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Frontier Centre for Public Policy

Transition Troubles: Medical Risks and Regret Among Trans Teens

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7 minute read

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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Alberta

Too Graphic For A Press Conference But Fine For Kids In School?

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From the Frontier Centre for Public Policy

By Lee Harding

Alberta moves to remove books after disturbing content, too graphic for media to view, was found in schools

Should elementary school children be given books to read with harsh insults against minorities, depictions of oral sex, and other disturbingly graphic and explicit content?

Such books have been in some Alberta elementary schools for a while, and in many school libraries across Canada.

In late May, the Alberta government announced it would establish new guidelines regarding age-appropriate materials in its schools. A government press release included quotes with disturbing content, but at a press conference, Education Minister Demetrios Nicolaides said some book illustrations could not be shown.

“I would show these images to all of you here and to the media, but they are too graphic for a live-stream media event. These examples … illustrate the kind of content that raises concerns amongst parents,” Nicolaides said.

You don’t say? This seems like the sort of stuff no one, except a pervert in a park, would dream of showing to a child. Ironically, the inability to publicize such graphic materials is part of the reason they have been shown to children with little public awareness.

Citizens’ group Action4Canada (A4C) has claimed its activism played a pivotal role in the Alberta decision. The organization has compiled a 36-page document online with examples of objectionable content in Canadian schools. Among the worst is Identical by Ellen Hopkins, which includes graphic descriptions of a little girl being molested by her father.

A4C founder Tanya Gaw has repeatedly tried to raise concerns about objectionable books with school boards, often without success. In some cases, she isn’t even allowed on the agenda if she states her topic upfront. When she is permitted to speak, she’s frequently cut off as soon as she begins quoting from the books, preventing the content from entering the public record.

In January 2023, Gaw made an online presentation to a school board in Mission, B.C. regarding materials in their schools. As she began to screenshare what was there, some board members objected, saying such permission had not been given in advance.

One month later, the board banned Action4Canada from making any further presentations. In later media interviews, the board chair justified the decision by saying Gaw’s PowerPoint contained some graphic and “inappropriate images.”

Exactly, and that is the problem. A recent check showed Mission’s school division only removed four of 15 books A4C objected to. Gaw is just glad “Identical” is one of them.

Pierre Barns, a father from Abbotsford, B.C., made it his mission to notify school boards across Canada what was on their school shelves. An online search was all it took to confirm. A “reply all” from a board member at the Halton School District in Ontario was most ironic.

“I am concerned. This individual has included links to publications and videos which may contain illegal content,” she wrote.

“I’m not sure how to investigate the content of the email safely. Would you please advise us whether or not this person ought to be reported to police? Is there some action we should take?”

There probably was action they should have taken, such as removing the books, but that never happened. Later, they defended a biologically male teacher in their school division who made international headlines by wearing large prosthetic breasts to school.

The Alberta government has committed to conducting public consultations before implementing new policies. It’s a good time for parents and citizens there and in other provinces to speak up. A young mind is a terrible thing to corrupt, but unfortunately, some schools are part of this corrosive effort.

Lee Harding is a research fellow with the Frontier Centre for Public Policy.

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Economy

Canada Treats Energy As A Liability. The World Sees It As Power

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From the Frontier Institute for Public Policy

By Marco Navarro-Genie

Research VP Marco Navarro-Genie warns that Canada’s future hinges on building energy infrastructure, not just expanding pipelines but forging a true North American energy alliance. With global demand rising and authoritarian regimes weaponizing energy, Ottawa’s dithering costs Canada $70 million daily. Sovereignty isn’t secured by speeches but by infrastructure. Until Canada sheds its regulatory paralysis, it will remain a discount supplier in a high stakes geopolitical game. Time to build.

