Don't politicize medical care for trans youth, says transgender N.L. man
Doctor, trans patient say policies banning care for trans youth are ill-informed and disrespectful
Alberta's plan to limit access to puberty-blocking medications and gender-affirming surgery won't directly affect people in Newfoundland and Labrador, but a transgender man says the policy has generated shock waves and left him fearful for the future of health care.
The Alberta government has announced plans to restrict medical care for trans youth in the province on the basis that young people should have to reach a certain age and level of maturity before making life-altering changes to their bodies.
Elliott Blackmore, a transgender man originally from Grand Falls-Windsor and now living in St. John's, says the policy direction is concerning and inappropriate.
"It is trying to make an environment where it is hard to transition, where it is stigmatized," said Blackmore. "Transitioning is fundamentally an act of self-care. It's taking control of your own life, saying that, 'This is what I want for myself.'"
Joyful transition
In an interview with CBC News, Blackmore reflected on his own transition, coming out as transgender at the age of 12, then starting on testosterone treatments at age 15.
"That brought me a lot of joy in my life," he said.
He said the Alberta government's indication that youth under a certain age aren't mature enough to know who they are and to make informed decisions about what they need is "disrespectful and condescending."
Blackmore said much of what is being discussed by politicians in the public sphere seems to be rooted in a lack of understanding about what transitioning means.
He said transition is first and foremost a personal and social change that doesn't always lead to medical interventions. as some may believe. Blackmore, who is now 20, has not yet had any surgery.
"It's thinking about yourself in a different way and wanting people to think about you in a different way," he said.
Process in place
Blackmore said all he could wish for trans youth in Alberta is for them to encounter people who are willing to listen and to help them be themselves, just as he experienced.
"When I went through the system here in Newfoundland and was able to receive hormones, I felt very respected, I felt very informed," he said. "The idea that youth are just being sent to transition without being informed is not true."
Dr. Mari Lynne Sinnott, a family physician in St. John's who has hundreds of gender-diverse patients, said there are safeguards in place for gender-affirming care to ensure that decisions that would have potentially permanent consequences are made only after a thorough assessment that involves youths and their families.
Sinnott speaks from her own experience as a surgical readiness assessor for transition-related surgery in Newfoundland and Labrador.
"The idea that's being perpetuated that health-care providers are sort of willy-nilly offering these procedures and interventions with permanent irreversible consequences without due consideration and comprehensive assessment is just incorrect and fear-mongering," Sinnott told CBC News.
Misconceptions
Sinnott is frustrated by what she said is an apparent lack of evidence-based reasoning for Alberta's ban on gender-affirming care for trans youth.
She said research suggests trans youth are at a greater risk for suicidal ideation and suicide attempts prior to starting to transition, and that the risk drops significantly over the course of transition and post-transition.
"To keep youth in this perpetual state of increased risk for their mental health, for their well-being, for their safety, and for their lives, to be very honest, is horrifying to listen to," said Sinnott.
Sinnott said she's concerned that misconceptions about gender-affirming care seem to be knowingly promoted as disinformation, so that even well-meaning people may be misled as to what is actually available.
For example, Sinnott said discussion about banning chest reconstruction surgeries and genital reconstruction surgeries for youth in Alberta is a moot point, since most surgical procedures aren't available to youth anywhere in Canada until age 18.
Sinnott also said banning the use of puberty-blocking medications until at least age 16 is misguided as, by that time, puberty is already well underway, and in some cases nearly complete.
She said the so-called puberty blockers referred to by the Alberta government offer a temporary and reversible pause to puberty for young people who are experiencing gender dysphoria, giving them a chance to explore their gender identity through social transition and counselling, and with the support of their family and community.
"All of this is meant to help them explore their sense of self and identity before committing to a treatment that may have a permanent effect," said Sinnott.
Sinnott said she believes it would be paternalistic and disrespectful to young people to take the view that adults always know better what is best for them.
"One of the worst things that we can do to a young person who is exploring themselves would be to deny or minimize or not affirm their sense of themselves," she said.
She said it's gratifying to hear in recent weeks from patients who appreciate the care she's helped to provide, but she said such testimonials are a mixed blessing, as she finds it heart-wrenching to think that youth in Alberta potentially face a reality where they won't have the same kind of access to medical care as her patients in this province.
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