Sweden, the UK, France, and Norway have all set age limits for medical transitioning due to the evidence and side effects concerns
Last week, Alberta Premier Danielle Smith announced that the province would no longer offer puberty blockers or cross-sex hormones for minors 15 and younger or gender transition surgeries for minors 17 and younger. This may be considered a bold step in Canada, but it makes Alberta the first province to follow the science and international precedent.
Many other jurisdictions have already made the decision to limit medical transitioning for minors. Finland was the first in 2020. After a dramatic growth in the number of young people seeking a medical transition, the Finnish Health Authority undertook a comprehensive study of the academic literature on medical transitioning.
The result of their study found that evidence supporting medical transitioning was scarce and of low quality. Medical transitioning did not lead to better health outcomes and was accompanied by numerous risks. Many psychiatric disorders were present in patients seeking a medical transition, making it difficult to disentangle gender dysphoria from these conditions. They also noted that young people may not be neurologically mature enough to comprehend the gravity of a medical transition.
Based on their findings, the Finish Health Authority recommended that cross-sex hormones generally not be prescribed before age 18, except in cases of severe gender dysphoria. They kept in place a complete ban on surgical interventions on minors and an absolute minimum age for cross-sex hormones at 16.
In 2021, Sweden’s Astrid Lindgren Children’s Hospital followed suit, setting the minimum age for puberty blockers and cross-sex hormones at 16 and surgical interventions at 18. Within a year, the Swedish National Board of Health and Welfare made this standard practice throughout the country.
In 2022, the United Kingdom set similar interim age requirements for medical transitioning as they re-assess their practice of care following the closure of the country’s sole gender clinic in Tavistock because of malpractice.
Later that year, France’s National Academy of Medicine urged medical practitioners to use the “greatest caution” when prescribing puberty blockers or cross-sex hormones, given the medical, emotional, and intellectual side effects of such a transition.
In 2023, the Norwegian Healthcare Investigation Board also found their national professional guidelines inadequate and is in the midst of re-drafting their guidelines.
In recent years, almost two dozen American states restricted or banned medical transitioning for minors.
Already this year, the World Health Organization declined to publish any recommendations on medical transitioning for minors “because, on review, the evidence base for children and adolescents is limited and variable regarding the longer-term outcomes of gender-affirming care for children and adolescents.”
Alberta’s decision to end medical transition for minors in the province follows the science and the lead of peer jurisdictions where the practice was critically examined. Childhood and adolescence are dynamic times of identity formation and reformation. The utmost care should be taken to avoid locking in these identities through permanent alterations of the body. Truly affirming care lets kids grow and develop naturally, with a focus on acceptance and celebration of their natural body. The best policy – and the one that Alberta has chosen – is simply to let kids be.
Rather than accusing Alberta of politicizing children or attacking human rights, the federal government and other provincial governments should examine the evidence base themselves and, when they discover the very limited evidence base to support medical transitioning for minors, follow Alberta’s lead.
The health and well-being of thousands of children, not just in Alberta but across the country, hang in the balance.
Levi Minderhoud is a policy analyst for the Association for Reformed Political Action (ARPA) Canada.
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