Frontier Centre for Public Policy
Transition Troubles: Medical Risks and Regret Among Trans Teens

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.
Economy
Support For National Pipelines And LNG Projects Gain Momentum, Even In Quebec

From the Frontier Centre for Public Policy
Public opinion on pipelines has shifted. Will Ottawa seize the moment for energy security or let politics stall progress?
The ongoing threats posed by U.S. tariffs on the Canadian economy have caused many Canadians to reconsider the need for national oil pipelines and other major resource projects.
The United States is Canada’s most significant trading partner, and the two countries have enjoyed over a century of peaceful commerce and good relations. However, the onset of tariffs and increasingly hostile rhetoric has made Canadians realize they should not be taking these good relations for granted.
Traditional opposition to energy development has given way to a renewed focus on energy security and domestic self-reliance. Over the last decade, Canadian energy producers have sought to build pipelines to move oil from landlocked Alberta to tidewater, aiming to reduce reliance on U.S. markets and expand exports internationally. Canada’s dependence on the U.S. for energy exports has long affected the prices it can obtain.
One province where this shift is becoming evident is Quebec. Historically, Quebec politicians and environmental interests have vehemently opposed oil and gas development. With an abundance of hydroelectric power, imported oil and gas, and little fossil fuel production, the province has had fewer economic incentives to support the industry.
However, recent polling suggests attitudes are changing. A SOM-La Presse poll from late February found that about 60 per cent of Quebec residents support reviving the Energy East pipeline project, while 61 per cent favour restarting the GNL Quebec natural gas pipeline project, a proposed LNG facility near Saguenay that would export liquefied natural gas to global markets. While support for these projects remains stronger in other parts of the country, this represents a substantial shift in Quebec.
Yet, despite this change, Quebec politicians at both the provincial and federal levels remain out of step with public opinion. The Montreal Economic Institute, a non-partisan think tank, has documented this disconnect for years. There are two key reasons for it: Quebec politicians tend to reflect the perspectives of a Montreal-based Laurentian elite rather than broader provincial sentiment, and entrenched interests such as Hydro-Québec benefit from limiting competition under the guise of environmental concerns.
Not only have Quebec politicians misrepresented public opinion, but they have also claimed to speak for the entire province on energy issues. Premier François Legault and Bloc Québécois Leader Yves-François Blanchet have argued that pipeline projects lack “social licence” from Quebecers.
However, the reality is that the federal government does not need any special license to build oil and gas infrastructure that crosses provincial borders. Under the Constitution, only the federal Parliament has jurisdiction over national pipeline and energy projects.
Despite this authority, no federal government has been willing to impose such a project on a province. Quebec’s history of resisting federal intervention makes this a politically delicate issue. There is also a broader electoral consideration: while it is possible to form a federal government without winning Quebec, its many seats make it a crucial battleground. In a bilingual country, a government that claims to speak for all Canadians benefits from having a presence in Quebec.
Ottawa could impose a national pipeline, but it doesn’t have to. New polling data from Quebec and across Canada suggest Canadians increasingly support projects that enhance energy security and reduce reliance on the United States. The federal government needs to stop speaking only to politicians—especially in Quebec—and take its case directly to the people.
With a federal election on the horizon, politicians of all parties should put national pipelines and natural gas projects on the ballot.
Joseph Quesnel is a senior research fellow with the Frontier Centre for Public Policy.
Education
Our Kids Are Struggling To Read. Phonics Is The Easy Fix

From the Frontier Centre for Public Policy
One Manitoba school division is proving phonics works
If students don’t learn how to read in school, not much else that happens there is going to matter.
This might be a harsh way of putting it, but it’s the truth. Being unable to read makes it nearly impossible to function in society. Reading is foundational to everything, even mathematics.
That’s why Canadians across the country should be paying attention to what’s happening in Manitoba’s Evergreen School Division. Located in the Interlake region, including communities like Gimli, Arborg and Winnipeg Beach, Evergreen has completely overhauled its approach to reading instruction—and the early results are promising.
Instead of continuing with costly and ineffective methods like Reading Recovery and balanced literacy, Evergreen has adopted a structured literacy approach, putting phonics back at the centre of reading instruction.
Direct and explicit phonics instruction teaches students how to sound out the letters in words. Rather than guessing words from pictures or context, children are taught to decode the language itself. It’s simple, evidence-based, and long overdue.
In just one year, Evergreen schools saw measurable gains. A research firm evaluating the program found that five per cent more kindergarten to Grade 6 students were reading at grade level than the previous year. For a single year of change, that’s a significant improvement.
This should not be surprising. The science behind phonics instruction has been clear for decades. In the 1960s, Dr. Jeanne Chall, director of the Harvard Reading Laboratory, conducted extensive research into reading methods and concluded that systematic phonics instruction produces the strongest results.
Today, this evidence-based method is often referred to as the “science of reading” because the evidence overwhelmingly supports its effectiveness. While debates continue in many areas of education, this one is largely settled. Students need to be explicitly taught how to read using phonics—and the earlier, the better.
Yet Evergreen stands nearly alone. Manitoba’s Department of Education does not mandate phonics in its public schools. In fact, it largely avoids taking a stance on the issue at all. This silence is a disservice to students—and it’s a missed opportunity for genuine reform.
At the recent Manitoba School Boards Association convention, Evergreen trustees succeeded in passing an emergency motion calling on the association to lobby education faculties to ensure that new teachers are trained in systematic phonics instruction. It’s a critical first step—and one that should be replicated in every province.
It’s a travesty that the most effective reading method isn’t even taught in many teacher education programs. If new teachers aren’t trained in phonics, they’ll struggle to teach their students how to read—and the cycle of failure will continue.
Imagine what could happen if every province implemented structured literacy from the start of Grade 1. Students would become strong readers earlier, be better equipped for all other subjects, and experience greater success throughout school. Early literacy is a foundation for lifelong learning.
Evergreen School Division deserves credit for following the evidence and prioritizing real results over educational trends. But it shouldn’t be alone in this.
If provinces across Canada want to raise literacy rates and give every child a fair shot at academic success, they need to follow Evergreen’s lead—and they need to do it now.
All students deserve to learn how to read.
Michael Zwaagstra is a public high school teacher and a senior fellow at the Frontier Centre for Public Policy.
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