Canada has energy the world is begging for, but ideology and red tape are holding us back

As Prime Minister Mark Carney met with U.S. President Donald Trump recently, energy should have been the issue behind every headline, whether mentioned or not. Canada’s future as a sovereign, economically resilient country will depend in no small part on whether the country seizes this moment or stalls out again in a fog of regulatory inertia and political ambivalence. Canada holds an underleveraged strategic card: the potential to be the world’s most reliable democratic energy supplier. Recent trade figures show Chinese imports of Canadian crude hit a record 7.3 million barrels in March, a direct result of newly expanded access to the Pacific via the Trans Mountain Expansion (TMX), a federally owned pipeline project that now connects Alberta crude to global markets through British Columbia’s coast. But one pipeline does not make a national strategy. Demand in Asia is growing fast. India is among the hungriest, but Canada’s infrastructure is nowhere near meeting that demand.

This matters not just for Canada, but for the United States as well. In a world where energy markets are weaponized and strategic reserves manipulated by authoritarian regimes, the case for a coordinated North American energy alliance is stronger than ever. Such an alliance should not erode national sovereignty. It should reinforce it, allowing Canada, the U.S. and Mexico to insulate themselves collectively from supply shocks and geopolitical blackmail while projecting democratic strength abroad.

But for that alliance to work, Canada must be a credible partner, not merely a junior supplier shackled by Ottawa-induced internal bottlenecks. While the U.S. has leveraged its shale revolution, LNG capacity and permitting reforms to pursue energy dominance, Canada dithers. Projects languish. Investment flees. And meanwhile, Canadian oil continues to flow south at a steep discount, only to be refined and resold, often back to us or our trading partners, at full global prices.

Yes, you read that right. Canada’s oil and gas is sold at a discount to U.S. customers, and that discount costs Canada more than $70 million every single day. The Frontier Centre for Public Policy has developed a real-time tracker to monitor these losses. This pricing gap exists because Canada lacks sufficient pipeline infrastructure to access overseas buyers directly, forcing producers to sell to the U.S., often at below-market rates.

Such massive losses should be unacceptable to any government serious about economic growth, geopolitical influence or environmental integrity. Yet Ottawa continues to speak the language of ambition while legislating the mechanics of paralysis. Stephen Guilbault’s statement that Canada already has enough pipelines speaks to more paralysis..

Canada’s energy infrastructure challenges are not just economic; they are matters of national defence. No country can claim to be secure while relying on another’s pipelines to transport its energy across its own territory. No country can afford to leave its wealth-producing regions boxed in by regulatory choke points or political resistance dressed as environmental virtue.

Our energy economy is fragmented. Western hydrocarbons are stuck inland and must pass through the U.S. to reach Eastern Canada or global markets eastward. This weakens national unity and leaves us exposed to foreign leverage. It also creates strategic vulnerabilities for our allies. American industries depend on Canadian crude. So do U.S. Gulf Coast refineries. And while American officials continue to treat energy as a tool of diplomacy and economic leverage, using energy exports to build alliances and reduce reliance on unstable regimes, Canada treats it as a domestic liability.

We need to shift the frame. Infrastructure isn’t just about steel in the ground; it’s the backbone of strategic autonomy. Pipelines, export terminals and utility corridors would allow Canada to claim its place in the emerging geopolitical order. They would also signal to global investors that Canada is open for business and capable of delivering returns without political obstruction.

The U.S. wants a stable, competent partner to help meet global energy needs. Increasingly, so does the rest of the world. But until we address our internal dysfunction and build, we’re stuck. Stuck watching global opportunities pass us by. Stuck selling low while others sell high. Stuck in a conversation about sovereignty we’re not structurally equipped to address, let alone win.

When Carney meets with Trump again, he would do well to remember that economic independence, not rhetorical unity, is the bedrock of sovereignty. Without infrastructure, Canada brings only words to a hard-power conversation.

Paraphrasing Thomas Hobbes, energy covenants without infrastructure are but words. It’s time to stop posturing and start building.

Marco Navarro-Genie is the vice-president of research at the Frontier Centre for Public Policy. He is co-author, with Barry Cooper, of Canada’s COVID: The Story of a Pandemic Moral Panic (2023).

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