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Frontier Centre for Public Policy

Transition Troubles: Medical Risks and Regret Among Trans Teens

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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.

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armed forces

Canada’s Military Can’t Be Fixed With Cash Alone

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From the Frontier Centre for Public Policy

By Lt. Gen. (Ret.) Michel Maisonneuve

Canada’s military is broken, and unless Ottawa backs its spending with real reform, we’re just playing politics with national security

Prime Minister Mark Carney’s surprise pledge to meet NATO’s defence spending target is long overdue, but without real reform, leadership and a shift away from bureaucracy and social experimentation, it risks falling short of what the moment demands.

Canada committed in 2014 to spend two per cent of its gross national product on defence—a NATO target meant to ensure collective security and more equitable burden-sharing. We never made it past 1.37 per cent, drawing criticism from allies and, in my view, breaching our obligation. Now, the prime minister says we’ll hit the target by the end of fiscal year 2025-26. That’s welcome news, but it comes with serious challenges.

Reaching the two per cent was always possible. It just required political courage. The announced $9 billion in new defence spending shows intent, and Carney’s remarks about protecting Canadians are encouraging. But the reality is our military readiness is at a breaking point. With global instability rising—including conflicts in Ukraine and the Middle East—Canada’s ability to defend its territory or contribute meaningfully to NATO is under scrutiny. Less than half of our army vehicles, ships and aircraft are currently operational.

I’m told the Treasury Board has already approved the new funds, making this more than just political spin. Much of the money appears to be going where it’s most needed: personnel. Pay and benefit increases for serving members should help with retention, and bonuses for re-enlistment are reportedly being considered. Recruiting and civilian staffing will also get a boost, though I question adding more to an already bloated public service. Reserves and cadet programs weren’t mentioned but they also need attention.

Equipment upgrades are just as urgent. A new procurement agency is planned, overseen by a secretary of state—hopefully with members in uniform involved. In the meantime, accelerating existing projects is a good way to ensure the money flows quickly. Restocking ammunition is a priority. Buying Canadian and diversifying suppliers makes sense. The Business Council of Canada has signalled its support for a national defence industrial strategy. That’s encouraging, but none of it will matter without follow-through.

Infrastructure is also in dire shape. Bases, housing, training facilities and armouries are in disrepair. Rebuilding these will not only help operations but also improve recruitment and retention. So will improved training, including more sea days, flying hours and field operations.

All of this looks promising on paper, but if the Department of National Defence can’t spend funds effectively, it won’t matter. Around $1 billion a year typically lapses due to missing project staff and excessive bureaucracy. As one colleague warned, “implementation [of the program] … must occur as a whole-of-government activity, with trust-based partnerships across industry and academe, or else it will fail.”

The defence budget also remains discretionary. Unlike health transfers or old age security, which are legally entrenched, defence funding can be cut at will. That creates instability for military suppliers and risks turning long-term procurement into a political football. The new funds must be protected from short-term fiscal pressure and partisan meddling.

One more concern: culture. If Canada is serious about rebuilding its military, we must move past performative diversity policies and return to a warrior ethos. That means recruiting the best men and women based on merit, instilling discipline and honour, and giving them the tools to fight and, if necessary, make the ultimate sacrifice. The military must reflect Canadian values, but it is not a place for social experimentation or reduced standards.

Finally, the announcement came without a federal budget or fiscal roadmap. Canada’s deficits continue to grow. Taxpayers deserve transparency. What trade-offs will be required to fund this? If this plan is just a last-minute attempt to appease U.S. President Donald Trump ahead of the G7 or our NATO allies at next month’s summit, it won’t stand the test of time.

Canada has the resources, talent and standing to be a serious middle power. But only action—not announcements—will prove whether we truly intend to be one.

The NATO summit is over, and Canada was barely at the table. With global threats rising, Lt. Gen. (Ret.) Michel Maisonneuve joins David Leis to ask: How do we rebuild our national defence—and why does it matter to every Canadian? Because this isn’t just about security. It’s about our economy, our identity, and whether Canada remains sovereign—or becomes the 51st state.

Michel Maisonneuve is a retired lieutenant-general who served 45 years in uniform. He is a senior fellow at the Frontier Centre for Public Policy and author of In Defence of Canada: Reflections of a Patriot (2024).

