You are currently browsing the tag archive for the ‘Evidence Based Medicine’ tag.
The public case for pediatric gender medicine is simple enough. Medical intervention is supposed to reduce distress and improve mental-health outcomes.
That claim matters because the interventions are not minor. Puberty blockers, cross-sex hormones, and related medical pathways are presented to parents, policymakers, and the public as serious treatments for serious suffering. Their case does not rest on compassion alone. It rests on the claim that they work.
The trouble is that the strongest population-level data now available does not show that happening.
A new Finnish nationwide register study reports severe psychiatric morbidity before referral, continued severe psychiatric morbidity after referral, and no sign that psychiatric need subsides after medical gender reassignment. The study does not prove that treatment caused worsening. It does, however, cut directly against confident claims that these interventions reliably resolve the underlying distress in young people.
Terms fixed in advance
This subject is saturated with semantic drift, so a few terms need fixing at the outset.
By pediatric gender medicine, I mean the medical management of gender-distressed minors and young people through interventions such as puberty blockers, cross-sex hormones, and, where applicable, surgical pathways. By psychiatric morbidity, I mean the study’s outcome measure: need for specialist psychiatric treatment, whether inpatient or outpatient. By improvement, I mean a measurable reduction in psychiatric morbidity relative to baseline or to relevant controls.
That is a demanding definition. It is also the clinically serious one. If an intervention is being justified as a mental-health measure, then some observable improvement in hard psychiatric outcomes is the least one should expect.
What the Finnish study is
The Finnish paper is not a survey, and it is not a self-report exercise. It is a nationwide register study of all 2,083 individuals under age 23 who contacted Finland’s centralized gender identity services between 1996 and 2019, compared with 16,643 matched controls. Follow-up extended to June 2022. The outcome was specialist-level psychiatric treatment recorded in national health registers.
That matters. Register data has limits, but it is still harder than the small, uncontrolled, self-reported studies so often used to manufacture confidence in this field.
What it found
Before referral, 45.7% of the gender-referred cohort had already received specialist psychiatric treatment, compared with 15.0% of controls. Two years or more after referral, 61.7% of the gender-referred cohort required specialist psychiatric care, compared with 14.6% of controls. The first fact that has to be faced squarely is that psychiatric burden in this population is not only high at baseline. It remains very high afterward.
The post-2010 cohort matters as well, because defenders of the current model often imply that older data says little about the newer referral population. In this study, referrals after 2010 were in markedly worse psychiatric shape before referral than the earlier cohort. Among referrals before 2010, pre-referral psychiatric morbidity was 23.7%, versus 11.8% among controls. Among referrals after 2010, it was 47.9%, versus 15.3% among controls. So the recent referral surge did not simply bring in more of the same patients. It brought in a population with substantially heavier psychiatric burden.
The most striking figures concern the medically treated subgroups. Among those proceeding down the feminizing pathway, pre-referral psychiatric treatment was 9.8%; at least two years after referral it was 60.7%. Among those proceeding down the masculinizing pathway, the figures were 21.6% before referral and 54.5% after. Those are not small fluctuations. They are large increases in specialist psychiatric treatment after entry into the care pathway.
The adjusted-risk figures are no less serious. After adjustment for prior psychiatric treatment, hazard ratios remained approximately 3.0 to 3.7 times higher than female controls and 4.7 to 6.1 times higher than male controls. In plain English, the excess psychiatric burden did not wash away once prior history was accounted for.
The authors’ own conclusion is worth quoting in fuller form than the clipped line now circulating online: “Severe psychiatric morbidity is common among gender-referred adolescents and appears to be more prevalent in those referred after the recent surge in referrals. Psychiatric needs do not subside after medical gender reassignment.” That is not activist spin. It is the paper’s conclusion.
“Psychiatric needs do not subside after medical gender reassignment.”
What this study does not claim
This part matters because opponents will often try to smuggle in a claim you did not make and then congratulate themselves for refuting it.
