Some minors can stay on puberty blockers under new Alberta law, Smith says

Alberta Premier Danielle Smith said on Tuesday that a new ban on puberty blockers won’t apply to children and teens who are currently using them.

Smith said in a video message that minors who have “already commenced their treatment” will be excluded from a soon-to-be-introduced law barring the use of puberty blockers and hormone therapies for the purpose of gender reassignment for Albertans under the age of 16.

The premier said that the new restrictions will be introduced when the Alberta legislature is back in session later this month, alongside new policies relating to student name and pronoun changes and female sports.

The new policy direction on issues relating to gender identity was first announced by the premier in late January.

Pharmaceutical hormone blockers like gonadotropin-releasing hormone (GnRH) analogues are synthetic compounds that target receptors in the brain that regulate the production of sex-related hormones, effectively fooling the brain into thinking such hormones are already being produced. Regular injections of such drugs delay sex-specific changes in adolescents (for example, facial hair, breast development). 

Defenders of puberty blockers say they give children dealing with gender dysmorphia crucial time to explore their gender identity. Critics point to scientific uncertainty over the long run cognitive and physiological effects of prolonged use.

Puberty blockers have historically been used to slow down early puberty in cisgendered children, with treatments generally winding down by the time patients hit their pre-teen years.

Minors who use puberty blockers to treat gender-related distress tend to start using them later on, typically as pre-teens or teenagers.

Puberty blockers were a major focus of a recent review led by retired British pediatrician Hilary Cass, a former president of the Royal College of Paediatrics and Child Health.

The final report of the so-called Cass Review, released in April, concluded that not enough is known to say whether puberty blockers are beneficial for gender dysmorphic minors or safe over the long run, citing the poor quality of existing studies.

Subsequent to the report’s publication, the U.K.’s then Conservative government issued a temporary ban on puberty blockers for minors under the age of 18. The ban has continued under the country’s new Labour government.

Smith told the National Post in May that the review’s findings vindicated her government’s position on gender-affirming medicine for minors.

Dr. Roy Eappen, an endocrinologist based in Montreal, said on Wednesday that stopping the use of puberty blockers carries little risk for pre-teens and younger teenagers.

“If you stop the pulse (emitted by puberty blockers) the normal rhythms of puberty will gradually start back up on their own,” Eappen said in an interview.

Eappen says he suspects that Smith’s decisions to grandfather in the puberty blocker ban is an attempt at compromise over the divisive issue.

Smith has repeatedly called for a cooling of the rhetoric surrounding trans issues.

Federal Minister for Gender Equality Marci Ien said on Tuesday that it was impossible to “depoliticize” the issue.

“In Canada, the freedom to be who you are isn’t about politics — it’s a right,” Ien said in a social media post targeting Smith.

A request to Alberta’s Ministry of Health for the number of Albertans aged 15 and under who are currently being prescribed puberty blockers was not answered by deadline.

A National Post investigation earlier this year found that there were 2,700 requests for hormone treatment in 2022–23, but it was uncertain how many of these were for gender-affirming care or were made by minors.

National Post [email protected]

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