As democracies around the world pull back on the tenets of youth gender medicine, Canada is emerging as one of the last countries still hewing to the idea that minors should be prescribed hormones and even surgery to affirm a self-described gender identity.
Just last month, two leading U.S. medical associations recommended a halt to elective mastectomies, orchiectomies (surgery to remove the testicles) and other “gender affirmation” surgeries for children.
In Canada, by contrast, virtually every health body and government agency continues to defend a policy of permitting children of any age to obtain hormone therapies with minimal oversight. Often, these therapies are framed as being completely safe and even reversible.
The Canadian Paediatric Society, most notably, explicitly dismissed all of the conclusions of the Cass Review, and continues to recommend an “affirming approach” to gender dysphoric youth.
Under the most recent version of their guidelines, published in June 2023, symptoms such as “a strong dislike of one’s sexual anatomy” and “a strong preference for playmates of the other gender” are among a list of markers that may warrant a diagnosis of gender dysphoria requiring a course of “gender-affirming hormone therapy.”
Health Canada’s official guidelines similarly break with conclusions in both Europe and the U.S. that puberty blockers carry both side-effects and long-term consequences.
“Puberty suppression is reversible, as puberty restarts when a person stops taking puberty-blocking medications,” reads a Government of Canada website entitled “how to access gender-affirming care.”
The only jurisdiction in Canada that has broken with the “affirmation” approach is Alberta, which in 2024 banned “hormone therapies to minors for the treatment of gender dysphoria or gender incongruence,” as well as “sex reassignment surgery on minors.”
The Canadian Medical Association has not only opposed the action, but has funded litigation to block it.
In a statement last May, the association complained that the Alberta law “directs physicians on how to deliver gender-affirming care to people under 18, down to which medications they can use, when and how.”
“When a government bans specific treatments, it interferes with a doctor’s ability to empower patients to choose the best care possible,” said association president Joss Reimer.