out of their developmental range to understand the extent to which some of these medical interventions are impacting them. They’ll say they understand, but then they’ll say something else that makes you think, oh, they didn’t really understand that they are going to have facial hair.”
Canadian endocrinologist Dr. Daniel Metzger acknowledged, “We’re often explaining these sorts of things to people who haven’t even had biology in high school yet.”
Metzger said neither he nor his colleagues were surprised at a Dutch study that found some young post-transition adults regretted losing their fertility.
“It’s always a good theory that you talk about fertility preservation with a 14-year old, but I know I’m talking to a blank wall. They’d be like, ew, kids, babies, gross,” Metzger said.
“I think now that I follow a lot of kids into their mid-twenties, I’m like, ‘Oh, the dog isn’t doing it for you, is it?’ They’re like, ‘No, I just found this wonderful partner, and now want kids.’ … It doesn’t surprise me.
“Most of the kids are nowhere in any kind of a brain space to really talk about [fertility preservation] in a serious way.”
While youth keeps some from grasping the lifelong consequences of their actions, mental illness does the same for others. But that doesn’t always mean the doctors refuse to transition them.
One gender therapist administered cross-sex hormones to a patient with dissociative identity disorder. The therapist said asking the split personalities if they approved the treatment was ethical. Otherwise, a lawsuit could follow.
In one case, a nurse practitioner struggled with how to handle a patient with PTSD, major depressive disorder, observed dissociations, and schizoid typical traits who wanted to go on hormone therapy. Somehow the clear moral dilemma was lost on Dr. Dan Karasic, lead author of the mental health chapter of WPATH Standards of Care 8.
Karasic replied, “I’m missing why you are perplexed… The mere presence of psychiatric illness should not block a person’s ability to start hormones if they have persistent gender dysphoria, capacity to consent, and the benefits of starting hormones outweigh the risks…So why the internal struggle as to ‘the right thing to do?’”
Testosterone injections carry cancer risks for those born female. In one case, a doctor acknowledged a 16-year-old had two liver masses, one 11 cm by 11 cm, and another 7 cm by 7 cm, and “the oncologist and surgeon both have indicated that the likely offending agent(s) are the hormones.”
The friend and colleague of one doctor received close to ten years of male hormones, leading to hepatocarcinoma. “To the best of my knowledge, it was linked to his hormone treatment… it was so advanced that he opted for palliative care and died a couple of months later,” the doctor said.
Some female-born transitioning patients had terrible pain during orgasms, while males on estrogen complained of erections “feeling like broken glass.”
The future may be even stranger, according to one doctor.
“I think we are going to see a wave of non-binary affirming requests for surgery that will include non-standard procedures. I have worked with clients who identify as non-binary, agender, and Eunuchs who have wanted atypical surgical procedures, many of which either don’t exist in nature or represent the first of their kind and therefore probably have few examples of best practices,” the doctor said.
Unsurprisingly, some people regret their medical transitions and want to change back. Some WPATH members want to discount this altogether. WPATH President Marci Bowers admitted, “[A]cknowledgment that de-transition exists even to a minor extent is considered off limits for many in our community.”
An unnamed researcher thought it was just a matter of perspective, saying, “What is problematic is the idea of detransitioning, as it frames being cisgender as the default and reinforces transness as a pathology. It makes more sense to frame gender as something that can shift over time, and to figure out ways to support people making the choices they want to make in the moment, with the understanding that feelings around decisions [may] change over time.”
Should our physical being be substantially altered and re-altered according to our feelings? Is transitioning a matter of mental health or self-expression? At least Alberta is putting the brakes on these dubious practices for minors. Other provinces should follow.
Lee Harding is a research fellow for the Frontier Centre for Public Policy.
Business
Carney’s Deficit Numbers Deserve Scrutiny After Trudeau’s Forecasting Failures
From the Frontier Centre for Public Policy
By Conrad Eder
Frontier Centre for Public Policy study reveals a decade of inflated Liberal forecasts—a track record that casts a long shadow over Carney’s first budget
The Frontier Centre for Public Policy has released a major new study revealing that the Trudeau government’s federal budget forecasts from 2016 to 2025 were consistently inaccurate and biased — a record that casts serious doubt on the projections in Prime Minister Mark Carney’s first budget.
Carney’s 2025–26 federal budget forecasts a $78.3-billion deficit — twice the size projected last year and four times what was forecast in Budget 2022. But if recent history is any guide, Canadians have good reason to question whether even this ballooning deficit reflects fiscal reality.
The 4,000-word study, Measuring Federal Budgetary Balance Forecasting Accuracy and Bias, by Frontier Centre policy analyst Conrad Eder, finds that forecast accuracy collapsed after the Trudeau government took office:
- Current-year forecasts were off by an average of $22.9 billion, or one per cent of GDP.
- Four-year forecasts missed the mark by an average of $94.4 billion, or four per cent of GDP.
- Long-term projections consistently overstated Canada’s fiscal health, showing a clear optimism bias.
