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Ten Canadian Children's Hospital Gender Clinics: A Primer for Parents

by Robin Singer



Until transyouthcan.ca published their studies in spring of 2022, the public knew very little about the existence of Canadian Children’s Hospital Gender Clinics and less about their locations, their Codes of Ethics, medical practices and resulting health care data. This secrecy is not accidental and is entirely consistent with the advice given activists in the famous “Denton’s Document” republished with permission by Graham Linehan in which he says,


"This document is crucial to understand what is happening in our society and why so many institutions across the West have been captured by gender ideology.”


The following hospital list includes some information found on the hospital clinics’ respective websites, results from Internet searches and data from TransYouthCAN! Community Webinars. Glaring inconsistencies between clinics, differences in professional standards and lack of transparency are striking.


Reading through these 10 hospital clinic descriptions one might ask:

  • Why is there such reluctance to inform the public of the existence of children’s hospital-based gender clinics when they are all publicly supported by taxes?

  • Why is there so little information in relation to a treatment actively promoted by all levels of government?

  • Why is there a 10x growth in referrals to gender clinics in Canada?

  • Why have so many other countries and jurisdictions stopped the practice of prescribing puberty blockers and cross-sex hormones for under-18’s and Canada has not?

  • Why do mental health assessments play little or no role in diagnosis?

  • Why is there such a patchwork approach to care with respect to gender questioning children?

  • Why is there such a preponderance of endocrinologists in this specialty?

  • Why are we medicalizing the normal human variation of gender non-conforming children?

  • Why are the many risks of all gender treatments minimized? Why are dissenting studies ignored?

In 2021 Canadian Gender Report first reported on the 10x growth in referrals to gender clinics over ten years in Canada and about our “consent” based model after the following news from Sweden "that their premiere gender clinics for children and young people has stopped the practice of prescribing puberty blockers and cross-sex hormones for under-18’s.”


In June 2022, Canadian Gender Report submitted this brief to the Federal Standing Committee on Children’s Health on behalf of Gender Dysphoria Alliance, LGB Alliance Canada, Vancouver Lesbian Collective, Genspect and Canadian Gender Report. It begins:


"Over the last ten years there has been a massive increase in the numbers of children and youth seeking medical gender interventions. Gender clinics for youth around the world have reported tenfold or greater increases in the numbers of referrals. The patient population has also undergone a radical change from a majority of natal boys and now consists predominantly of adolescent natal girls.”


CHILDREN'S HOSPITAL GENDER CLINICS ARE LISTED BELOW FROM EAST TO WEST


1 - Halifax, NS -- Isaak Walton Killam IWK Health Centre Transgender Clinic


There are no listings or URL for this children’s hospital gender clinic online but transgender hormone therapy is listed in the Endoctrine Clinic. There is no mention online of a psychologist or of a psychiatrist’s involvement with the study or with patient care.


IWK endocrinologist Dr. Mokashi admits in a Community Webinar, “I have started Lupron in straightforward cases without MH [mental health] assessment.” The child highlighted in Nova Scotia’s “I Am Skylar”, where the IWK Clinic and endocrinologist were featured, seemed not to have received any psychiatric care although he had a very sudden gender reveal and family medical trauma in his history. There was no mention made of his future sexual dysfunction in this documentary. Skylar also stated that he never felt that he was a girl when he was younger.


The clinic began in 2012 and currently follows 130 patients, although it has treated 200 patients in total. The clinic is located in the Pediatric Endocrinology Wing and treats patients from prepuberty to age 18. Referrals can come from a family physician or nurse practitioner.


The TransYouthCAN! Community Webinar said that two thirds of patients had at least one diagnosis other than gender dysphoria including anxiety disorder, depression/mood disorder, ADHD, Autism Spectrum and Learning or Developmental Disorder. The webinar provided some other information shared below.

Graphics from the IWK community webinar

2 - Montreal, QC -- Centre Meraki Gender Variance Program


The website states: “Please note that at this time, our Gender Variance Program GVP waitlists are currently closed, as waiting times remain quite long for new consultations. For information about where to direct referrals during this period, please contact coordination@centremeraki.com. Thank you.”


For parents of children 7 and under who do not necessarily require medical intervention, information sessions are available to address the topic of gender variance. Please contact the clinic if you are interested in attending a session. For patients under 7, we mainly offer psychosocial support. Children can be placed on our waitlist but will rarely be needing medical services before the age of 8.(RS: The implication here is that medical services such as puberty blockers may be provided from age 8.)


