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Frontier Centre for Public Policy

Transition Troubles: Medical Risks and Regret Among Trans Teens

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From the Frontier Centre for Public Policy

By Lee Harding

Do teens going through cross-gender hormones and surgeries know what they’re doing? A leak of internal conversations by the World Professional Association for Transgender Health shows even some doctors administering the procedures have serious doubts.

The U.S. advocacy organization Environmental Progress, led by president and founder Michael Shellenberger, made the leaks public.

“The WPATH Files show that what is called ‘gender medicine’ is neither science nor medicine,” Shellenberger said in a press release.

A short list of excerpts highlighted many telling comments.

Child psychologist Dianne Berg, who co-authored the child chapter of the 8th edition of WPATH Standards of Care, said young girls don’t understand what it means to get male hormones.

“[It is] out of their developmental range to understand the extent to which some of these medical interventions are impacting them. They’ll say they understand, but then they’ll say something else that makes you think, oh, they didn’t really understand that they are going to have facial hair.”

Canadian endocrinologist Dr. Daniel Metzger acknowledged, “We’re often explaining these sorts of things to people who haven’t even had biology in high school yet.”

Metzger said neither he nor his colleagues were surprised at a Dutch study that found some young post-transition adults regretted losing their fertility.

“It’s always a good theory that you talk about fertility preservation with a 14-year old, but I know I’m talking to a blank wall. They’d be like, ew, kids, babies, gross,” Metzger said.

“I think now that I follow a lot of kids into their mid-twenties, I’m like, ‘Oh, the dog isn’t doing it for you, is it?’ They’re like, ‘No, I just found this wonderful partner, and now want kids.’ … It doesn’t surprise me.

“Most of the kids are nowhere in any kind of a brain space to really talk about [fertility preservation] in a serious way.”

While youth keeps some from grasping the lifelong consequences of their actions, mental illness does the same for others. But that doesn’t always mean the doctors refuse to transition them.

One gender therapist administered cross-sex hormones to a patient with dissociative identity disorder. The therapist said asking the split personalities if they approved the treatment was ethical. Otherwise, a lawsuit could follow.

In one case, a nurse practitioner struggled with how to handle a patient with PTSD, major depressive disorder, observed dissociations, and schizoid typical traits who wanted to go on hormone therapy. Somehow the clear moral dilemma was lost on Dr. Dan Karasic, lead author of the mental health chapter of WPATH Standards of Care 8.

Karasic replied, “I’m missing why you are perplexed… The mere presence of psychiatric illness should not block a person’s ability to start hormones if they have persistent gender dysphoria, capacity to consent, and the benefits of starting hormones outweigh the risks…So why the internal struggle as to ‘the right thing to do?’”

Testosterone injections carry cancer risks for those born female. In one case, a doctor acknowledged a 16-year-old had two liver masses, one 11 cm by 11 cm, and another 7 cm by 7 cm, and “the oncologist and surgeon both have indicated that the likely offending agent(s) are the hormones.”

The friend and colleague of one doctor received close to ten years of male hormones, leading to hepatocarcinoma. “To the best of my knowledge, it was linked to his hormone treatment… it was so advanced that he opted for palliative care and died a couple of months later,” the doctor said.

Some female-born transitioning patients had terrible pain during orgasms, while males on estrogen complained of erections “feeling like broken glass.”

The future may be even stranger, according to one doctor.

“I think we are going to see a wave of non-binary affirming requests for surgery that will include non-standard procedures. I have worked with clients who identify as non-binary, agender, and Eunuchs who have wanted atypical surgical procedures, many of which either don’t exist in nature or represent the first of their kind and therefore probably have few examples of best practices,” the doctor said.

Unsurprisingly, some people regret their medical transitions and want to change back. Some WPATH members want to discount this altogether. WPATH President Marci Bowers admitted, “[A]cknowledgment that de-transition exists even to a minor extent is considered off limits for many in our community.”

