The Alberta Medical Association’s Section of Pediatrics has noted, with much dismay and sadness, the introduction of Bills 26, 27 and 29, with specific provisions that target transgender individuals in this province. As a group of pediatricians, we unequivocally oppose the singling out of this population and, specifically, the child and youth patients who will be affected adversely by these bills.
There is no place for the government in the medical decisions being made by parents and their children in conjunction with physicians. Government speaks about “preserving parental rights,” however the proposed legislation will take away the right of parents to make medical decisions for their children when it comes to puberty blockers and hormone therapy. We want everyone to clearly understand that these decisions are not being made solely by children or adolescents, but rather by their parents who want to help their children. These children and their parents deserve better than the government removing their rights to medical treatment.
We also would like to state that puberty is permanent, but puberty blocking is not! Puberty blockers are a pause to allow the individual who is contemplating transition more time to consider, preserving their choice, while medically supporting their mental health and physical wellbeing. If the blocker is discontinued later, then biological puberty will ensue. On the other hand, requiring an individual to proceed through biological puberty before transitioning reduces their choice and may result in the need for surgery that might have been unnecessary. Puberty blockers have no significant side effects and do not affect fertility. Although safely used for over 30 years, we are not against further research into the use of these medications – but this should not be to the detriment of these patients.
We find it abhorrent that the government would suggest punishing physicians who practice gender affirming care and prescribe hormone blockers or hormone therapy outside the rules laid out in Bill 26. It is both inappropriate and wrong for physicians to be punished for providing a medical treatment option that is recognized by both the Canadian Paediatric Society and the American Academy of Pediatrics as being within the standards of care. Governmental interference by legislating medical therapy options is inappropriate, unethical and represents serious government overreach into the practice of medicine and patient/family rights to autonomy in their health care decisions. If the government truly cared for transgender individuals, they would increase funding to the two existing pediatric transgender clinics so they could provide additional services, including increased mental health supports to their patients and funding for additional research. It is no surprise that transgender youth and adolescents have increased mental health issues when you consider the harassment, ostracization and bullying they are subjected to. This government is not helping this by legislating against these individuals who comprise a very small portion of the population in this province.
In summary, the AMA Section of Pediatrics opposes these bills and will continue to do so. The proposed bills reflect a lack of compassion, deprive parents and patients’ rights to independent medical decision making and therapy, and potentially punish physicians for providing a proven and accepted medical therapeutic option. The government should work with pediatricians to enhance the care of transgender and gender diverse youth in Alberta, not limit it.