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  • Writer's pictureAlexis Haws

Visibility and Vulnerability: The Impact of Alberta's Policies on Trans Youth

Updated: Apr 9



March 31st is International Transgender Day of Visibility. This day is intended to celebrate the lives of transgender individuals. At Healing With Alexis, it is also a day to reflect on important issues that still impact trans people today, such as inequities in their mental health and barriers to accessing gender-affirming supports. In this post, I would like to talk about how the rights of the trans-youth are being infringed upon by Danielle Smith and the UCP government.


Recently Danielle Smith announced changes she is making in legislation regarding gender-affirming care. Many people, myself included believe that this legislation is a backward movement in terms of human rights and effective client care. In this blog entry, I will explain why I feel this way by exploring why this issue is so important, what gender-affirming care is, what Danielle Smith is proposing, and what the research says about gender-affirming care. 


Why is This Issue Important?

Trans and non-binary youth are a particularly vulnerable population. They are at high risk of attempting suicide, experiencing mental health struggles, and facing homelessness. Some statistics include the following: 


  • 66% of trans youth have engaged in self-harm in the past year (Veale et al., 2015).

  • 33% of trans youth have attempted suicide in the past year, and 65% of the sample reported having thought about attempting suicide at some point in their life (Veale et al., 2015)

  • Over 90% of trans youth between the age of 14-18 did not reach out for mental health support out of fear that their parents would find out about it (Veale et al., 2015).

  • 2SLGBTQIA+ youth make up between 25% and 40% of homeless youth in Canada (CMHC, 2022).

  • Many of these 2SLGBTQIA+ youth become homeless after coming out to their families (CMHC, 2022).


What is gender-affirming care? 


In 2015, The American Psychological Association outlined guidelines for healthcare providers to provide gender-affirming care. The applicable guidelines have been happily adopted at Healing With Alexis in order to provide gender-affirming mental health services. The guidelines are as follows: 


  • Respect for Gender Identity: Affirming the gender identity of individuals and recognizing that gender is a spectrum.

  • Cultural Competence: Healthcare providers should be culturally competent, informed, and aware of the diverse experiences and challenges within the transgender community.

  • Use of Affirmative Language: Using respectful and affirming language, including correct names and pronouns, as chosen by the individual.

  • Access to Gender-Affirming Healthcare: Supporting access to gender-affirming healthcare options, including hormone therapy and gender confirmation surgeries.

  • Mental Health Support: Providing mental health services that are sensitive to the unique needs and experiences of transgender individuals, addressing issues such as gender dysphoria and discrimination.


What is Danielle Smith Proposing? 


Danielle Smith is suggesting that we deny all the recommendations laid out by the APA, and deny the rights that transgender individuals have worked so hard to get. She is specifically putting the following into place according to CBC News and The Conversation: 


  • Prohibition of Hormonal Treatment and Puberty Blockers: Alberta will prohibit hormonal treatment and puberty blockers for children 15 years and younger.

  • Ban on Gender-Affirming Surgery: Gender-affirming surgery for minors will be banned. 

  • Restrictions on Sports Participation: Changes may also include policies affecting the participation of transgender youth in sports, although specific details on these restrictions have not yet been provided. 

  • Legislation on Gender Policies: The legislation aims to put limits on gender-affirming care for trans youth, indicating a broader approach to regulating how gender identity is addressed in healthcare, education etc. An example of a new gender policy is the restriction of using a youth’s preferred pronouns in school without parental consent. 


What I’m taking from the research: 


Contrary to what is being proposed by Danielle Smith, gender-affirming care is effective for transgender youth and addresses their mental health concerns and risk of suicide. 


  • Research indicates that transgender and non-binary youth who undergo gender-affirming hormone therapy as part of their transition experience significant improvements in their mental health (Allen et al., 2019; Digitale, 2022).

  • Those who started gender-affirming hormone therapy in adolescence had better mental health outcomes compared to those who began treatment in adulthood or those who wanted but never received hormone therapy including reduced substance use and decreased rates of suicide attempts (Allen et al., 2019; Digitale, 2022). 

