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.
Frontier Centre for Public Policy
New Book Warns The Decline In Marriage Comes At A High Cost

From the Frontier Centre for Public Policy
Travis Smith reviews I… Do? by Andrea Mrozek and Peter Jon Mitchell, showing that marriage is a public good, not just private choice, arguing culture, not politics, must lead any revival of this vital institution.
Andrea Mrozek and Peter Jon Mitchell, in I… Do?, write that the fading value of marriage is a threat to social stability
I… Do? by Andrea Mrozek and Peter Jon Mitchell manages to say something both obvious and radical: marriage matters. And not just for sentimental reasons. Marriage is a public good, the authors attest.
The book is a modestly sized but extensively researched work that compiles decades of social science data to make one central point: stable marriages improve individual and societal well-being. Married people are generally healthier, wealthier and more resilient. Children from married-parent homes do better across almost every major indicator: academic success, mental health, future earnings and reduced contact with the justice system.
The authors refer to this consistent pattern as the “marriage advantage.” It’s not simply about income. Even in low-income households, children raised by married parents tend to outperform their peers from single-parent families. Mrozek and Mitchell make the case that marriage functions as a stabilizing institution, producing better outcomes not just for couples and kids but for communities and, by extension, the country.
While the book compiles an impressive array of empirical findings, it is clear the authors know that data alone can’t fix what’s broken. There’s a quiet but important concession in these pages: if statistics alone could persuade people to value marriage, we would already be seeing a turnaround.
Marriage in Canada is in sharp decline. Fewer people are getting married, the average age of first marriage continues to climb, and fertility rates are hitting historic lows. The cultural narrative has shifted. Marriage is seen less as a cornerstone of adult life and more as a personal lifestyle choice, often put off indefinitely while people wait to feel ready, build their careers or find emotional stability.
The real value of I… Do? lies in its recognition that the solutions are not primarily political. Policy changes might help stop making things worse, but politicians are not going to rescue marriage. In fact, asking them to may be counterproductive. Looking to politicians to save marriage would involve misunderstanding both marriage and politics. Mrozek and Mitchell suggest the best the state can do is remove disincentives, such as tax policies and benefit structures that inadvertently penalize marriage, and otherwise get out of the way.
The liberal tradition once understood that family should be considered prior to politics for good reason. Love is higher than justice, and the relationships based in it should be kept safely outside the grasp of bureaucrats, ideologues, and power-seekers. The more marriage has been politicized over recent decades, the more it has been reshaped in ways that promote dependency on the impersonal and depersonalizing benefactions of the state.
The book takes a brief detour into the politics of same-sex marriage. Mrozek laments that the topic has become politically untouchable. I would argue that revisiting that battle is neither advisable nor desirable. By now, most Canadians likely know same-sex couples whose marriages demonstrate the same qualities and advantages the authors otherwise praise.
Where I… Do? really shines is in its final section. After pages of statistics, the authors turn to something far more powerful: culture. They explore how civil society—including faith communities, neighbourhoods, voluntary associations and the arts can help revive a vision of marriage that is compelling, accessible and rooted in human experience. They point to storytelling, mentorship and personal witness as ways to rebuild a marriage culture from the ground up.
It’s here that the book moves from description to inspiration. Mrozek and Mitchell acknowledge the limits of top-down efforts and instead offer the beginnings of a grassroots roadmap. Their suggestions are tentative but important: showcase healthy marriages, celebrate commitment and encourage institutions to support rather than undermine families.
This is not a utopian manifesto. It’s a realistic, often sobering look at how far marriage has fallen off the public radar and what it might take to put it back. In a political climate where even mentioning marriage as a public good can raise eyebrows, I… Do? attempts to reframe the conversation.
To be clear, this is not a book for policy wonks or ideologues. It’s for parents, educators, community leaders and anyone concerned about social cohesion. It’s for Gen Xers wondering if their children will ever give them grandchildren. It’s for Gen Zers wondering if marriage is still worth it. And it’s for those in between, hoping to build something lasting in a culture that too often encourages the opposite.
