This article originally appeared in the Toronto Sun.
By Mia Hughes, April 22, 2025
Canada’s pediatric gender clinics are overwhelmed with long waiting lists, so a team of researchers published a paper offering a solution: Get pediatricians comfortable socially and medically transitioning children and adolescents.
The paper, published in the Canadian Paediatric Society’s journal, is highly ideological and ignores all of the recent international developments that call the practice of affirming and transitioning minors into serious doubt. The paper gives informed readers the impression that gender medicine in Canada exists inside a protective bubble that evidence and reason cannot penetrate.
The authors base their recommendations on two case studies. One is a six-year-old boy who goes by the name of Eva. Eva “has worn dresses for the past two years” and the parents use female pronouns to refer to their son. In such circumstances, pediatricians are advised to “describe the many benefits” of affirming a young child’s transgender identity.
The trouble is there are only questionable benefits and evident costs. Rather than being a harmless, non-medical step that can easily be undone the U.K.’s Cass Report found that children who socially transitioned at an early age were “more likely to proceed to a medical pathway.” This information should not come as a surprise. Back in 2012, the early Dutch pioneers of the puberty suppression experiment noted, “some children who have (socially transitioned) barely realize that they are of the other natal sex.”
Therefore, it stands to reason that a boy raised as a girl would desire puberty suppression, cross-sex hormones, and surgeries in adolescence because, believing himself to be a girl, he will feel a strong aversion to going through male puberty. A 2022 study on social transition confirms this, finding that the majority of children who socially transitioned progressed to medical interventions. In contrast, before social transition became commonplace, up to 98% of children overcame their gender distress naturally and averted the need for lifelong medicalization.
With this in mind, instead of advising parents to lie to a child about something as fundamental as the reality of their body, pediatricians should explain that while social transition may appear to be an inconsequential step to relieve distress in the short term, it carries a substantial risk of leading to a desire for irreversible procedures in adolescence that have serious health consequences.
In the second case study, a 12-year-old girl who “describes identifying as a boy,” has been “engaging in stereotypically masculine activities since age nine” and finds her periods and breast development distressing. As a remedy, pediatricians are advised to “explore options for menstrual suppression (including hormone blockers)” and offer her advice on “binding” her breasts and “packing” a prosthetic penis into her underwear.
Absent from this advice is any mention of the multiple systematic reviews that have found the evidence for puberty suppression to be exceptionally weak, nor the unintended consequence that the drugs prevent the cognitive and sexual development necessary for the young person to overcome their gender dysphoria naturally, making progression to cross-sex hormones almost a foregone conclusion.
There is also no recognition that this adolescent girl may simply be a tomboy grappling with the challenges of puberty, who, after encountering the messaging of modern trans activism has mistaken her normal pubertal woes for a sign that she is transgender. That the recommended response to her distress prioritizes advice on wearing a prosthetic penis over psychotherapy to help her accept her body highlights just how far off the rails gender medicine has plunged under the influence of trans activism.
To round off the paper, the authors make a dramatic claim about affirmation reducing suicide attempts, citing a 2012 survey that found rates dropped from 57% among youth with unsupportive parents to 4% among those with strong parental support. However, surveys are low-quality evidence — a fact the authors fail to acknowledge. They also omit mention of more rigorous studies showing suicide risk exists before, during and after medical transition, as well as a recent Finnish study that found gender-affirming interventions had no impact on reducing suicide risk in adolescents.
The paper could mislead Canada’s pediatricians into believing that affirming a child’s transgender identity prevents suicide when there is no good quality science to support this, and this in turn risks pediatricians coercing parents into affirming their child’s transgender identity when that may not be in the child’s best interest.
In truth, the last thing Canadian youth need is for pediatricians with no understanding of the complexity of the debate surrounding pediatric gender medicine to be taking on the responsibility of overseeing social and medical interventions. A more effective way to ease the strain on gender clinics would be to address the social contagion driving the surge in trans-identifying youth. This means examining the impact of exposing children and adolescents to the pseudoscience of gender identity ideology and the role social media plays in the spread of the epidemic.
Most importantly, this paper provides yet more evidence that those who are guided by ideology cannot be trusted to give advice that is evidence-based, scientifically sound, or in the best interests of young patients and their families. It is long past time that our governments, both federal and provincial, stepped in to protect some of Canada’s most vulnerable youth from a medical world that has lost its way. Blind allegiance to affirmation is not medicine: It is activism masquerading as care.
Mia Hughes specializes in pediatric gender medicine, psychiatric epidemics, social contagion and the intersection of trans rights and women’s rights. She is the author of “The WPATH Files” and a senior fellow at the Macdonald-Laurier Institute.
The author of this piece has worked independently and is solely responsible for the views presented here. The opinions are not necessarily those of the Macdonald-Laurier Institute, its directors or supporters. The Macdonald-Laurier Institute is non-partisan and neither endorses nor supports candidates or political parties. We encourage our senior fellows to comment on public policy issues, including during election campaigns, but the publication of such expert commentary should not be confused with the institute taking a position for or against any party or candidate.
