This article originally appeared in the National Post.
By Mia Hughes, February 18, 2025
One of the most controversial issues of the culture war is being fought in the unlikeliest of places: competing ad campaigns about pediatric gender medicine are emblazoned on the sides of buses rolling through London, Ont. The battle provides a perfect microcosm of the debate surrounding medical interventions for youth who identify as transgender, showcasing the polarized views held by each side.
It began in December, when the Association for Reformed Political Action (ARPA), a Christian group, commissioned advertisements saying, “Put the brakes on medical transitions for minors,” to be displayed on city buses.
Local activists first attempted to have the ads taken down, but when that failed, they decided to hit back with an ad campaign of their own, featuring messages urging residents to “Protect Trans Kids” and “Trust kids when they tell you who they are.”
The response to the initial ARPA campaign clearly illustrates the lack of understanding in Canada about this highly controversial medical treatment. Transgender activist Stevie Brocksom called ARPA’s ad “transphobic.” Richard MacDonagh of the London InterCommunity Health Centre said it makes “things seem very black and white and very alarmist.”
The Registered Nurses Association of Ontario (RNAO) even went so far as to send an email to its members suggesting the ads were “hate and bigotry,” and accusing Conservative Leader Pierre Poilievre of “echoing and amplifying anti-transgender views across the country.”
The organization urged its members to sign a petition calling on Poilievre to stop targeting “transgender and gender-diverse youth,” and applauding Prime Minister Justin Trudeau for his support for the transgender community.
The trouble with all this is that we do need to “put the brakes on medical transition for minors.” The RNAO accused Poilievre and Alberta Premier Danielle Smith of proposing restrictions that “appear to be founded on ideology, not informed by evidence.” This claim is a staggering inversion of reality.
Gender-affirming care is ideology-based medicine with no grounding in evidence. It demands affirmation of a person’s self-declared transgender identity and views access to hormonal and surgical interventions as a human right.
Every country that has examined the evidence for the medical transitioning of trans-identified youth has reached the same damning conclusion: the evidence for its purported benefits is exceptionally weak. Systematic reviews, such as those included in the U.K.’s Cass Review, are the gold standard in evidence-based medicine and have resulted in numerous European countries either halting or significantly limiting access to this experimental treatment.
This makes the activist call to “protect trans kids” deeply ironic. The most effective way to protect young people who identify as transgender is to hold pediatric gender medicine to the same rigorous standards as any other field of medicine.
This includes demanding robust, high-quality evidence to justify an invasive treatment protocol that could permanently impact a young person’s fertility and result in the loss of healthy body parts. Hurling unfounded accusations of transphobia at those who voice concerns only increases the risk of young people being harmed by these unproven medical interventions.
Even more remarkable is the caption: “Trust kids when they tell you who they are.” This statement leaves one wondering if these activists have ever even met a child. Only a society in the grips of collective madness could believe that children and adolescents know who they are, as such a belief disregards all knowledge about child and adolescent development.
A sane society recognizes that children are still learning about the world and have great capacity for imaginative and magical thinking. They do not have any concrete sense of identity. Similarly, adolescents are known for shifting between identities as they navigate the process of self-discovery. This stage of life is marked by experimentation and identity exploration, with full cognitive and emotional maturity typically not reached until the mid-20s, when the brain is fully developed.
The truth of the matter is that pediatric gender medicine shows every sign of being a major medical scandal — one that is causing untold harm to some of the most vulnerable youth in Canada. The seriousness of this issue warrants urgent attention from medical institutions.
The Canadian Paediatric Society, Canadian Medical Association and Health Canada should be holding emergency meetings, and ethics boards at pediatric hospitals should be reviewing their practices in light of the Cass report (the most thorough independent review of pediatric gender medicine done to date).
Federal and provincial governments should have already imposed strict limits on puberty suppression treatments, and an inquiry should be underway to investigate how an unproven medical protocol with such grave risks was widely adopted without robust evidence.
Yet, with the exception of Alberta, no such action has been taken. Instead, in Canada, this complex issue is reduced to simplistic slogans on the side of buses. Our youth deserve far better.
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.