We offer parent information sessions (in group format) led by Dr. Françoise Susset, psychologist. Information sessions are intended to support and equip parents (and/or other family members) who have a young child with variance of gender expression or identity. You can watch the Centre Meraki Community Webinar here. https://www.youtube.com/watch?v=Nef-saFrv1A

3 - Ottawa, Ontario -- Children's Hospital of Eastern Ontario (CHEO) Diversity Clinic


The CHEO newsletter, “Celebrating Pride Month 2022” noted that more than 280 trans and non-binary children and youth are supported by CHEO’s Gender Diversity Clinic each year. (RS: Are numbers of diabetic children celebrated by the endocrinology department as well?)


The clinic website tells children how to get a referral but “If you don’t have a family doctor or community partner who can refer you, you can refer yourself.”


And from the CTV News item, “Pembroke teen one of the youngest to receive gender affirming care at CHEO,” Dr. Margaret Lawson, a CHEO endocrinologist, said that there is no explanation for the growth in the number of young people transitioning: “We really don’t know.”


But Dr. Erica Anderson, psychologist, trans identified former USWPATH president and WPATH member thinks the reason for the explosion in numbers of children identifying as trans is social contagion. The San Francisco Examiner explains here: Dr. Erica Anderson: Social contagion at work”. Might parents think that it would be a good idea to try to find out the reason for an individual child’s transition before advocating for irreversible treatments?


4 - Toronto, ON -- SickKids Hospital Gender Clinic

The clinic was established in October 2013 with 20 - 30 referrals per month, 14 new assessments per month and 66 follow-up appointments per month. One consulting psychiatrist is included on their team. The number of paediatric endocrinologists on the team is not mentioned. The hospital’s website is clear that psychiatric or psychological care is not in their scope of practice. Young people choose their medicalization “gender journey” based on their “self-directed gender goals.”


The website states, “A treatment plan may be developed; however, medications are rarely prescribed at the initial visit. It takes time for us to get to know you and your family so we can decide together on future steps. Care of each person is individualized with topics discussed including options for hormone blocking when appropriate, with further medical options discussed on an ongoing basis.”


Canadian Gender Report has published evidence about HSC to the contrary here: Sick Kids Toronto Gender Clinic Review. During the first visit, one parent saidthey considered her to be a good candidate for Lupron but they could not give her a prescription until we had blood work done and the mandatory 3 month waiting period was complete. They handed us a lab requisition form for the blood work further stating that on our next visit they could administer the hormone blockers if the blood work was done…We left the hospital shocked at the outcome. Not feeling that a one-hour long interview with a child and ignoring all parental input and concerns was sufficient to start on a course of hormones. We never returned to Sick Kids hospital. “


The Sick Kids Hospital Community Webinar revealed very little information beyond their Infographic on Experiences of Parents which is here: https://transyouthcan.ca/results/toronto-sickkids-webinar/.


For Canada’s oldest children’s hospital, is this minimal effort to communicate to their community impressive or informative?

Graphic from the Sick Children’s Hospital Community Webinar


The Sick Kids Foundation offers a page of FAQs for parents:


Is the SickKids clinic the only clinic of its kind?


No, there are other hospital-based clinics. There is one at CHEO in Ottawa and another at McMaster in Hamilton and now (mysteriously) a couple are being started at community sites. But the model of care is different in every clinic and in every province. SickKids has one of the largest inter-professional clinics, which means we provide youth with access to a range of expertise.”


(RS: Can an inference be drawn from the fact that the former president of Denton’s Canada, a branch of the world’s largest law firm, is a member of the SickKids Hospital Board of Directors?)


5 - Hamilton, ON -- McMaster Children's Hospital Adolescent Medicine Clinic


There is no URL for Outpatient Gender Diversity Clinic at McMaster Children’s Hospital but the clinic began in 2006. There is no psychiatrist or psychologist or family therapist listed on the TransYouthCAN! Study and there is no mention of patient numbers during the previous sixteen years. An Internet search revealed an article by HamiltonHealth.ca that a $500,000 grant from TD Bank Group will help the program towards funding 85 - 100 patients annually:


“With the current model, 60 to 70 new youths can receive basic care and support each year. This grant will support these 60 to 70 youths along with an incremental 25 to 30 youths to receive comprehensive care and support – enabling the program to fully support 85 to 100 unique patients annually.”


“A reduction in suicide and self-harm affects more than just the individual; it also impacts the youth’s family and friends – an estimated 400 to 600 people every year. The clinic can enhance access for those in a wide geographic area, including south-central Ontario and farther afield.”

Graphics are from the McMaster Children's Hospital Adolescent Medicine Clinic Community Webinar

Have the McMaster Children’s Hospital Adolescent Medicine Clinic and the TD Bank Group taken into account the many studies which have disproved the association of suicide with gender dysphoria? https://www.statsforgender.org/suicide/ lists three studies. Anecdotally there have been many online accounts from parents of doctors citing suicide statistics in front of the child!


