A recent report has identified Canada as the most lenient country in the world when it comes to legal and medical gender transition processes for minors. This finding comes from a study conducted by the Calgary-based Aristotle Foundation for Public Policy and Do No Harm, a group advocating for keeping identity politics out of medical practices.
According to the study, Canadian policies are more relaxed compared to Northern and Western European countries. Endocrinologist Dr. Roy Eappen, the lead author of the study, highlighted that Canada and certain U.S. states are the most permissive in terms of allowing legal and medical gender transition procedures for minors, including invasive surgeries that could have potentially harmful and irreversible effects.
While European countries like France have relatively permissive policies, they have also recognized the uncertainties surrounding transgender medical care for children and have advised caution. In North America, there is a strong emphasis on gender affirmation, believing that questioning a minor’s gender self-definition is detrimental and unethical. However, Northern and Western Europe are beginning to challenge these automatic assumptions.
The study also emphasized the importance of strict barriers to protect minors, as only a small percentage of cases of childhood gender dysphoria persist into adulthood. The use of gender-affirming care, which is largely irreversible, necessitates caution and oversight.
Regarding puberty blockers, the study found that Canada has more liberal age requirements compared to other countries. Most provinces do not have a minimum age requirement, with the exception of Alberta and Nova Scotia. European nations generally allow puberty blockers for young teenagers with parental consent and at age 15 or 16 without parental consent. In the U.S., puberty blockers cannot be prescribed before age 18 without parental consent.
Similarly, the study highlighted variations in the use of cross-sex hormones, with different age restrictions in Canada, the U.S., and European countries. Canada generally has fewer restrictions, while some U.S. states are considering imposing limitations. The report recommended giving more weight to studies from countries like Sweden and the UK, which have raised concerns about the safety and effectiveness of certain gender-affirming treatments.
In conclusion, the study calls for a reevaluation of the gender-affirming care model in Canada and the United States, suggesting that these countries should follow the lead of European nations in reconsidering their approach to medical interventions for minors with gender dysphoria.
Growth of the clitoris, hair loss or gain, and voice changes are all permanent.
Sex-Reassignment Surgery
Most provinces in Canada set 18 as the age of informed consent for sex-reassignment surgery, although four provinces allow it at earlier ages if the minor is “deemed capable of making informed decisions” without parental consent.
Saskatchewan, Manitoba, New Brunswick, and Newfoundland and Labrador follow that philosophy while Alberta, Ontario, and Prince Edward Island all adhere to the 18-or-older rule. In British Columbia, surgery applicants must be 19 or older for bottom reassignment surgery, but permit top surgery “with consent of the applicant or their guardians, depending on their assessed capability.”
In Quebec and Nova Scotia, patients must be at least 18 for bottom reassignment surgery but can request a mastectomy at the age of 16.
Some U.S. states restrict minors’ access to sex reassignment surgery, while lawmakers in other states are considering it, the study said, noting that “gender-affirming” mastectomies have been performed on children as young as 12.
In the UK, Sweden, Luxembourg, Belgium, Germany, and Finland, sex reassignment surgery is not performed before age 18.
“Parental consent is not a factor since surgery is not performed on individuals under the age of consent,” the study said, although some countries allow mastectomies before the age of 18. France was the most liberal of the countries, saying breast removal surgery is “theoretically possible” at the age of 14, but is generally performed after age 16.
Aside from age, requirements to receive surgery in Canada vary from province to province.
