Peter Smith
Canadian Anti-Hate Network
Source: Saul Flores/Unsplash
The University of Utah has released an extensive literature review on hormonal gender affirming care for minors. Triggered by a state ban—dubbed a “moratorium” by lawmakers—on the treatment, the review found that there is ample evidence that transgender youth benefit from the hormonal treatment, with few instances of regret.
Written by the university's Drug Regime Review Center, the over 1,000-page report conducts an extensive review of literature relating to the impacts of gender affirming care treatments on pediatric patients.
The Republican-dominated Utah state legislature placed its moratorium on minors receiving gender affirming hormone treatments in 2023..
The fifth US state to do so at the time, lawmakers who supported the bill questioned if there was enough data on the subject to prove that the treatments were safe. The legislation charged the Department of Health and Human Services (UDHHS) to review the medical evidence and determine if there was cause to lift the moratorium.
Despite finding that gender affirming care leads to “positive mental health and psychosocial functioning outcomes,” lawmakers have vowed to maintain the moratorium, citing weak evidence—despite the report finding the opposite.
“The conventional wisdom among non-experts has long been that there are limited data on the use of GAHTs [gender affirming hormone treatments] in pediatric patients with GD. However, results from our exhaustive literature searches have led us to the opposite conclusion,” the study reads.
For studies to be included, they had to meet a variety of criteria designed to mitigate bias. Some of the criteria marked as critical to a study being included in the assessment included having sound data collection practices, disclosure of funding sources, and more.
In total, the study captured data from 277 full texts, which included 230 primary studies of at least 28,056 pediatric patients from all over the world.
“The consensus of the evidence supports that the treatments are effective in terms of mental health, psychosocial outcomes, and the induction of body changes consistent with the affirmed gender in pediatric GD patients.”
The study also said the evidence supports that hormonal treatments are safe in terms of changes to bone density, cardiovascular risk factors, metabolic changes, and cancer.
Patient-level changes were found to be minimal, and “despite any small improvements or decrements in individual disease risk factors,” patients remained within acceptable norms.
“For example, transgender women typically realize adult [bone mineral density] levels that, while lower than their pre-treatment potential, remain in the normal range for healthy cisgender women,” the report said.
Assessing medical risk factors remained the highest priority for the authors, they did use the already gathered data to assess instances of regret. In the retrieved studies, the researchers found 32 studies that addressed persistence, desistance, and/or regret among patients.
“Persistence, desistance, and regret were not among our high-priority outcome categories for this review. However, these concepts were pointedly of interest to the legislature.”
The report also found that of people who desisted with hormonal transitioning, there were “virtually no regret associated with receiving treatment.” The report notes that patients chose to discontinue hormonal treatments for a variety of reasons.
The study did not assess surgical transition, but did note repeatedly that this type of transition being recommended to children is extremely rare. The examination also found “no evidence” that pharmacologic and hormonal treatments are offered to pre-pubertal children with gender dysphoria.
“Numerous means are available to [transgender and non-binary] people wishing to transition. ‘Social transition’—meaning everything from wearing gender non-conforming clothes, to hair and makeup, to mannerisms, habits, and activities, to name and pronoun changes—is flexible, reversible, and available to anyone, including pre-pubertal children.”
Fighting for Trans Rights in Canada
The report adds to the body of existing evidence that gender affirming care is safe and effective for treating transgender youth. The findings are not surprising, as gender affirming care has been recommended by the American Academy of Pediatrics since 2018.
In Canada, Alberta’s Premier Danielle Smith passed a law that prevented minors from receiving gender affirming care, specifically hormone therapy, even if parents seek it for their child. Smith said in 2024, she would use the Notwithstanding Clause to push the bill through if it was blocked.
This resulted in a group representing 75,000 Canadian physicians announcing they would be challenging the constitutionality of the ban on hormonal treatments for children under the age of 16. On May 28, the Canadian Association of Physicians filed a challenge arguing the legislation violates their Charter right to freedom of conscience.
Part of a broader series of moves by Premier Smith’s government, two other bills relating to transgender people have also been proposed, including a requirement for children to receive parental consent to change their names and/or pronouns at school.
Also in May, Smith’s government announced a plan to enact policies around the appropriateness of certain books in school libraries, singling out four 2SLGBTQ+ titles with mature content. Despite school libraries already having systems in place to review books, the Province is moving ahead with a new system to approve “age-appropriate” titles.
Following the announcement, School Board Chairs from Edmonton and Calgary’s public school divisions said the change was a "complete surprise" in a joint statement.
“Both our divisions follow established, rigorous processes to ensure that library resources are age-appropriate and relevant for students,” the statement reads. “Both divisions have clear mechanisms in place for any member of the school community to bring forward concerns about specific resources.”
The plan has also drawn criticism from anti-2SLGBTQ+ activists like Amy Hamm, who denies that the move amounts to a book ban by Smith’s government, but also worries the legislation could lead to “real book bans” in the future.
The Alberta Teachers Association (ATA) also released a letter voicing their concern.
″It seems like there is no coincidence that the government's announcement on library materials specifically singled out 2SLGBTQIA+ materials,” Jason Schilling, ATA president, said in a statement. “The Association welcomes being included in policy decisions concerning school libraries and learning commons spaces.”
The ATA also said it worries that the government may prioritize special interest groups arriving with “predetermined agendas and to further target diverse communities.”
This may in part already be true, as Brett McKay reported that the anti-2SLGBTQ+ activist groups Parents for Choice in Education (PCE) and Action4Canada provided the government with the list of books and excerpts they deemed inappropriate.
The Canadian Anti-Hate Network has reported on Action4Canada for years. Steeped in conspiracy theories, overt racism, and blatant Islamophobia, A4C activists also find the time to advocate for ending comprehensive sex education, including lessons that teach about the existence of transgender and gender diverse people.
A4C leader and founder Tanya Gaw and any of the group’s representatives were banned from attending school board meetings in Mission, BC, for one year in 2023. Board Chair Shelley Carter told City News that Gaw used the meeting to spread hate propaganda.