An unnamed researcher thought it was just a matter of perspective, saying, “What is problematic is the idea of detransitioning, as it frames being cisgender as the default and reinforces transness as a pathology. It makes more sense to frame gender as something that can shift over time, and to figure out ways to support people making the choices they want to make in the moment, with the understanding that feelings around decisions [may] change over time.”

Should our physical being be substantially altered and re-altered according to our feelings? Is transitioning a matter of mental health or self-expression? At least Alberta is putting the brakes on these dubious practices for minors. Other provinces should follow.

Lee Harding is a research fellow for the Frontier Centre for Public Policy.

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Business

Canada Urgently Needs A Watchdog For Government Waste

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From the Frontier Centre for Public Policy

By Ian Madsen

From overstaffed departments to subsidy giveaways, Canadians are paying a high price for government excess

Not all the Trump administration’s policies are dubious. One is very good, in theory at least: the Department of Government Efficiency. While that term could be an oxymoron, like ‘political wisdom,’ if DOGE is useful, so may be a Canadian version.

DOGE aims to identify wasteful, duplicative, unnecessary or destructive government programs and replace outdated data systems. It also seeks to lower overall costs and ensure mechanisms are in place to evaluate proposed programs for effectiveness and value for money. This can, and usually does, involve eliminating some departments and, eventually, thousands of jobs. Some new roles within DOGE may need to become permanent.

The goal in the U.S. is to lower annual operating costs and ensure that the growth in government spending is lower than in revenues. Washington’s spending has exploded in recent years. The U.S. federal deficit exceeds six per cent of gross domestic product. According to the U.S. Treasury Department, annual debt service cost is escalating unsustainably.

Canada’s latest budget deficit of $61.9 billion in fiscal 2023–24 is about two per cent of GDP, which seems minor compared to our neighbour. However, it adds to the federal debt of $1.236 trillion, about 41 per cent of our approximate $3 trillion GDP. Ottawa’s public accounts show that expenses are 17.8 per cent of GDP, up from about 14 per cent just eight years ago. Interest on the escalating debt were 10.2 per cent of revenues in the most recent fiscal year, up from just five per cent a mere two years ago.

The Canadian Taxpayers Federation (CTF) continually identifies dubious or frivolous spending and outright waste or extravagance: “$30 billion in subsidies to multinational corporations like Honda, Volkswagen, Stellantis and Northvolt. Federal corporate subsidies totalled $11.2 billion in 2022 alone. Shutting down the federal government’s seven regional development agencies would save taxpayers an estimated $1.5 billion annually.”

The CTF also noted that Ottawa hired 108,000 more staff in the past eight years at an average annual cost of over $125,000. Hiring in line with population growth would have added only 35,500, saving about $9 billion annually. The scale of waste is staggering. Canada Post, the CBC and Via Rail lose, in total, over $5 billion a year. For reference, $1 billion would buy Toyota RAV4s for over 25,600 families.

Ottawa also duplicates provincial government functions, intruding on their constitutional authority. Shifting those programs to the provinces, in health, education, environment and welfare, could save many more billions of dollars per year. Bad infrastructure decisions lead to failures such as the $33.4 billion squandered on what should have been a relatively inexpensive expansion of the Trans Mountain pipeline—a case where hiring better staff could have saved money. Terrible federal IT systems, exemplified by the $4 billion Phoenix payroll horror, are another failure. The Green Slush Fund misallocated nearly $900 million.

Ominously, the fast-growing Old Age Supplement and Guaranteed Income Security programs are unfunded, unlike the Canada Pension Plan. Their costs are already roughly equal to the deficit and could become unsustainable.

Canada is sleepwalking toward financial perdition. A Canadian version of DOGE—Canada Accountability, Efficiency and Transparency Team, or CAETT—is vital. The Auditor General Office admirably identifies waste and bad performance, but is not proactive, nor does it have enforcement powers. There is currently no mechanism to evaluate or end unnecessary programs to ensure Canadians will have a prosperous and secure future. CAETT could fill that role.

Ian Madsen is the Senior Policy Analyst at the Frontier Centre for Public Policy.