The former Chair of the Child and Adolescent Committee for the World Professional Association for Transgender Health (WPATH), Dr Laura Edwards-Leeper, remarked in a now famous podcast:

“As far as I know there are no studies that say that if we don’t start these kids immediately on hormones when they say they want them that they are going to commit suicide. So that is misguided…in terms of needing to intervene medically to prevent suicide and doing it quickly, I know of no studies that have shown that.”

6 - London, ON -- London Health Science Children’s Hospital Gender Pathways Service


There does not seem to be a URL for this hospital but a search of the name reveals a pdf document. The image below is a Gender Pathways letter which is part of a larger “informed consent” document sent to referring general practitioners. The entire document has been published by Canadian Gender Report here.


THE LHSC Children’s Hospital Gender Pathways Service in London, Ontario drew press and social media attention recently from The Post Millennial.com for this letter which appears on the clinic website advising GPs to prescribe puberty blockers before being seen by the clinic.


(RS: Why are blood tests and a three-month waiting period not a safety protocol here similar to that of HSC?)


Canadian lawyer Justdad7’s explanation of “Uninformed Consent: What do consent forms in pediatric medicine really say?” is an extremely valuable resource for parents explaining the many deceptions and dangers to be aware of before signing. Yet, the document is written in the first person and is intended for a child to sign, even a prepubertal child!


Lifesite News wrote The Transgender Experiment is the Biggest Child Abuse Scandal Of Our Lifetimes calling out THE LHSC Children’s Hospital Gender Pathways Service in particular for criticism.


The London Gender Pathways Service is moving away from the terminology of “gender dysphoria” for patients to “gender distress” as evidenced by a segment of their infographic in the TransYouthCAN! study (above). Presumably the goal of this change is to give patients greater permission to accept or decline possibly stigmatizing diagnoses as well as potential treatments that are available to them while ensuring gender-affirming care. (Treatment will ensure optimum “feelings” similar to diabetic optimization?) Unfortunately, long term reviews state that “increasing voices of desisters and detransitioners suggest the rate of regret within this novel cohort will not be as rare as previously estimated.”


7 - Winnipeg, Manitoba -- Gender Dysphoria Assessment and Action for Youth (GDAAY) Clinic

This Children’s Hospital Gender Clinic’s website gives no information other than the rainbow graphic above. However, Winnipeg’s Rainbow Resource Centre says GDAAY accepts referrals for youth aged 8 years old up until their 17th birthday.


We do not know when they begin puberty blockers or hormones. An Internet search of the clinic yielded a Community Webinar Event from TransYouthCAN! led by three endocrinologists and no psychiatrists but which quotes illuminating Stories of Care from the patients. In one of the stories, the patient says,


“I can’t wait to have boobs. I’m down with the blockers, but like, estrogen!”


This is a troubling approach to medical procedures that will impact the patient for the rest of his life. Advocates for transitioning children as early as possible repeat the mantra that puberty blockers are completely reversible, like a pause button, but 99% proceed to cross-sex hormones. Physicians must maintain this blinkered “pause button” story with diligence since there is a great deal of research to the contrary. Most recently Genspect published this article “Ask Dr. Julia About Puberty Blockers” on June 9, 2022. The famed Cleveland Clinic states that the most recent data show that two-thirds of children will be OK without puberty blockers.

Graphics from GDAAY Community Webinar


8 - Calgary, AB -- Alberta Children's Hospital METTA Clinic


The website states: “The clinic is a multi-disciplinary team that offers an affirming approach to gender identify and care for patients 5 - 18 years and was established in 2014.The clinic went from 1- 3 requests per month to 15 - 20 requests per month and now follows 500 patients. The team includes one full-time family therapist in addition to psychiatrists, endocrinologists and an adolescent medicine specialist.”


Parents might wonder if one full-time family therapist is sufficient to effectively meet the needs of 500 patients with comorbidities? Does the very rapid increase in the number of requests over a short period raise any alarm bells? Metta Clinic suggests a heavily biased pharmaceutical model booklist for patients nd families which indicates they may be encouraging ever-increasing numbers.


9 - Edmonton, AB -- Stollery Children's Transgender Clinic


There is currently no separate URL for the clinic or even mention of it in the main hospital website but its existence is confirmed here.


Is there a professional rationale for keeping a tax-supported service for children a secret? The clinic’s community webinar was equally uninformative. However, Gender Dissent did manage to discover information surrounding their funding and relationship with the transmission of gender ideology in schools in the article, The Stollery Manoeuvre.