This study does not prove that medical transition caused worsening in every case. It does not isolate a single causal mechanism. It does not show that no individual patient experienced subjective relief. It does not establish that specialist psychiatric treatment is a perfect one-to-one proxy for every dimension of psychological distress.
Those are real limits. They should be stated plainly.
But none of them rescues the stronger public claim that pediatric medical transition is clearly supported by solid evidence showing reliable mental-health benefit.
The strongest counterargument
The strongest counterargument is easy enough to state. Patients who go on to medical treatment may differ in important ways from those who do not. There may be unmeasured confounding. Some young people selected for treatment may have had more severe, more persistent, or more complex underlying psychiatric problems than the registers fully capture.
This is plausible.
Even if granted in full, however, it concedes the central problem.
If these interventions are working as claimed at the population level, then some clear signal of mental-health improvement should appear in the aggregate outcomes. Instead, psychiatric burden remains extremely high, does not converge toward control levels, and in key medically treated subgroups rises sharply. Increased specialist psychiatric treatment does not by itself prove worsening in every individual. What it does show is substantial psychiatric need persisting at levels incompatible with confident claims of broad psychiatric resolution.
That is the point critics keep trying to dodge. The question is not whether every confounder has been abolished. The question is whether the real-world outcome pattern supports the certainty with which these treatments have been promoted. This study says no.
Absence of demonstrated benefit is not a trivial problem
A common dodge here is to pretend that unless one has a perfect randomized trial proving direct harm, no serious concern exists. That is not how responsible pediatric medicine works.
Lack of demonstrated benefit is not identical to proof of harm. But weak evidence plus invasive intervention is not a neutral combination, especially in minors. When the evidence base is low quality and the strongest real-world data still fails to show the promised mental-health improvement, caution is not reactionary. It is simply what evidence-based medicine looks like once ideology is removed from the room.
“If an intervention works, population data should eventually show it. This does not.”
The larger evidence context
The Finnish register study matters on its own, but it lands in a broader evidentiary landscape that has already shifted under activists’ feet.
The independent Cass Review in England concluded that the evidence base for medical intervention in children and young people with gender-related distress is weak, that studies are generally small and uncontrolled, and that the field has been marked by overconfidence unsupported by good evidence. The review also incorporated earlier evidence reviews commissioned from NICE on puberty blockers and hormones.
Those NICE evidence reviews found the evidence for both puberty blockers and cross-sex hormones in this population to be of very low certainty. They remain among the most cited formal evaluations of the literature in this area.
Sweden’s National Board of Health and Welfare likewise revised its national guidance, concluding that for minors the risks of puberty blockers and hormone treatment currently outweigh the expected benefits, and that such treatment should be offered only in exceptional cases within structured specialist settings.
That pattern is not accidental. It reflects a broader recognition across evidence reviews and national reassessments: the confidence of the clinical rhetoric has run ahead of the quality of the evidence.
What can actually be concluded
Several conclusions can be made safely.
First, the psychiatric burden in this population is real and often severe. Nothing in this argument denies that.
Second, the new Finnish register data does not show psychiatric need subsiding after medical gender reassignment. On the contrary, the burden remains high, and in some medically treated subgroups the observed specialist psychiatric treatment rates rise sharply.
Third, the broader review literature and policy reassessments from major health authorities do not justify the level of certainty with which pediatric medical transition has often been promoted. The evidence is not robust enough for that.
Fourth, this study does not by itself prove a simple causal story of treatment-induced worsening in every case. Anyone claiming that from this paper alone is saying more than the evidence can bear. But anyone claiming that the strongest available population-level data clearly supports a confident mental-health benefit is also saying more than the evidence can bear.
The policy problem
That mismatch is the real issue.
This is not a case in which critics are denying a clearly established medical benefit. It is a case in which weak evidence, ambiguous long-term outcomes, and very serious interventions have too often been wrapped in the language of settled science.