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Business

BC Ferries And Beijing: A Case Study In Policy Blindness

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From the Frontier Centre for Public Policy

By Scott McGregor

Scott McGregor warns BC Ferries’ contract with a Chinese state-owned shipbuilder reveals Canada’s failure to align procurement with national security. It is trading short-term savings for long-term sovereignty and strategic vulnerability.

BC Ferries’ recent decision to award the construction of four new vessels to China Merchants Industry (Weihai), a state-owned shipyard under the Chinese Communist Party (CCP), is a cautionary tale of strategic policy failure. While framed as a cost-effective solution to replace aging vessels, the agreement reveals a more critical issue: Canada’s persistent failure to align vital infrastructure procurement with national security and economic resilience.

The situation goes beyond transportation. It is a governance failure at the intersection of trade, security, and sovereignty.

Outsourcing Sovereignty

China Merchants Industry is part of a sprawling state-owned conglomerate, closely connected to the CCP. It is not merely a commercial player; it is a geopolitical actor. In China, these organizations thrive on a unique blend of state subsidies, long-term strategic direction, and complex corporate structures that often operate in the shadows. This combination grants them a significant competitive edge, allowing them to navigate the business landscape with an advantage that many try to replicate but few can match.

The same firms supplying ferries to BC are also building warships for the People’s Liberation Army Navy. That alone should give pause.

Yet BC Ferries, under provincial oversight, proceeded without meaningful scrutiny of these risks. No Canadian shipyards submitted bids due to capacity constraints and a lack of strategic investment. But choosing a Chinese state-owned enterprise by default is not a neutral act. It is the consequence of neglecting industrial policy.

Hybrid Risk, Not Just Hybrid Propulsion

China’s dominance in shipbuilding, now over 60% of global orders, has not occurred by chance. It is the result of state-driven market distortion, designed to entrench foreign dependence on Chinese industrial capacity.

Once that dependency forms, Beijing holds leverage. It can slow parts shipments, withhold technical updates, or retaliate economically in response to diplomatic friction. This is not speculative; it has already happened in sectors such as canola, critical minerals, and telecommunications.

Ordering a ferry, on its face, might seem apolitical. But if the shipbuilder is state-owned, its obligations to the CCP outweigh any commercial contract. That is the nature of hybrid threats to security: they appear benign until they are not.

Hybrid warfare combines conventional military force with non-military tactics (such as cyber attacks, disinformation, economic coercion, and the use of state-owned enterprises) to undermine a target country’s stability, influence decisions, or gain strategic control without resorting to open conflict. It exploits legal grey zones and democratic weaknesses, making threats appear benign until they’ve done lasting damage.

A Policy Void, Not Just a Procurement Gap

Ottawa designed its National Shipbuilding Strategy to rebuild Canadian capability, but it has failed to scale quickly enough. The provinces, including British Columbia, have been left to procure vessels without the tools or frameworks to evaluate foreign strategic risk. Provincial procurement rules treat a state-owned bidder the same as a private one. That is no longer defensible.

Canada must close this gap through deliberate, security-informed policy. Three steps are essential for the task:
Ottawa should mandate National Security reviews for critical infrastructure contracts. Any procurement involving foreign state-owned enterprises must trigger a formal security and economic resilience assessment. This should apply at the federal and provincial levels.
Secondly, when necessary, Canada should enhance its domestic industrial capabilities through strategic investments. Canada cannot claim to be powerless when there are no local bids available. Federal and provincial governments could collaborate to invest in scalable civilian shipbuilding, in addition to military contracts. Otherwise, we risk becoming repeatedly dependent on external sources.

Canada should enhance Crown oversight by implementing intelligence-led risk frameworks. This means that agencies, such as BC Ferries, must develop procurement protocols that are informed by threat intelligence rather than just cost analysis. It also involves incorporating security and foreign interference risk indicators into their Requests for Proposals (RFPs).

The Cost of Strategic Amnesia

The central point here is not only about China; it is primarily about Canada. The country needs more strategic foresight. If we cannot align our economic decisions with our fundamental security posture, we will likely continue to cede control of our critical systems, whether in transportation, healthcare, mining, or telecommunications, to adversarial regimes. That is a textbook vulnerability in the era of hybrid warfare.

BC Ferries may have saved money today. But without urgent policy reform, the long-term cost will be paid in diminished sovereignty, reduced resilience, and an emboldened adversary with one more lever inside our critical infrastructure.

Scott McGregor is a senior security advisor to the Council on Countering Hybrid Warfare and Managing Partner at Close Hold Intelligence Consulting Ltd.

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