
There should be no irreversible medical treatment until the parents agree, or the child reaches an age with the requisite maturity of a “mature minor”.
Background Information
In the fall of 2018, Children’s Hospital staff pressured the child’s father to consent to the treatment prior to him launching a court application. The father had grave concerns about starting the treatment prior to proper consideration being given to treating AB for depression. The father also has grave concerns about the treatment itself, for reasons set out in the paragraphs below.
According to a 2011 Swedish study, people who receive affirmation therapy, cross-sex hormone therapy and surgical manipulation of their bodies, experience life-long psychological trauma and a suicide rate 19 times higher than the general population. Further, cross-sex hormones result in irreparable changes such as increased risk of cancers, heart disease, osteoporosis and permanent infertility. Other changes include permanent voice changes, facial hair, and lower bone density. In 2018, Brown University published Lisa Littman’s findings from a case study with 256 parents evidencing the rapid onset of gender dysphoria in adolescent girls. The study evidences a correlation between social media use and peer influence as twin factors contributing to the phenomenon. Gender dysphoria is often linked with mental health problems and childhood trauma. It may be triggered by peer pressure, or by social environment. But gender confusion typically desists following puberty. The psychologist who was treating AB, Dr. IJ, has publicly stated that only 2% to 20% of transgender kids stay transgender. The vast majority grow out of it. Dr. IJ’s claim is consistent with medical research, which shows that more than 80% of gender-confused children accept their biological gender by the time they are 18, absent “affirmation therapy” and cross-sex hormones. However, if gender-confused children receive pubertal suppressant drugs and opposite-sex hormones, most will continue with the gender transition process past the age of 18. The Supreme Court of Canada has ruled that the Charter gives parents rights generally to make decisions for the good of their children. The law recognizes that nobody is more invested in protecting children then their parents. Parents across Canada, regardless of creed, race or political view, have a deep personal and abiding interest in their children’s health and long-term happiness. The Charter, like the U.N. Declaration on the Rights of the Child, recognizes that parents are typically in a far better position than the state to raise children, and to make decisions regarding their care.What makes for a “mature minor” at law?
Part of what qualifies a minor to be recognized as legally “mature” (able to make adult decisions independently from her parents and from government) is her ability to think through difficult issues, and deal maturely with opposing viewpoints.
In cases involving teenage Jehovah’s Witnesses who refuse life-saving blood transfusions, one of the things considered by courts, when assessing whether the minor is legally “mature” and able to make this decision on her own, is her capacity to hear and consider differing viewpoints. If a child is already dealing with significant emotional and mental stress that impedes her ability to rationalize and consider competing medical opinions, she will not be able to handle differing advice (for example, doctors urging her to accept a blood transfusion while religious leaders urge her to refuse this) and cannot therefore be deemed legally “mature.” Justice Bowden’s Order prohibits the father from trying to persuade his female-born child to refrain from experimental and irreversible testosterone treatments. This assumes that the child is not sufficiently mature to handle differing opinions, and to think through the pros and cons of different options. If true, this means the child is not a mature minor. If the child is not a mature minor, the child cannot decide on serious and irreversible medical treatments; it’s up to the parents. Yet the lower court views the child as mature enough to decide on experimental medical treatments, but not mature enough to deal with the father’s objections.