They are not settled.
The evidence base is weak. The psychiatric burden remains high. The strongest register data now available does not show the promised relief in hard mental-health outcomes. That should force a lower-confidence, higher-caution clinical posture than the activist narrative has allowed.
Verdict
No honest reading of this literature permits the triumphant line that pediatric gender medicine is clearly evidence-based and reliably improves youth mental health.
The better reading is harsher and simpler.
The evidence is weak. The certainty has been inflated. And the strongest real-world data now available does not show psychiatric needs subsiding after medical gender reassignment.
When the evidence does not show improvement, escalation is not caution.
It is risk.
References
Ruuska, S.-M., Tuisku, K., Holttinen, T., & Kaltiala, R. (2026). Psychiatric morbidity among adolescents and young adults who contacted specialised gender identity services in Finland in 1996–2019: A register study. Acta Paediatrica. Advance online publication. https://doi.org/10.1111/apa.70533
Cass, H. (2024). Independent review of gender identity services for children and young people: Final report. https://cass.independent-review.uk/home/publications/final-report/
NICE / NHS England. (2020). Evidence review: Gonadotrophin releasing hormone analogues for children and adolescents with gender dysphoria. https://www.engage.england.nhs.uk/consultation/puberty-suppressing-hormones/user_uploads/nice-evidence-review-gnrh-analogues-for-children-and-adolescents-with-gender-dysphoria-october-2020.pdf
NICE / Cass Review. (2020). Evidence review: Gender-affirming hormones for children and adolescents with gender dysphoria. https://cass.independent-review.uk/wp-content/uploads/2022/09/20220726_Evidence-review_Gender-affirming-hormones_For-upload_Final.pdf
Socialstyrelsen. (2022). Care of children and adolescents with gender dysphoria – Summary of national guidelines – December 2022. https://www.socialstyrelsen.se/publikationer/care-of-children-and-adolescents-with-gender-dysphoria–summary-of-national-guidelines–december-2022-2023-1-8330/
Socialstyrelsen. (2022, December 16). Updated knowledge support for care in gender dysphoria among young people. https://www.socialstyrelsen.se/om-socialstyrelsen/pressrum/press/uppdaterat-kunskapsstod-for-vard-vid-konsdysfori-hos-unga/
Hostile Reader FAQ
“You’re claiming gender-affirming care causes harm.”
No. This piece does not claim causation. It shows that the strongest population-level data does not demonstrate the expected mental-health improvement. Absence of demonstrated benefit is not the same as proof of harm—but it is not neutral either.
“Psychiatric service use isn’t the same as worse mental health.”
Correct. It is not a perfect proxy for subjective distress. It is, however, a hard clinical outcome and a strong indicator of ongoing psychiatric need. Persistent high rates of specialist care are not consistent with claims of broad resolution.
“These patients were already more distressed.”
Yes. The study shows elevated psychiatric burden before referral. The question is whether that burden improves. At the population level, it does not converge toward control levels, and in some subgroups increases substantially.
“This is just one study.”
It is one of the largest and longest nationwide register studies to date. More importantly, its findings align with multiple systematic reviews and policy reassessments that rate the evidence base as low quality and uncertain.
“Other studies show benefits.”
Some smaller or short-term studies report improvements, often based on self-report and without strong controls. Systematic reviews consistently find these studies to be low certainty and at high risk of bias. That is why several national health authorities have revised their guidance.
“You’re ignoring patient experiences.”
Individual experiences vary, and some patients report relief. Clinical policy, however, is not built on anecdote. It is built on aggregate outcomes and evidence quality. Those are the focus here.
Canada’s Bill C-4 was sold as a targeted ban on abusive “conversion therapy.” That goal of ending coercive, shame-based attempts to “pray the gay away”is legitimate, and the harms from such practices are well documented. (Library of Parliament)
But C-4 didn’t stop at prohibiting coercion. It built contested premises about “gender identity” into the Criminal Code—then wrapped ordinary clinical caution in legal risk. For children, that’s not a symbolic problem. It’s a downstream harm problem.
