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.
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