Editor:
I am writing to laud Canmore Mayor Sean Krausert for his message of welcome and solidarity to the 2SLGBTQ+ members of the Bow Valley community in the Feb. 8 Outlook.
An opinion by psychologist Dr. S. Pappas, in the Feb. 29 Outlook deserves a response.
I’m a psychiatrist who has cared for dozens of gender dysphoric people over decades of practice, many of them in the Bow Valley. I’m guided in my practice by both my professional training and experience, and by the peer-reviewed literature.
I agree with many of Dr. Pappas' well-informed points: Human brain development continues well into the mid-twenties. Youths are prone to impulsive decisions, often driven by social pressure. They need guidance and support from invested, well-informed others. I have never met a parent who doesn’t wish the best for their child, but at times, parental decisions are not in their best interest and can result in harm to the youth. In the case of trans youth who are barred from gender-affirming care, such harms can include marked emotional distress and suicidality.
Delay of puberty-blocking drugs until 16, as proposed by Premier Danielle Smith as a government mandate, represents a source of potential harm to trans youth. Such medications provide a temporary and reversible brake on sexual maturation, specifically the development of secondary sex characteristics like breast and voice deepening. These body changes can cause much distress to youth who experience themselves as of a gender incongruent with their birth-assigned gender.
The research on the use of puberty blockers has many studies, including hundreds of youth, which document better emotional and psychological function, improved social life, and less suicidality in adulthood. A few studies failed to find benefits. Side effects can occur, like low bone density. Long-term fertility effects can depend on if the youth also takes gender-affirming hormones, like testosterone or estrogen. All this information speaks to the necessity of individualized care for the trans youth involving their full care team: physician, ideally their counsellor, sometimes a social worker, and of course, the person and their social supports.
No drugs are prescribed before a careful evaluation for a diagnosis of gender dysphoria, usually by a psychiatrist like myself, or a psychologist such as Dr. Pappas. The decision to prescribe isn’t taken lightly, nor driven solely by the desire of the youth. As for surgery, bottom surgery has never been done in Canada in people under 18. I haven’t personally heard of any top surgery in under 18s, but the data is hard to find.
The data show unequivocally the trans person fares best in an environment of acceptance and support for their sense of self, whether they take medications or not. I thank Mayor Krausert for his declaration of such support in the town of Canmore. I protest the proposed limits by Premier Smith on an individual's choice of their healthcare.
Suzanne Perkins,
Canmore
