Our Brief to the Province of Ontario's Standing Committee on Social Policy

Bill 17 - Gender Affirming Health Care Advisory Committee Act, 2021

Submitted November 25, 2021

Introduction

In the past decade, throughout the West, two worrying trends have appeared in the world of gender medicine. The first is a dramatic increase in the number of minors being referred to gender clinics, and the second is a notable increase in the number of young people detransitioning after pursuing medical transition[1]. Initial data indicate that natal females are greatly impacted by both these trends, and it is therefore on behalf of Ontario’s girls and young women that we submit this brief[2].

Our three main areas of concern are:

1. The emphasis on the gender-affirming model of care, which is coming under increased scrutiny throughout the world.

2. The intention to adopt the Informed Consent Model of care, which falls far short of current guidelines in jurisdictions which have recently reviewed and updated the practice.

3. The lack of diversity of opinion and experience in the proposed committee.

Is gender-affirming care beneficial?

There is an ongoing debate in the field of gender medicine regarding what is the best model of care for treating children and adolescents who suffer from gender dysphoria. In the past, therapists treating gender dysphoric children practiced watchful waiting – a therapeutic approach in which the child received on-going psychotherapeutic support while the causes of his or her gender dysphoria were investigated, with the aim of alleviating it without the need for medical intervention. This approach was highly successful – studies show desistance rates of up to 98%.[i] However, in recent years, watchful waiting has been replaced by the gender-affirming care approach, which requires that clinicians do not question the child’s transgender identity, but instead affirm them and support them in their desire to medically transition. Rather than focusing on psychotherapy to avert the need for medical transition, affirmative care prioritizes medical intervention in the form of puberty blockers and cross-sex hormones as the first line of treatment. We believe this approach is harmful for all children and adolescents, but particularly so for the cohort of teenage girls who may be experiencing a new, atypical form of late-onset gender dysphoria.

This new atypical late-onset gender dysphoria often begins suddenly at puberty in individuals who experienced no obvious discomfort with their natal sex throughout childhood. Little is yet known about its causes, but clinicians have observed that this new cohort is unlike those previously recorded in medical literature.