If your experiences already tell you that strong, healthy marriages are among the greatest of human goods, I… Do? will affirm what you know. If you’re skeptical, it won’t convert you overnight, but it might spark a much-needed conversation.
Travis D. Smith is an associate professor of political science at Concordia University in Montreal. This book review was submitted by the Frontier Centre for Public Policy.
Carbon Tax
Canada’s Carbon Tax Is A Disaster For Our Economy And Oil Industry

From the Frontier Centre for Public Policy
By Lee Harding
Lee Harding exposes the truth behind Canada’s sky-high carbon tax—one that’s hurting our oil industry and driving businesses away. With foreign oil paying next to nothing, Harding argues this policy is putting Canada at a major economic disadvantage. It’s time to rethink this costly approach.
Our sky-high carbon tax places Canadian businesses at a huge disadvantage and is pushing investment overseas
No carbon tax will ever satisfy global-warming advocates, but by most measures, Canada’s carbon tax is already too high.
This unfortunate reality was brought to light by Resource Works, a B.C.-based non-profit research and advocacy organization. In March, one of their papers outlined the disproportionate and damaging effects of Canada’s carbon taxes.
The study found that the average carbon tax among the top 20 oil-exporting nations, excluding Canada, was $0.70 per tonne of carbon emissions in fiscal 2023. With Canada included, that average jumps to $6.77 per tonne.
At least Canada demands the same standards for foreign producers as it does for domestic ones, right? Wrong.
Most of Canada’s oil imports come from the U.S., Saudi Arabia, and Nigeria, none of which impose a carbon tax. Only 2.8 per cent of Canada’s oil imports come from the modestly carbon-taxing countries of the U.K. and Colombia.
Canada’s federal consumer carbon tax was $80 per tonne, set to reach $170 by 2030, until Prime Minister Mark Carney reduced it to zero on March 14. However, parallel carbon taxes on industry remain in place and continue to rise.
Resource Works estimates Canada’s effective carbon tax at $58.94 per tonne for fiscal 2023, while foreign oil entering Canada had an effective tax of just $0.30 per tonne.
“This results in a 196-fold disparity, effectively functioning as a domestic tariff against Canadian oil production,” the research memo notes. Forget Donald Trump—Ottawa undermines our country more effectively than anyone else.
Canada is responsible for 1.5 per cent of global CO2 emissions, but the study estimates that Canada paid one-third of all carbon taxes in 2023. Mexico, with nearly the same emissions, paid just $3 billion in carbon taxes for 2023-24, far less than Canada’s $44 billion.
Resource Works also calculated that Canada alone raised the global per-tonne carbon tax average from $1.63 to $2.44. To be Canadian is to be heavily taxed.
Historically, the Canadian dollar and oil and gas investment in Canada tracked the global price of oil, but not anymore. A disconnect began in 2016 when the Trudeau government cancelled the Northern Gateway pipeline and banned tanker traffic on B.C.’s north coast.
The carbon tax was introduced in 2019 at $15 per tonne, a rate that increased annually until this year. The study argues this “economic burden,” not shared by the rest of the world, has placed Canada at “a competitive disadvantage by accelerating capital flight and reinforcing economic headwinds.”
This “erosion of energy-sector investment” has broader economic consequences, including trade balance pressures and increased exchange rate volatility.
According to NASA, Canadian forest fires released 640 million metric tonnes of carbon in 2023, four times the amount from fossil fuel emissions. We should focus on fighting fires, not penalizing our fossil fuel industry.
Carney praised Canada’s carbon tax approach in his 2021 book Value(s), raising questions about how long his reprieve will last. He has suggested raising carbon taxes on industry, which would worsen Canada’s competitive disadvantage.
In contrast, Conservative leader Pierre Poilievre argued that extracting and exporting Canadian oil and gas could displace higher-carbon-emitting energy sources elsewhere, helping to reduce global emissions.
This approach makes more sense than imposing disproportionately high tax burdens on Canadians. Taxes won’t save the world.
Lee Harding is a research fellow for the Frontier Centre for Public Policy.
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