Latest news with #Bill26
National Post
11-06-2025
- Health
- National Post
Dr. J. Edward Les: The Canadian Medical Association's inexplicable stance on pediatric gender medicine
Late last month, the Canadian Medical Association (CMA) announced that it, along with three Alberta doctors, had filed a constitutional challenge to Alberta's Bill 26 'to protect the relationship between patients, their families and doctors when it comes to making treatment decisions.' Article content Bill 26, which became law last December, prohibits doctors in the province from prescribing puberty blockers and hormone therapies for those under 16; it also bans doctors from performing gender-reassignment surgeries on minors (those under 18). Article content Article content Article content The unprecedented CMA action follows its strongly worded response in February 2024 to Alberta's (at the time) proposed legislation: Article content Article content 'The CMA is deeply concerned about any government proposal that restricts access to evidence-based medical care, including the Alberta government's proposed restrictions on gender-affirming treatments for pediatric transgender patients.' Article content But here's the problem with that statement, and with the CMA's position: the evidence supporting the 'gender affirmation' model of care — which propels minors onto puberty blockers, cross-gender hormones, and in some cases, surgery — is essentially non-existent. That's why the United Kingdom's Conservative government, in the aftermath of the exhaustive four-year-long Cass Review, which laid bare the lack of evidence for that model, and which shone a light on the deeply troubling potential for the model's irreversible harm to youth, initiated a temporary ban on puberty blockers — a ban made permanent last December by the subsequent Labour government. And that's why other European jurisdictions like Finland and Sweden, after reviews of gender affirming care practices in their countries, have similarly slammed the brakes on the administration of puberty blockers and cross-gender hormones to minors. Article content Article content It's not only the Europeans who have raised concerns. The alarm bells are ringing loudly within our own borders: earlier this year, a group at McMaster University, headed by none other than Dr. Gordon Guyatt, one of the founding gurus of the 'evidence-based care' construct that rightfully underpins modern medical practice, issued a pair of exhaustive systematic reviews and meta analyses that cast grave doubts on the wisdom of prescribing these drugs to youth. Article content Article content And yet, the CMA purports to be 'deeply concerned about any government proposal that restricts access to evidence-based medical care,' which begs the obvious question: Where, exactly, is the evidence for the benefits of the 'gender affirming' model of care? The answer is that it's scant at best. Worse, the evidence that does exist, points, on balance, to infliction of harm, rather than provision of benefit.
Globe and Mail
29-05-2025
- Business
- Globe and Mail
Morning Update: Canadian doctors take Alberta to court
Good morning. Canada's largest medical organization has joined the legal battle against Alberta's controversial Bill 26 – more on that below, along with the rebirth of BlackBerry and the country's summer forecast. But first: In a seven-and-a-half minute video posted to social media last year, Alberta Premier Danielle Smith attempted to assure transgender youth that she had their backs. 'As long as I lead this province,' Smith began, 'I will ensure you are supported and your rights are protected.' Then she proceeded to unveil the most aggressive set of proposals anywhere in Canada to limit trans rights. Part of the legislation bans transgender athletes from playing in women's and girls' sports leagues. Part of it requires parental consent for name and pronoun changes in schools. But it's Alberta's Bill 26, which restricts access to gender-affirming treatment for trans youth, that has already prompted legal challenge. Right after it passed into law in December, two advocacy organizations and five families with gender-diverse kids filed an action alleging Bill 26 violates the Charter of Rights and Freedoms. And yesterday, the Canadian Medical Association joined them with its own constitutional challenge, arguing the law violates doctors' Charter right to freedom of conscience. Taking a provincial government to court is new territory for the CMA and the 75,000 physicians it represents. But the national organization said it was compelled to step in to safeguard the relationship between patients, their families and their doctors. 