1) C-4 hard-codes a contested concept into criminal scope
The Criminal Code definition of “conversion therapy” includes any “practice, treatment or service designed to… change a person’s gender identity to cisgender,” or “repress… a person’s non-cisgender gender identity.” (Department of Justice Canada)
That’s not the same category as sexual orientation. Whatever one’s politics, “gender identity” is not measured like blood pressure. In real child psychotherapy, you do differential diagnosis: you test hypotheses, you treat comorbidities, you watch patterns over time, you revisit interpretations.
C-4 makes one interpretive direction toward “cisgender”a uniquely danger to be seen as the “design” of therapy. (Department of Justice Canada)
2) The preamble signals something stronger than “don’t abuse people”
The Act’s preamble denounces “myths and stereotypes,” including “the myth that… cisgender gender identity… [and] gender expression that conforms to the sex assigned… are to be preferred over other… gender identities.” (Parliament of Canada)
Supporters will say this is a dignity claim: no one should be pressured to “be cis.” Fine. But when Parliament declares a core premise a “myth,” it doesn’t just condemn abuse it pressures institutions to treat skepticism as suspect.
In therapy, that matters, because the clinician’s job is not to recite a moral slogan. It’s to find the causal engine of distress in a specific child.
3) “Exploration” is permitted—until it looks like exploration with a destination
C-4 includes a “for greater certainty” carve-out for “exploration or development of an integrated personal identity… such as… gender transition,” provided the service is not “based on an assumption that a particular… gender identity… is to be preferred over another.” (Department of Justice Canada)
Here’s the problem: in actual clinical practice, the line between exploration and influence is not a clean statutory boundary.
A careful therapist might say:
- “Let’s treat anxiety/OCD first and see what remains.”
- “Let’s explore trauma and dissociation before we interpret identity claims.”
- “Let’s reduce online reinforcement and stabilize sleep, mood, and social stress.”
- “Let’s slow down—puberty is a confounder, not an oracle.”
That’s not “conversion.” That’s normal clinical sequencing.
But under C-4’s language, a motivated complainant (or risk-averse administrator) can reframe caution as an attempt to “repress” a non-cis identity, or as therapy “designed” to steer toward “cisgender.” (Department of Justice Canada)
Even if a prosecution is unlikely, the chilling effect doesn’t require convictions. It only requires enough ambiguity that clinicians and clinics decide it’s not worth the exposure.
4) This isn’t “college policy.” It’s Criminal Code territory.
Bill C-4 received Royal Assent on December 8, 2021 and came into force in January 2022. (Parliament of Canada)
It created Criminal Code offences around causing someone to undergo conversion therapy, promoting/advertising it, and profiting from it. (Parliament of Canada)
So when therapists ask, “Can I safely do exploratory work with this child without being accused of ‘conversion’?” they are not being melodramatic. They are doing what professionals do when lawmakers write broad definitions: they assume the worst plausible reading—and they self-censor.
5) Why this hits children hardest
Adults can absorb bad ideology and still have time to course-correct. Kids often can’t.
Children need therapy that is:
- exploratory (many hypotheses, not one script),
- developmentally sober (puberty changes the picture),
- comorbidity-first (anxiety, depression, autism traits, trauma, dissociation),
- family-systems aware (parents are usually the safety net, not “the enemy”),
- outcome-humble (no foreclosed conclusions).
C-4 subtly tilts the playing field: it makes “don’t be seen as steering away from trans identity” the safest institutional posture regardless of whether that posture serves the child in front of you.