The Internet revealed a questionable Internet podcast developed by Dr. Simone Lebeuf, an adolescent medicine pediatrician at the Stollery Children’s Hospital, called Transgender Health: Transitioning with a Focus on Hormone Replacement Therapy. This is questionable because Dr. Lebeuf is attempting to normalize medicalizing normal human variations of gender non-conforming children with the familiar and benign HRT terminology.


Hormone Replacement Therapy is defined by The Mayo Clinic, as “ medication that contains female hormones. You take the medication to replace the estrogen that your body stops making during menopause. Hormone therapy is most often used to treat common menopausal symptoms, including hot flashes and vaginal discomfort.”


Parents might want to red flag this clinic for providing insufficient information about tax-supported services for children.


10 - Vancouver, BC -- British Columbia Children’s Hospital Gender Clinic


The website states: “The Gender Clinic provides treatment with puberty blockers and/or gender-affirming hormones for transgender and gender-questioning youth.” The BC Hospital has two psychiatrists on their team and they are the only Canadian hospital mentioning WPATH STANDARDS OF CARE VERSION 7 which include mental health considerations.


It is encouraging to see that Gender Clinic officials liaise with Eating Disorder Clinics. There is a great deal of overlap between eating disorders and gender confusion. It is notable that eating disorder patients are never affirmed in their delusions unlike children who seek gender transition. There seems to be a connection between disordered eating patterns and gender-related distress.


Stats for Gender found: In a review [1] of 20 publications, a consistent theme emerged: transgender youth (aged 8 to 25) engaged in food restriction and/or compensatory eating behaviors to prevent puberty onset or progression.


The BC Children’s Hospital clinic says it treats 650 patients currently; however we don’t know total patient numbers since 1998. We do know that Dr. Wallace Wong, BC government psychologist, has taken credit for transitioning over 500 patients and those are just patients who were in Ministry Care at the time of The Bridgehead article, which contains troubling comments about counselling suicide.


Their “clinic without walls’’ operates throughout the province. Does this mean that puberty blockers and hormones may be accessed anywhere? Would there be psychological therapeutic facilities readily available in rural BC?


BCCHGC claims to be the first clinic in Canada to prescribe blockers and hormones for patients starting in 1998. However, the Wikipedia entry below for Dr. Susan Bradley argues that a Child and Adolescent Gender Clinic began administering puberty blockers much earlier at the Clarke Institute in Toronto.


For an important insight into what happened to the earlier therapeutic model of “watchful waiting” treatment for transgender children in Canada watch ‘This World Transgender Kids by BBC2 but banned in Canada by CBC and YouTube. Dr. Bradley’s most recent peer reviewed paper is here.


“Bradley was certified in medicine in 1967. She earned her specialty licenses in psychiatry and child psychiatry in 1972. In the late 1970s, Bradley founded the Child and Adolescent Gender Identity Clinic at the Clarke Institute of Psychiatry. In collaboration with her co-author Zucker, she saw over 400 cases of children and adolescents with gender identity disorder and related issues. Bradley served on the American Psychiatric Association DSM-IV Subcommittee on Gender Identity Disorders.


She was Clinical Director of the Department of Psychiatry from 1984 to 1988 and Psychiatrist- in-Chief and Head of the Division of Child Psychiatry at the University of Toronto from 1988 to 1998.


Bradley has argued that gender identity disorder in children is sometimes rooted in serious family problems, underlying anxiety disorders or psychological trauma and might need other treatment than change of gender.”


Underlying problems is a recurring theme for many with substantial experience with these procedures. BC Children’s Hospital is to be commended for seeming to be the only Canadian Gender Clinic to recognize the importance of patients’ psychiatric evaluation.


WPATH recently came out with a preview of their new standards of care in which all treatments may be started earlier because they say it is unethical and harmful to withhold early treatment. At the same time Dr. Marci Bowers, transwoman and president-elect of WPATH, surgeon on 2000 bottom surgeries (with the youngest being just 16 years old), discusses during a Duke University zoom conference, the complete absence of sexual function in children treated early with puberty blockers. Dr. Bower’s recorded speech was removed by activists from YouTube but a short transcript appears below. More than ever, parents must do their upmost to keep informed to protect their children and approach this area of medicine with extreme caution.

Conclusion


Our exploration of 10 Canadian Children’s Hospital Gender Clinics has concluded that standards of care differ greatly across the country and they are poorly articulated. We have seen evidence of carelessness which includes advocating the use of puberty blockers without blood tests, a waiting period or even a mental health assessment. Websites which should be transparent are frequently empty and one clinic is without a website. We have little information about care for the youngest and most vulnerable patients, even though one hospital sees children under seven years old. Concerningly, we have a clinical leader claiming not to know why there is a tenfold increase in patients over ten years and appears to be disinclined to find out why.

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