Alberta to restrict access to transgender medical care for youth, require parents’ consent for name change

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Alberta Premier Danielle Smith on Wednesday unveiled Canada’s most aggressive package of proposals limiting transgender rights, including restricting access to medical treatments for youth and excluding transgender athletes from women’s sporting competitions.

Ms. Smith, in a video released on social media, also said Alberta intends to require schools to obtain parental permission before every lesson involving gender identity, sexual orientation and human sexuality. The Premier’s video, which also proposed a ban on teachers using a student’s preferred pronouns or name without parental notification, spanned seven minutes and 28 seconds. Ms. Smith’s office says she will field questions from reporters on Thursday.

Alberta’s proposals are the most restrictive in the country when it comes to legislation regarding gender, sexuality and identity. The United Conservative Party’s policies are far more sweeping than those imposed by conservative governments in Saskatchewan and New Brunswick last year.

Premiers in those provinces last year introduced rules requiring parental consent before schools use the preferred name or pronouns of students younger than 16.

The pair drew widespread criticism and Saskatchewan invoked the notwithstanding clause to override protections offered in the Canadian Charter of Rights and Freedoms. In New Brunswick, the Canadian Civil Liberties Association has filed a court action to overturn parts of that province’s policy.

Advocacy groups in Alberta are already preparing for a legal challenge. Egale Canada and Skipping Stone Foundation said in a joint statement that the province’s “draconian measures” run counter to expert guidance, violate constitutional rights and will lead to unimaginable harm and suffering.

”We will not stand for it,” they said.

Ms. Smith prefaced the policy announcement with a message to transgender residents.

“As Premier of this province, I want every Albertan that identifies as transgender to know I care deeply care about you and I accept you as you are,” she said. “As long as I lead this province, I will ensure you are supported and your rights are protected.”

Alberta will not permit “top and bottom gender-reassignment surgeries” for youth under 18 years old, Ms. Smith said. (Experts note that top surgery for transgender youth is rare and few young people can access it without parental support. Bottom surgery is not performed on people under 18 in Canada). She also said children under 16 will not be allowed to access puberty blockers or hormone therapy for the purpose of gender affirmation, save for those who have already started such treatments.

Transgender youth who are 16 and 17 will be allowed to start gender-affirming therapies so long as they have “parental, physician and psychologist approval,” Ms. Smith said. Again, experts note that it is rare for youth to access such treatment without extensive medical consultation and parental involvement.

Kristopher Wells, the Canada Research Chair in the public understanding of sexual and gender minority youth, said Alberta is violating the human rights and bodily autonomy of affected youth by denying them access to puberty blockers and other therapies.

“To be singling out trans youth from accessing medical care – it is immoral, it is illegal, it is punitive,” Mr. Wells said in an interview. “It is horrific. It will have immense life-altering consequences in the lives of these young people, including death.”

Physicians prescribe hormone therapy for adults and youth, regardless of gender identity, to treat a spectrum of conditions, he noted. And if transgender youth are unable to access treatment through the medical system, they will get it on the black market, which could put them in danger, he said.

“It is an absolute attack on trans individuals and their very right to exist in our society.”

Young patients often use puberty blockers to buy time as they sort through their sexuality, he said. The effects, he said, are largely reversible.

Mr. Wells, a professor at MacEwan University in Edmonton, said the medical system accounts for a patient’s capacity to consent, rather than chronological age. The government’s position, he said, is therefore about far more than transgender youth.

“This is about, fundamentally, people’s right to access health care and to make informed decisions about their own lives,” he said.

Teenagers who want access to birth control, without parental consent, have that right if they have the capacity to make an informed decision, he said as an example. “This is that slippery slope: Whose body are they going to go after next?”

Blaine Badiuk, a transgender woman and UCP member, said Alberta’s age limit on puberty blockers and hormone therapies is too restrictive, and transgender youth should be allowed such treatment if the child’s parents and medical team are on board.

“Why are we preventing medical care?” Ms. Badiuk asked, noting transition surgeries are more complicated after puberty. “It is a violation of parental rights.”

Ms. Smith’s policies also reached into how educators treat transgender youth and what can be taught in schools.

Alberta will require parental notification and consent before schools use the preferred name and pronouns of students under 16. For 16 and 17-year-olds, pupils can change their name and pronouns without parental approval, but the schools must notify their guardians, Ms. Smith said.

UCP members, at the party’s annual meeting in November, voted overwhelmingly in favour of a resolution that said Ms. Smith’s government should adopt what are known as parental-rights policies similar to Saskatchewan and New Brunswick. Alberta’s decision to notify parents for older students makes the province’s policy more aggressive.

Ms. Smith’s proposals also give parents more power to pull their children from school when teachers are discussing topics around sex.

Teachers will have to alert parents ahead of every lesson that involves “gender identity, sexual orientation and human sexuality” and they will have to sign off on their children’s participation, the Premier said.

Jason Schilling, president of the Alberta Teachers’ Association, is worried about the opt-in requirement in order for children to learn about gender identity, sexual orientation and human sexuality. He said it is already a challenge to get permission slips returned, and the proposal could further discourage instruction on these topics.

Alberta already has legislation allowing parents to opt out – rather than opt in – when it comes to their kids learning about human sexuality. The association, he said, was not consulted by the government.

Ms. Smith said the province will work with sports organizations to ensure that women and girls will not have to compete against transgender athletes. She said Alberta will expand co-ed and gender-neutral divisions.

Editor’s note: This article has been updated to clarify that in Canada, top surgery for transgender youth is rare, and bottom surgery is not performed on people under 18.