6) Why this question is sharper now
After the February 10, 2026 Tumbler Ridge shootings, public attention has turned—again—to institutional failure chains: mental health, gatekeeping, warning signs, and what “care” actually means when a young person is unstable. The BC RCMP’s Feb 13 update refers to autopsies for “eight victims and the suspect” (nine deceased total), and notes ongoing review of prior interactions with the suspect. (RCMP)
A tragedy doesn’t “prove” a policy critique. But it does remove the luxury of pretending that scripts are the same thing as safeguards.
A better standard (without reviving abusive conversion practices)
If Parliament’s aim is to ban coercion and fraud, it can do so cleanly without criminalizing clinical caution.
A fix would explicitly protect:
- Open-ended psychotherapy for gender distress, including differential diagnosis and comorbidity treatment.
- Neutral therapeutic goals (reducing distress, improving functioning, strengthening self-acceptance) without predetermining identity outcomes.
- The clinician’s ability to discuss biological sex reality, uncertainty, and developmental pathways without that being treated as “preference” or “myth.” (Parliament of Canada)
- Bright-line prohibitions aimed at the actual evils: coercion, aversive techniques, confinement, threats, and misrepresentation.
Canada can still denounce abuse and defend evidence-based exploration. Kids deserve therapists unbound by ideology—not just ideology unbound by evidence.
References
- Bill C-4 — First Reading (House of Commons) — Nov 29, 2021
https://www.parl.ca/DocumentViewer/en/44-1/bill/C-4/first-reading
Source: (Parliament of Canada) - Bill C-4 — Third Reading (House of Commons) — Dec 1, 2021
https://www.parl.ca/DocumentViewer/en/44-1/bill/C-4/third-reading
Source: (Parliament of Canada) - Bill C-4 — Royal Assent (Chapter 24) — Dec 8, 2021
https://www.parl.ca/DocumentViewer/en/44-1/bill/C-4/royal-assent
Source: (Parliament of Canada)
Core legal text (Criminal Code, consolidated)
- Criminal Code — s. 320.101 (definition + exploration carve-out)
https://laws-lois.justice.gc.ca/eng/acts/c-46/section-320.101.html - Statutes of Canada 2021, c. 24 (Annual Statutes full text — includes preamble)
https://laws-lois.justice.gc.ca/eng/AnnualStatutes/2021_24/FullText.html
Official legislative record / metadata (timeline, status)
- LEGISinfo — Bill C-4 (44-1) (dates, stages, summary trail)
https://www.parl.ca/legisinfo/en/bill/44-1/c-4
Source: (Parliament of Canada)
Neutral institutional summary
- Library of Parliament — Legislative Summary (PDF)
https://publications.gc.ca/collections/collection_2022/bdp-lop/ls/YM32-3-441-C4-eng.pdf
Source: (Government of Canada Publications)
Government explainer / enforcement framing
- Justice Canada — “Conversion therapy” page (in-force date, offences overview)
https://www.justice.gc.ca/eng/rp-pr/jr/ct-tc/p1.html
Context reference used in the essay (Tumbler Ridge)
- RCMP — Tumbler Ridge investigative update (Feb 13, 2026)
https://rcmp.ca/en/bc/tumbler-ridge/news/2026/02/4350292
As it is with most cult ideologies the majority of what they say is bullshit. The suicide myth is particularly pernicious as it is used to coerce parents into consenting to have their children surgically mutilated in a misguided attempt to solve their mental issues.
“There is no evidence of a large rise in suicides in young patients attending a gender identity clinic in London, an independent review has found.
Professor Louis Appleby was asked by Health Secretary Wes Streeting to examine the data following claims made by campaigners of a rise in suicide rates since puberty-blocking drugs were restricted at the Tavistock and Portman NHS Trust in 2020.
Prof Appleby’s review concludes “the data do not support the claim”, and he added the way the issue had been discussed on social media was “insensitive, distressing and dangerous”.
This is the truth that the people who advocate for this transgender social contagion do not want you to know.
“That was recommended in the Cass Review, published in April, which found “remarkably weak” evidence on the use of the treatment.