'This legislation has put me and many of my colleagues in a state of moral crisis,' said family physician Jake Donaldson, a co-applicant with the CMA, who provides gender-affirming care to about 40 youth in Calgary. Alberta's law exposes an already vulnerable group to greater harm, he told The Globe, and 'commands physicians to stand on the sidelines and watch them suffer.' The bill Bill 26 bans top and bottom gender-reassessment surgeries on youth under the age of 18. It also prohibits doctors in the province from prescribing hormone therapies and puberty blockers for people under 16. The United Conservative government insists these are necessary measures to protect the health and safety of Alberta youth. 'Encouraging or enabling children to alter their very biology or natural growth,' Smith said in her social-media video, 'poses a risk to that child's future that I as Premier am not comfortable with permitting in this province.' But much of this legislation is largely moot. Gender-affirming surgeries on lower body parts are already age-restricted by the Canadian Paediatric Society – they can't be performed on people under 18. Top surgery is only funded by Alberta Health if patients are at least 18 years old. Even without public coverage, it is rarely performed on anyone younger. According to the province's own numbers, doctors carried out just eight pediatric breast surgeries for gender-affirming reasons between January 2022 and November 2023. And very few youth under 16 receive hormone therapies, where estrogen or testosterone is taken to produce physical changes that reflect a person's gender identity. Canadian endocrine societies already recommend physicians wait until then to start hormone treatment. Instead, it's Alberta's age limits on puberty blockers that fall well outside established medical practice and could pose the greatest threat to trans youth. Organizations like the World Professional Association for Transgender Health and the Canadian Paediatric Society support the use of puberty blockers to buy time for young people to consider their decision without the pressure of a changing body. Medical guidelines recommend adolescents start blockers once they show the first physical signs of puberty, which happens, on average, between the ages of 10 and 12. Waiting until 16 to begin this treatment is simply too late for most teens. Should young people change their minds, the effects of puberty blockers are completely reversible. But delaying access to blockers, and forcing adolescents to undergo development inconsistent with their gender identity, can cause significant distress that could result in depression, self-harm and suicide. When kids are able to 'move around in a body that aligns with their gender identity, they are safer and happier,' physician Jake Donaldson told The Globe. 'It's just this massive impact on quality of life that we can fix if we're able to support these folks through their initial puberty.' The response In a statement yesterday, Heather Jenkins, press secretary to Alberta Justice Minister Mickey Amery, said that 'Bill 26 was introduced to protect and preserve children and youth from potentially irreversible decisions.' She added that the provincial government will 'vigorously' defend its position in court. The Canadian Medical Association is ready for that fight. 'This legal challenge is not just about Alberta and gender-affirming care,' the CMA said. Health decisions are complex and deeply personal. 'They must be made by patients and their families, in partnership with their health provider – not by politicians.' Minister of Agriculture Heath MacDonald expressed exasperation yesterday at the U.S. President's latest pitch: Canada can shell out US$61-billion to join Donald Trump's 'fabulous Golden Dome system' (his words) or get it for free by becoming the 51st state. Read more here about the proposal that diplomat Bob Rae called a 'protection racket.' Abroad: Four people died yesterday after thousands of Palestinians burst into a United Nations warehouse in Gaza, ripping off pieces of the metal walls in a desperate bid to find food. At home: The Weather Network forecasts a hot summer across Canada, with droughts, wildfires and powerful thunderstorms likely in the works. On the map: Ukrainian children, abducted from their homes by Russian forces, are being trained to fight for Vladimir Putin. A Canadian-funded project is helping track them down. Changing lanes: Former smartphone titan BlackBerry has a new CEO and big plans to dominate another market: self-driving cars. Cashing in: Hailey Bieber's skincare brand, Rhode, was just acquired by E.l.f. Beauty for US$1-billion.