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Energy

Federal Clean Power Plan Risks Blackouts And Higher Bills

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From the Frontier Centre for Public Policy

By Maureen McCall

Ottawa’s Clean Electricity Regulations could derail Canada’s energy future. Here’s what we need to do

The federal government’s push to make Canada’s electricity system net-zero is running straight into reality—and it’s not pretty.

Through the Clean Electricity Regulations (CER), the government wants all provinces to eliminate greenhouse gas emissions from electricity generation by 2035. It is an ambitious goal, but one that ignores a basic fact: demand for electricity is exploding, and provinces are struggling to keep up.

New technologies like artificial intelligence are supercharging this demand. AI systems, including tools such as ChatGPT, rely on massive data centres—huge warehouses of computer servers that need constant cooling and enormous amounts of electricity to function. According to a recent Royal Bank of Canada report, if all proposed data centre projects in Canada move ahead, they would consume 14 per cent of the country’s entire electricity supply by 2030. That is roughly the same as projections in the United States, where data centres are expected to use up to 15 per cent of the national total.

This is a serious problem. Provinces such as Alberta and Saskatchewan have already raised the alarm, arguing that the federal regulations overstep Ottawa’s constitutional authority. Energy supply, like natural resources, has traditionally been under provincial control. Alberta and Ontario operate their own electricity markets to attract investment and ensure reliability. Federal regulations threaten to undermine these efforts, adding risk and driving up costs.

The situation is already tense. Alberta, for example, issued multiple grid alerts in 2024 due to shortages and market disruptions. The province is now looking at “behind-the-fence” power solutions, encouraging data centres to generate their own electricity to guarantee stability.

Canada was not always in this bind. For decades, we enjoyed an abundance of clean, affordable hydroelectric power. Provinces like Quebec, British Columbia, Manitoba and Newfoundland and Labrador built massive hydro projects starting in the 1960s, creating cheap power and even surpluses to export to U.S. markets. In 2022, for example, B.C. sent 74 per cent of its exported power to the U.S., while Quebec sent 63 per cent and Ontario an impressive 81 per cent, generating billions in revenue.

But that era is coming to an end. Most of the best sites for hydro dams have already been developed. New projects would require expensive, long-distance transmission lines to bring power from remote areas to the cities that need it. On top of that, growing environmental concerns make new dam construction an uphill battle.

The truth is, there is no quick fix. A 2025 study by the Fraser Institute paints a grim picture: to meet future electricity demand solely with solar power would require 1,680 years of construction. Wind power? About 1,150 years. Even hydro would take close to a millennium. Even if we combined these sources, we are still looking at more than 1,000 years to build enough capacity.

Meanwhile, federal projections estimate that Canada’s electricity demand will double by 2050.

Without significant policy changes, Canadians could soon face the worst of both worlds: soaring electricity bills and the threat of power shortages. Our economy could also suffer as companies and data centres look to other jurisdictions with more reliable power supplies.

So what should Canada do? Here are three practical steps:

  1. Scrap the Clean Electricity Regulations. Provinces like Alberta and Saskatchewan are already committed to reaching net-zero by 2050. Federal interference only creates unnecessary political battles and delays investments.
  2. Fast-track approvals for new interprovincial transmission lines. Today, building a new transmission line can take more than a decade. Speeding up this process would help provinces share power and avoid costly overbuilding of generation capacity.
  3. Launch a major low-interest loan program to build new power infrastructure. We need to dramatically expand our generation and transmission systems, including natural gas-fired plants, to meet future demand.

Canadians deserve a reliable, affordable and clean energy future. But we will not get there by ignoring the realities of rising demand and provincial responsibilities. It is time for the federal government to listen to the provinces, embrace practical solutions and avoid an avoidable crisis.

Otherwise, we are on track for blackouts, higher bills and missed economic opportunities.

Maureen McCall is an energy business analyst and Fellow at the Frontier Center for Public Policy. She writes on energy issues for EnergyNow and the BOE Report. She has 20 years of experience as a business analyst for national and international energy companies in Canada.

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