In response to their claims, the new health secretary launched an independent review led by Prof Appleby which analysed data from NHS England on suicides of patients at the Tavistock clinic, based on an audit at the trust.
Covering the period between 2018-19 and 2023-24, he found there were 12 suicides – five in the three years leading up to 2020-21 and seven in the three years afterwards.
“This is essentially no difference,” Prof Appleby says in his report, “taking account of expected fluctuations in small numbers, and would not reach statistical significance.”
He adds: “In the under 18s specifically, there were 3 suicides before and 3 after 2020-21.”
The patients who died were in different points in the care system, including post-discharge, suggesting no consistent link to any one aspect of care, Prof Appleby noted.”
Make note this is what evidence based medicine looks like.
“Dr Cass’ review found there was insufficient evidence to show puberty blockers were safe for under 18s which is why the NHS has already stopped their routine prescription for children with gender dysphoria.
“We are committed to ensuring children questioning their gender receive the best possible multidisciplinary care, led by expert clinical guidance. That is why we are reforming gender identity services.”
So, when will Canada return to actual medical practices instead of the gender activist quackery that it is currently following?
Children are being harmed because medical practitioners are either ideologically captured or too scared to speak out against the grotesque medical experimentation undertaken in the name of transgender ideology.
The transgender debate revolves around thought terminating clichés being flung at people rather than actual arguments based on facts and evidence. “No debate”, “TWAW”, and of course “you don’t want trans people to exist!” are all meant to emotionally manipulate and coerce people into agreement or at least silence on the the matters of gender affirming care specifically, and transgender health care in general. This is why (trans) activists almost always take this route because the facts (and medical evidence) DO NOT support their position and said evidence often indicates a risk of significant iatrogenic harm for children and adults.
When talking with the gender religious another dodge they will use is puberty blockers are just being used in a small number of cases. Replace ‘puberty blockers’ with lobotomies or thalidomide treatments to see how well this argument holds up…
This tragic medical scandal is what happens when we allow medical decisions to be made on the basis of feelings and activism, as opposed to evidence based medicine.
GAC is being halted in the UK and across Europe – Canada needs to get its head out of the sand and rejoin the medical community that follows evidence based medicine instead of the strictures of transgender activism. Children’s lives are being ruined because of this quackery and it needs to stop.
The article quoted below by Maria Maynes describes the content of the study. Read the full article here.
“A new study has suggested that damage done by puberty blockers is permanent, casting doubt on claims by trans campaigners that the hormone drugs simply “pause” puberty and provide time for children who question their gender.
The preprint study from the Mayo Clinic, a world-renowned leader in medical research, found mild to severe atrophy in the testes and sperm of male children on puberty blockers. The authors of the groundbreaking study have expressed doubt about the “reversibility” of such blockers, a claim made by campaigners who promote the use of the drugs for gender dysphoric children.
Scientists at the world-renowned clinic who carried out the study found that puberty blockers can lead to fertility problems, withering testicles, and even cancer among children who take them. Authors found that puberty blockers hurt the development of testicles and sperm production in ways that cannot be fully reversed, with problems including impacting users’ ability to have children in adulthood.”
[…]
“The recently published preprint came ahead of the long-anticipated Cass Review in Britain, released on Wednesday, with the independent review warning that healthcare professionals felt afraid to discuss their views on transgender services for children. The report also found that there was no evidence that puberty blockers or hormone drugs “buy time to think” or reduce the suicide risk in children suffering from gender dysphoria.
The publication of the review by paediatrician Dr Hilary Cass has confirmed the NHS in England’s shift away from the medicalised treatment of children struggling with their gender, to one focused on talk therapy and support.
The Mayo Clinic preprint, although not yet peer-reviewed or published, suggests that some of the effects of puberty blockers on testes and sperm may not be reversible, sparking concern from leading medics.