  • Overall, participants in a long-term medical transition study including puberty-suppressing medications, hormone therapy and gender-affirming surgeries reported satisfaction with the interventions they received (Lawson et al., 2019).

  • No regret was reported for those receiving trans-affirming care in this study (Lawson et al., 2019). These findings are inconsistent with Danielle Smith’s popular worry that youth may regret their choices to engage in gender-affirming care (CTV, 2024).


The most challenging part about accessing gender-affirming care was the waitlist and the limited number of clinics providing trans-affirming care, something Danielle Smith wants to make worse, not better. 


  • Those seeking surgery were often ineligible due to their age, yet they were the group that reported the most significant level of distress (Lawson et al., 2019).

  • For all interventions, the greatest source of discontentment for the participants was waiting on the waitlist to receive their gender-affirming care (Lawson et al., 2019).


There is so much to learn and do further research in the area of trans-affirming care for youth, especially for those able to access surgery. Danielle Smith is right that we need more research in this area, and if she limits access to such services, how can we do said research? 


Conclusion: 


Trans-affirming care honours the diverse experiences and needs of a very vulnerable population, transgendered individuals. From what we know about trans-affirming care, it is showing great promise in mental health improvement and suicide prevention due to interventions such as puberty blockers, hormones, and even surgery. However, there is still limited access to these services, especially surgical ones. I believe that Danielle Smith and her government are contributing to this problem by establishing policies that go against the principles of trans-affirming care. They are restricting access to life-saving interventions. I believe that our trans community deserves better. 


References: 


Allen, L. R., Watson, L. B., Egan, A. M., & Moser, C. N. (2019). Well-being and suicidality among transgender youth after gender-affirming hormones. Clinical Practice in Pediatric Psychology, 7(3), 302–311. https://doi-org.libproxy.mtroyal.ca/10.1037/cpp0000288


American Psychological Association. (2015). Guidelines for Psychological Practice with Transgender and Gender Nonconforming People. American Psychologist, 70(9), 832–864. https://doi.org/10.1037/a0039906


Canada Mortgage and Housing Corporation. (2022, February). 2SLGBTQIA+ housing needs and challenges. CMHC. https://www.cmhc-schl.gc.ca/blog/2022/2slgbtqia-housing-needs-challenges

CBC News. (2024). Alberta premier says legislation on gender policies for.... Retrieved from https://www.cbc.ca/news/canada/edmonton/danielle-smith-1.7101595


The Conversation. (2024). Alberta's new policies are not only anti-trans, they are.... Retrieved from https://theconversation.com/albertas-new-policies-are-not-only-anti-trans-they-are-anti-evidence-222579


CTV News. (2024, February). Premier Smith says Alberta's gender identity policies are based on a concern about 'what will happen'. CTV News. https://www.ctvnews.ca/politics/premier-smith-says-alberta-s-gender-identity-policies-are-based-on-a-concern-about-what-will-happen-1.6756959 


Digitale, E. (2022, January 12). Better mental health was found among transgender people who started hormones as teens. Stanford Medicine News Center. https://med.stanford.edu/news/all-news/2022/01/mental-health-hormone-treatment-transgender-people.html


Lawson, M. L., Ducharme, J., Ghosh, S., & Holmes, C. (2019). The experiences of gender diverse and trans children and youth considering and initiating medical interventions in Canadian gender-affirming specialty clinics. International Journal of Transgenderism, 20(4), 371–387. https://doi-org.libproxy.mtroyal.ca/10.1080/15532739.2019.1652129


Veale, J., Saewyc, E., Frohard-Dourlent, H., Dobson, S., Clark, B., & the Canadian Trans Youth

Health Survey Research Group. (2015). Being Safe, Being Me: Results of the Canadian Trans Youth Health Survey. Stigma and Resilience Among Vulnerable Youth Centre, School of Nursing, University of British Columbia. https://saravyc.sites.olt.ubc.ca/files/2017/10/SARAVYC_Trans-Youth-Health-Report_Alberta-V2-WEB.pd

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