Alberta's Proposed Trans Policy

It's been 3 days since Premier Danielle Smith dropped a bomb on Alberta's transgender community, and I'm still reeling.  I'm alternating between being angry with the government, and grieving for the youth that will be most deeply affected by these policies. 

Before I dive into a deeper analysis of what Premier Smith announced, and my thoughts about it, I just want to say to my readers who are not themselves transgender, and may be looking at this as "well, this seems reasonable":  Ask yourself how you would feel if your access to treatment, social validity, and activities were arbitrarily legislated away?  Because that's exactly what's being done to transgender people (not just youth) here. 

Now, onwards into the policy bundle that Premier Smith announced on Wednesday.

Let's break this into its constituent pieces.  The announcement on Wednesday afternoon was a bit of a hodge-podge, and would be confusing on several levels if you weren't paying really close attention. 

Policy Analysis

CBC breaks them out as follows: 

• Top and bottom surgeries will be banned for minors aged 17 and under. Doctors say bottom surgeries aren't performed on youth and top surgeries are rare.
• Puberty blockers and hormone therapies for gender affirmation will not be permitted for children aged 15 and under.
• Youths aged 16 and 17 will be permitted to start hormone therapies for gender affirmation "as long as they are deemed mature enough" and have parental, physician and psychologist approval.
• Parental notification and consent will be required for a school to alter the name or pronouns of any child under age 15. Students who are 16 or 17 won't need permission but schools will need to let their parents know first.
• Parents will have to "opt-in" their children every time a teacher plans to teach about gender identity, sexual orientation or sexuality. Alberta law currently requires parental notification and gives them the option to opt students out.
• All third-party teaching materials on gender identity, sexual orientation or sexuality will need to be approved in advance by the education ministry.
• Transgender women will be banned from competing in women's sports leagues. Smith said the government will work with leagues to set up coed or gender-neutral divisions for sports.

This breaks into the following major categories:

1. Access to treatment for transgender youth
2. School Environment Issues
1. Names / Pronouns / Etc 
2. Sex Education 
3. Sports Access 

Let's walk through each of these carefully, shall we?  

Part 1 - Access to Treatment For Transgender Youth

This is a particularly problematic part of things because it is using the force of legislation and/or policy to drive when certain medical decisions can be made.

Let’s start with the notion of hard lines on when “top or bottom surgeries” can be done.  The reality here is that for the most part gender affirming surgeries are limited to those already considered legal adults.  While a handful might be performed on people before that age, it’s done rarely, and only under the rubric of the ethical concept of “Mature Minor”.  

But, the restriction is based not on what's actually happening in reality.  It's based on an urban myth that anti-transgender activists have been spreading about.  The myth is that when a child expresses any cross-gender identity, they are immediately rushed off for surgery and hormones.  Note that the emphasis is on surgeries (and they mischaracterize those too) - this is purposeful, as it evokes a sense of urgency in their audiences.  

The reality is that if the child is pre-puberty, nobody is talking about things like surgery or even hormones.   Instead, we're probably talking about letting the child transition socially and see how things go.  When puberty begins (that's several years away for a 5 year old), that's when a discussion about puberty blockers would happen, and similarly in teen years is when a discussion about hormones would take place.  At any time, the individual undergoing the process always has the power to say "nope, this isn't working for me".  The autonomy rests with the individual.  Parents, therapists, doctors, and other caregivers play a supporting role, regardless of the direction taken.  The patient leads here.

Placing arbitrary age limits on access to either puberty blockers or hormone therapy is enormously problematic.  Smith's proposal sets a floor age for puberty blockers of 15.  By 15, most children have gone through the bulk of puberty.  In effect, the policy places a ban on puberty blockers because puberty begins for most people between 10 and 12 years of age.  In essence, Smith is condemning transgender children to a puberty that they are already expressing as undesired.  This is intrinsically traumatizing to the transgender person. 