Prof Ashley Grossman, a University of Oxford endocrinologist, has pointed to the study as proof that there is ‘no good evidence’ showing puberty blockers help children.
The endocrinologist highlighted the study, saying that the drugs are too risky to be given to the “greatly increased” number of adolescents who identify as transgender.
“Routine puberty blocking treatment for this use has not yet been adequately studied, and many of these children may have other problems for which they need help,’ he added, hinting at a growing body of evidence showing gender confused youngsters often have other, underlying mental health issues,” he said, as he pointed to the early data released by the Mayo Clinic in the preprint last month.
The UK last month joined the Netherlands, Sweden, Finland and Norway in a growing list of European nations to have either placed restrictions on or banned medical interventions for gender dysphoric children.”
We need to act now to stop this reckless experimentation on our children.
TL:DR – The column on the left is activist dogma that has been pushed into the medical system. The column on the right is what proper evidence based care looks like.
Thank you to Our Duty Canada for composing this letter.
An Open Letter to the Alberta Medical Association (AMA)
Regarding the February 1st Statement from the AMA
Section of Pediatrics on gender-affirming treatments March 2024
On February 1, 2024 your association released a statement in response to
Alberta Premiere Danielle Smith’s proposed changes to the treatment of
trans-identified children and adolescents, those struggling with gender
ideation. We ask that you consider and respond to our questions and
concerns regarding your statement and explain how the official position
described therein is consistent with your profession’s fundamental
principle to first “do no harm.”
We are a group of concerned parents, most of whom have children
struggling with gender ideation and grappling with the largely unrestricted
social and medical options being presented to them in Canada. We believe
that no child has the necessary cognitive and psychosocial maturity to
provide informed consent to the use of off-label synthetic hormones and
surgical procedures, often referred to as “gender-affirming healthcare,”
that have irreversible and damaging effects on their health and fertility.
We also carefully follow the results of peer-reviewed research in this area,
which, to date, has NOT yielded strong evidence of the safety or efficacy
of gender-affirming medical treatments. Therefore, we work to increase
public awareness and pressure our social, medical and political
organizations to conduct themselves from an evidence-based perspective.
We have identified several areas of concern in your recent statement and
we address them herein. In summary, your statement contains
generalizations that are not supported by sound evidence; false statements
about the safety and efficacy of the off-label drugs you recommend for
children and adolescents; reference to your steadfast opposition to
safeguarding children and adolescents through proper regulatory
processes and networks; and finally, a strong disregard for age-appropriate
decision-making and consent to medical treatments and surgical
procedures that have irreversible and damaging effects, and which
increasing numbers of youth are living to regret.
Your statement first asserts that “transgender youth have higher rates of
mental health issues and suicidality because of the stigma attached to
their status. The mental health of these children and youth will be markedly
worse when denied care.” The fact is, however, that recent peer-reviewed
research, such as this 20-year Finnish study, does NOT show that gender
affirming healthcare improves the mental health outcomes of children and
adolescents. For example, and perhaps most importantly, this research
does NOT find decreased suicide rates in youth who have accessed
gender-affirming medical treatment.
Your statement further asserts that “the effects of puberty-blocking agents
are not irreversible; and once treatment stops, puberty goes forward.
Treatment allows the patient time to determine their options without
permanent effects.” This assertion is particularly disturbing for two
reasons: (1) it blatantly misleads readers about how puberty blockers are
actually used in trans-identified children and adolescents, and (2)
consequently, it evades the full truth about the actual impacts of these
off-label drugs. In regard to (1), your assertion is premised on cases where
puberty blockers are used for brief periods of time and then stopped so
that natural puberty can progress.