Globe and Mail
29-05-2025
- General
- Globe and Mail
Alberta doctors' group supports CMA's constitutional challenge of bill limiting access to medical care for trans youth
The Alberta Medical Association, which advocates on behalf of thousands of local doctors, says it strongly supports its national counterpart in taking the provincial government to court over its transgender legislation. On Wednesday, the Canadian Medical Association filed a constitutional challenge in the Court of King's Bench of Alberta against Bill 26, which limits access to medical care for transgender youth. Three Alberta doctors, all of whom provide gender-affirming care, are co-applicants in the filing. The CMA contends that Bill 26, which became law last December, violates physicians' freedom of conscience as guaranteed in Section 2 of the Charter of Rights and Freedoms. The organization says the bill undermines the principle of clinical autonomy and 'cuts at the core' of a physician's professional identity. 'This profound violation cannot be justified in a free and democratic society,' the application states. Shelley Duggan, president of the AMA, said in a statement released Wednesday that the provincial organization supports 'in the strongest terms' the legal action brought forward by the CMA. 'The CMA's review application addresses the moral distress of physicians who are being barred from delivering the evidence-based care that they are called to provide under both their code of ethics and the standard of care,' Dr. Duggan said. 'That distress is real. I hear it every day in many places.' The legislation bars doctors from prescribing puberty blockers and hormone therapies for people under 16 and prohibits any gender-reassignment surgeries on minors (those under 18) – which are already performed rarely in Alberta. Heather Jenkins, press secretary to Alberta Justice Minister Mickey Amery, said in a statement Wednesday that the Alberta government will 'vigorously' defend its position in court. 'Bill 26 was introduced to protect and preserve children and youth from potentially irreversible decisions,' she said. This is the second legal action that has been taken against the Alberta government for Bill 26. Advocacy groups Egale Canada and Skipping Stone Foundation, together with families with gender-diverse children, filed a legal challenge last December that alleges the law violates several Charter-protected rights and contradicts Alberta's own Bill of Rights. Premier Danielle Smith has defended Bill 26 as necessary to protect children from making life-altering decisions that they could later regret. She has argued that the legislation strikes a balance between protecting children and upholding the rights of transgender people. Children's Healthcare Canada, in a statement Wednesday, also voiced support for the CMA's constitutional challenge. Jillian Demontigny, Jake Donaldson and Joseph Raiche, the Alberta doctors who are co-applicants with the CMA, said in their individual affidavits that this legislation has put them in an impossible position. They argue that they must now choose between compromising their ethical standards or breaking the law. Dr. Demontigny, in her affidavit, said restricting gender-affirming care for youth can cause suffering, including from gender dysphoria and gender incongruence. She said this type of care is vital and only provided after meaningful consultation. 'I cannot in good conscience abandon these patients,' she said. Dr. Raiche, in his affidavit, said he is 'profoundly troubled by the grave human cost' that the prohibitions will bring. 'Denying treatment and telling physicians that they are powerless to act is not a neutral posture,' he said. 'It is an affront to the dignity of patients whose dignity is already under daily attack by our society, and to the professional and ethical agency of doctors who care for them.' With a report from Kristy Kirkup in Ottawa
CTV News
28-05-2025
- Health
- CTV News
Canadian Medical Association files lawsuit challenging gender-care legislation
Aerial shot of the Alberta legislature on Monday, May 26, 2025. (Cam Wiebe/CTV News Edmonton) The Canadian Medical Association (CMA) and three Alberta physicians are pursuing a judicial review of Bill 26, known as the province's gender-care legislation. A statement from the CMA said the bill directs physicians on how to deliver gender-affirming care to people under 18, down to which medications they can use. 'This is a historic and unprecedented government intrusion into the physician-patient relationship and requires doctors to follow the law rather than clinical guidelines, the needs of patients and their own conscience,' said the statement issued Wednesday morning. The CMA said it has filed an application with the Court of King's Bench for the judicial review of Bill 26, the Health Statutes Amendment Act, 2024 and its proposed changes to the Health Professions Act R.S.A 2000. Bill 26 was introduced on Oct. 31, 2024, to preserve choice for minors identifying as transgender while refocusing the health-care system, according to the province. 'Medicine is a calling. Doctors pursue it because they are compelled to care for and promote the well-being of patients,' said CMA president Joss Reimer in a statement. 'When a government bans specific treatments, it interferes with a doctor's ability to empower patients to choose the best care possible. The CMA said the legislation renders physicians powerless in providing independent expertise, clinical guidance and treatment options when it comes to gender-affirming care. Jake Donaldson, a Calgary-based family physician who provides gender-affirming care to about 40 adolescents, said the legislation has put him and his colleagues in a state of 'moral crisis.' 'These patients are a vulnerable group that already face significant and disproportionate discrimination, violence and mental health challenges,' said Donaldson in a CMA statement. 'Bill 26 commands physicians to stand on the sidelines and watch them suffer.' Since the bill and other transgender legislation was introduced, advocacy groups and families have protested and taken legal action against the province, arguing that Bill 26 violates gender-diverse young people's section 7 right to security of the person, their section 12 right to be free from cruel and unusual treatment and their section 15 right to equality. Part of Bill 26 prohibits gender-affirming 'top' surgeries for minors which went into effect when the bill received royal assent in December 2024. The legislation also bans puberty blockers and hormone therapy for those with gender dysphoria. Egale Canada and Skipping Stone, both LGBTQ2S+ advocacy groups, have requested for an injunction to block the denial of health care for gender diverse youth while the bill faces a constitutional test. Sarah Hoffman, NDP shadow minister of health, said she is pleased to see doctors stand with their patients in opposing UCP law. 'When medical experts and parents agree on safe medical treatment, the government shouldn't be preventing it,' said Hoffman in an emailed statement. 'The new CMA legal challenge to Bill 26 is about defending parental and human rights.' CTV News Edmonton reached out to the Ministry of Justice for comment.