Similarly, placing arbitrary age boundaries on access to HRT is problematic because it doesn't acknowledge the different abilities of individuals to make those kinds of decisions rationally.  One person might be ready to make that decision at 13, another may well not be ready until they reach 18 or older.  Hard lines are easy to understand, but they make terrible clinical guidelines. 

The Alberta government has decided that it is willing to force transgender youth through the wrong puberty.  Sit with that for a moment.  The last time the Alberta government was so brutally traumatizing to individuals was when it passed the Eugenics Act which was used to justify sterilizing people against their will.  That didn't end well for the Alberta government in the courts.  

Part 2 - School Environment Issues 

The second part of the announcement focuses primarily around how schools are supposed to handle name change requests, and so on, but also contains an important bit of sleight-of-hand policy change regarding sexuality education.  

Like the government’s actions on GSAs, the mandatory parental notification aspect of this policy overtly undermines the “school as a safe place” aspect of the current environment.  Currently, if a student changes their working names / pronouns at school, there is an opportunity for the school to work with the student to help them get to a place where they feel safe enough to come out to their families.  

This is normal.  Transition is hard, it’s scary, and it’s full of uncertainties.  Family seldom learns first if the person transitioning is over the age of 10 or 11 for the simple reason that as we get older we start to look to our peers for support.  Families are complex relationships, and even when we anticipate support, nobody wants to blow the entire family system up, so caution is needed.  That’s for those whose families are understanding and supportive.  For those whose families have made it clear they won’t be, well, it’s that much harder.  

This part of the policy is simply wrong-headed and slams doors in the face of youth that need support, need access to safety, and above all, need to be able to be themselves. 

The second part is a subtle bit of sleight-of-hand.  To date, sex education topics have been subject to an “opt-out” approach.  If a parent doesn’t want their child in those classes, they have the right to “opt out” and their child leaves the classroom when the subject comes up.  The government is turning that on its head, and now it’s an “opt-in” model.  In other words, parental consent is required to attend those classes.

Sex education is desperately needed.  Few parents are emotionally or intellectually equipped to talk to their children about sexuality in any meaningful way.  In the long run, this approach will set Alberta up for waves to STI transmission, teenage pregnancies, and leaves our youth vulnerable to exploitation by actual sexual predators.  Yes, that education needs to be broadly inclusive, and it needs to include homosexual and transgender dimensions because those are real people too.  Facts matter. 

Part 3 - Sports Ban

The sports ban is interesting because of its nature. This isn’t just about youth sports, it’s about all levels of sport.  The claim is (broadly) that transgender women have “massive physical advantages in sport”.  This is far from clearly proven, and there is a considerable amount of conflicting evidence on the matter. 

At anything below professional elite level competition, this kind of claim completely overlooks the purpose and benefits of sport:  namely developing long term patterns of exercise and socialization for participants.  We know that pre-puberty, there is simply no appreciable differences, and frankly the evidence for “advantages” for transgender women who have been on HRT for multiple years is pretty damn thin.  

This policy flies in the face of policies developed both nationally and internationally, and is more of a signal that this policy package is ultimately designed to shove transgender people (and transgender women in particular) out of public life.

My Thoughts

This entire announcement reflects the degree of control and influence that Alberta’s “Religious Rump” has on the current UCP government.  For someone who claims to have a transgender person in their family circle, Danielle Smith just rolled out a policy steamroller that is deeply harmful to the transgender community as a whole. 

It will, as a matter of course, force transgender youth in Alberta through the trauma of the wrong puberty. If you don’t think that is inherently traumatic, consider what you would have experienced if your body developed differently while your mind remained exactly the same.  This will create a cohort of transgender people in this province who will experience long term physical and psychological trauma.  

The other part of it is the damage it will do to Alberta’s minority communities.  The signal here is clear:  If you aren’t “Straight, White, Male, and Christian(tm)”, buckle up, because old-school patriarchy is about to be imposed, whether you like it or not. 

Mark my words:  Just as we have seen in the US, these laws will be expanded, and they will become increasingly draconian for anybody who is transgender.  Once that is done, you can bet that the next hobby horse issues will be things like abortion.

… More to come …