However, this is not how puberty
blockers are actually being used in the majority of trans-identified children
and adolescents. In reality, puberty blockers are most often followed by
cross-sex hormone treatment (up to 98% of the time) and these minors
never go through natural puberty. Further, the long-term effects of puberty
blockers when they are followed by cross-sex hormones are
well-documented and dire, as even the president of WPATH confirms in
this linked video and with this statement, “Every single child or adolescent
who was truly blocked at Tanner Stage 2 has never experienced orgasm, I
mean it’s really about zero.” The pituitary gland is actually rendered
indefinitely dormant with GnRH Analogues (Puberty Blockers), which is why
several countries, most recently England, have corrected their course and
banned their use for gender affirming healthcare. Medical associations owe
it to the public to provide COMPLETE and TRUTHFUL information, which
your statement does NOT do.
Your statement goes on to point out that “Bottom surgery in Canada is
already limited to patients over 18 years.” Once again, you assert a
half-truth that is misleading to readers when you state that “bottom surgery”
is limited, but you remain silent about bilateral mastectomies (“top
surgery”). The fact is that bilateral mastectomies ARE being performed
on patients UNDER 18 YEARS old in Canada. We know this first-hand
because it has happened to our own children, and we know that this
procedure is completely irreversible. Asserting half-truths and omitting
information is not conducive to maintaining the trust of the public.
In light of the recent release of the WPATH Files, we find the following part
of your statement to be an effort to escape the duty to be transparent that,
as a regulatory body for the entire province of Alberta, is crucial to the
AMA’s role and responsibility: “Requiring a private registry of physicians to
provide gender-affirming care has the feel of surveillance, to which we
object. It is an unnecessary bureaucratic process given the current
existence of effective referral processes and networks.” First, what you
refer to as “surveillance” is understood by the Albertans to whom you are
accountable as the transparency you are charged to uphold. Second, you
fail to explain that your referral process is based on the WPATH guidelines,
which have been largely discredited. The fact is that these guidelines, for
“gender-affirming healthcare,” are not evidence-based, but experimental.
A 2023 article in the prestigious British Medical Journal confirms this. As
parents, we are paying close attention to this, and we are asking that our
medical professionals do the same. Statements like the one you have just
made show us that you are NOT paying attention and that you are NOT
following the overwhelming and growing body of evidence.
When professional medical associations cease to be guided by
evidence-based research and principles, and cease to be open and honest
with the public, then the public– rightly and understandably– becomes
alarmed and will, in turn, support the intervention of governments and
ultimately the courts. While we do respect the doctor/patient relationship,
your lack of adherence to the evidence is a symptom of a problem to which
you, as a medical association, have contributed. Your statement is shining
evidence of this.
There is, however, one part of your statement with which we could not
agree more: “Children and youth have the right to the appropriate medical
care.” Children and adolescents DO have the right to safe, evidence-based,
non-experimental medical care that protects them from long-term harm
such as loss of sexual function and infertility. This right is enshrined in the
United Nations Convention on the Rights of the Child. Moreover, children,
adolescents and their families ALSO have the right to provide informed
consent to drugs and surgical procedures that are recommended to them.
This requires doctors and medical associations to be informed and
evidence-based, transparent and accountable. Your statement shows a
shocking disregard for these responsibilities, which the AMA SHOULD hold
sacred. Full stop.
We strongly recommend that your organization cease to follow the
guidelines put forth by the heavily discredited WPATH, stop promoting
medical negligence and harm while operating from a non-evidence-based
perspective, and change course now as progressive European countries
including Sweden, Finland, England, Norway and France have already
done.
We ask that you explain your comments from an evidence-based
perspective. If you cannot, we must assume that they, along with your
official position, are ideologically driven, in which case we call for complete
retraction or substantial correction to the AMA’s original statement. Should
you fail to respond, we will understand that as further dismissal of the
parents, children and adolescents, and citizens to whom you are
responsible, and we will proceed accordingly.
In Support of Children and Families,
Our Duty Canad
Letter to the PM and Premier Doug Ford on the danger of “gender affirming care”. Share widely. 
bleatmop
Mystro
Dead Wild Roses 
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