Globe and Mail
28-05-2025
- Health
- Globe and Mail
Canadian Medical Association to file legal challenge over Alberta law limiting access to treatment for transgender youth
In a rare move, the Canadian Medical Association will file a constitutional challenge Wednesday alongside three Alberta doctors against the province's legislation that limits access to medical treatment for transgender youth. The national advocacy organization, which represents more than 75,000 physicians, is venturing into new territory by taking a provincial government to court. The CMA says it had no choice but to step in to guard the relationship between patients, doctors and families in making treatment decisions. Alberta's Bill 26, which became law last December, prohibits doctors from prescribing puberty blockers and hormone therapies for those under 16. It also bans doctors from performing gender-reassignment surgeries on minors (those under 18) – an already rare occurrence in the province. On Wednesday, the CMA will submit a judicial challenge to the Court of King's Bench of Alberta, arguing the legislation violates doctors' Section 2 Charter right to freedom of conscience. The organization calls Bill 26 an 'unprecedented government intrusion' because it requires physicians to follow a law rather than clinical guidelines, the needs of patients and their own conscience. It will be the second legal challenge against Alberta's transgender legislation. The first was filed last December by advocacy groups Egale Canada and Skipping Stone Foundation and families with gender-diverse children that allege the law violates several Charter-protected rights and contradicts Alberta's own Bill of Rights. CMA president Joss Reimer said the law has created a 'moral crisis' for physicians and it affects patients' ability to make medical decisions in consultation with their family and their physician. She said doctors see individuals in their offices who are vulnerable and who have experienced challenges, adding that an 'ideological influence' does not help the patient. 'When governments get involved and start restricting medical decisions, that means that doctors are then put into a position where they have to choose between following their ethical standards, following what they feel is best for their patients, or following the law,' Dr. Reimer said in an interview. The legislation is part of a trio of laws passed in Alberta that affect transgender people – also in classrooms and sports – that together form the most restrictive legislative package in Canada dealing with gender, sexuality and identity. Premier Danielle Smith has come under widespread criticism for the measures, from transgender advocates and medical experts in Alberta and beyond. The Alberta government has yet to comment on the CMA's legal filing because it will be made in court on Wednesday. It declined to comment on the earlier legal action last year, citing it was before the courts. The United Conservative government has defended Bill 26 as a measure to protect the health and safety of Alberta youth, who Ms. Smith has argued are not able to 'fully understand' the risks associated with gender-affirming treatments. The Premier, when the legislation was tabled last October, also contended that doctors do not always make the right decisions for care. Calgary-based physician Jake Donaldson, a co-applicant with the CMA, who provides gender-affirming care to about 40 youth, said Bill 26 puts an already-vulnerable group of people at risk for more harm. These individuals already face significant and disproportionate rates of discrimination, violence and mental-health challenges. 'If they are able to blend into society and move around in a body that aligns with their gender identity ... they are safer and they are happier,' said Dr. Donaldson, who also served as a witness in Egale's case. 'It's just this massive impact on quality of life that we can fix if we were able to support these folks through their initial puberty, at the point of adolescence.' Dr. Donaldson said he and other doctors are experiencing moral injury when they are at risk of being reprimanded for providing gender-affirming care to their patients. He estimates fewer than 20 physicians prescribe hormones for youth in Alberta. The legislation, he said, 'commands physicians to stand on the sidelines and watch them suffer.' The CMA's Dr. Reimer said her organization wants to work with government to repeal the law. It is important 'politicians are not making medical decisions,' she added. Those decisions, she said, should be made based on the best science, along with what an individual patient needs, adding this can only happen between a patient and provider. 'We don't want to see any laws that are restricting medical decision-making because science evolves over time,' she said. The Premier has said she would be willing to invoke the notwithstanding clause, which is a rarely used mechanism that allows government to override certain sections of the Charter of Rights and Freedoms for up to five years, as a 'last resort.' This could shield Alberta from legal action, though Ms. Smith has said she is confident it won't be necessary, arguing the legislation is reasonable, proportionate and evidence-based.