Eder’s analysis shows that every three- and four-year forecast under Trudeau predicted a stronger financial position than what actually occurred, masking the true scale of deficits and debt accumulation. The study concludes that this reflects a systemic optimism bias, likely rooted in political incentives: short-term optics with no regard to long-term consequences.
“With Prime Minister Carney now setting Canada’s fiscal direction, it’s critical to assess his projections in light of this track record,” said Eder. “The pattern of bias and inaccuracy under previous Liberal governments gives reason to doubt the credibility of claims that deficits will shrink over time. Canadians deserve fiscal forecasts that are credible and transparent — not political messaging disguised as economic planning.”
The study warns that persistent optimism bias erodes fiscal accountability, weakens public trust and limits citizens’ ability to hold government to account — a threat to both economic sustainability and democratic transparency.
Business
Capital Flight Signals No Confidence In Carney’s Agenda
From the Frontier Centre for Public Policy
By Jay Goldberg
Between bad trade calls and looming deficits, Canada is driving money out just when it needs it most
Canadians voted for relative continuity in April, but investors voted with their wallets, moving $124 billion out of the country.
According to the National Bank, Canadian investors purchased approximately $124 billion in American securities between February and July of this year. At the same time, foreign investment in Canada dropped sharply, leaving the country with a serious hole in its capital base.
As Warren Lovely of National Bank put it, “with non-resident investors aloof and Canadians adding foreign assets, the country has suffered a major capital drain”—one he called “unprecedented.”
Why is this happening?
One reason is trade. Canada adopted one of the most aggressive responses to U.S. President Donald Trump’s tariff agenda. Former prime minister Justin Trudeau imposed retaliatory tariffs on the United States and escalated tensions further by targeting goods covered under the Canada–United States–Mexico Agreement (CUSMA), something even the Trump administration avoided.
The result was punishing. Washington slapped a 35 per cent tariff on non-CUSMA Canadian goods, far higher than the 25 per cent rate applied to Mexico. That made Canadian exports less competitive and unattractive to U.S. consumers. The effects rippled through industries like autos, agriculture and steel, sectors that rely heavily on access to U.S. markets. Canadian producers suddenly found themselves priced out, and investors took note.
Recognizing the damage, Prime Minister Mark Carney rolled back all retaliatory tariffs on CUSMA-covered goods this summer in hopes of cooling tensions. Yet the 35 per cent tariff on non-CUSMA Canadian exports remains, among the highest the U.S. applies to any trading partner.
Investors saw the writing on the wall. They understood Trudeau’s strategy had soured relations with Trump and that, given Canada’s reliance on U.S. trade, the United States would inevitably come out on top. Parking capital in U.S. securities looked far safer than betting on Canada’s economy under a government playing a weak hand.
The trade story alone explains much of the exodus, but fiscal policy is another concern. Interim Parliamentary Budget Officer Jason Jacques recently called Ottawa’s approach “stupefying” and warned that Canada risks a 1990s-style fiscal crisis if spending isn’t brought under control. During the 1990s, ballooning deficits forced deep program cuts and painful tax hikes. Interest rates soared, Canada’s debt was downgraded and Ottawa nearly lost control of its finances. Investors are seeing warning signs that history could repeat itself.
After months of delay, Canadians finally saw a federal budget on Nov. 4. Jacques had already projected a deficit of $68.5 billion when he warned the outlook was “unsustainable.” National Bank now suggests the shortfall could exceed $100 billion. And that doesn’t include Carney’s campaign promises, such as higher defence spending, which could add tens of billions more.
Deficits of that scale matter. They can drive up borrowing costs, leave less room for social spending and undermine confidence in the country’s long-term fiscal stability. For investors managing pensions, RRSPs or business portfolios, Canada’s balance sheet now looks shaky compared to a U.S. economy offering both scale and relative stability.
Add in high taxes, heavy regulation and interprovincial trade barriers, and the picture grows bleaker. Despite decades of promises, barriers between provinces still make it difficult for Canadian businesses to trade freely within their own country. From differing trucking regulations to restrictions on alcohol distribution, these long-standing inefficiencies eat away at productivity. When combined with federal tax and regulatory burdens, the environment for growth becomes even more hostile.
The Carney government needs to take this unprecedented capital drain seriously. Investors are not acting on a whim. They are responding to structural problems—ill-advised trade actions, runaway federal spending and persistent barriers to growth—that Ottawa has yet to fix.
In the short term, that means striking a deal with Washington to lower tariffs and restore confidence that Canada can maintain stable access to U.S. markets. It also means resisting the urge to spend Canada into deeper deficits when warning lights are already flashing red. Over the long term, Ottawa must finally tackle high taxes, cut red tape and eliminate the bureaucratic obstacles that stand in the way of economic growth.
Capital has choices. Right now, it is voting with its feet, and with its dollars, and heading south. If Canada wants that capital to come home, the government will have to earn it back.
Jay Goldberg is a fellow with the Frontier Centre for Public Policy.
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