Canadian doctors demand ability to offer child sex change services via video call

A new book detailing the procedure for youth telemedicine reveals that doctors believe they should be able to offer sex change services to minors virtually.

Amy Eileen Hamm Montreal QC

Some Canadian doctors want children to be able to access medical gender transition via video calls—and they don't even think those children should have to appear on camera to get it. A new book detailing the procedure for youth telemedicine reveals that doctors believe they should be able to offer sex change services to minors virtually, and that due to the potential for "distress" to those minors, they should not even have to show their faces on the video call.

While the scandal that is pediatric gender medicine falls out of favour across the Western world, physicians from the BC Children's Hospital in Vancouver are calling for easier access for kids to medically transition. Doctors argued that children should be able to obtain a medical transition without even appearing on camera to their healthcare team—claiming that could be "distressing" for the kids.

In a 2024 book on telemedicine for youth, physicians Carolina Silva and Brenden Hursh, of BC Children's Hospital, alongside researcher Smita Mukherjee, have said that there are too many barriers to Canadian children wanting medical transition, and that they should be able to do this via telehealth, "an easier, less costly way for trans youth access specialized care."

"Some important considerations for successful delivery of gender-affirming care via telemedicine include ensuring a welcoming and safe environment, offering to disable self-view if it is distressing for the youth, and creating a space for private and confidential discussions," the authors wrote. They argued that online care access would reduce fear of discrimination or "negative experiences" for youth identifying as transgender.

This publication comes on the tail of the final report of Dr. Hilary Cass, commissioned by NHS England, which revealed damning evidence that pediatric gender transition is a medical scandal not based on sound, or any, evidence. The UK has now banned puberty blockers for youth as a result. The Cass Review fallout has led to several countries further restricting or banning the medical transition of children and youth. It was also cited by Alberta premier Danielle Smith when she introduced legislation this year to put limits on youth transition in her province, such as access to double mastectomies for minor girls. Gender activists predictably responded to Smith's legislation with accusations of transphobia and hate—ignoring the growing body of evidence that pediatric gender medicine is harmful and based on politics and activism, rather than science.

The Canadian physicians and researchers now calling for telehealth access to gender transition have been characterized as activists. "These authors have medical credentials, but make no mistake, they are activists first and foremost," posted investigative journalist Christina Buttons.

Mukherjee's research history includes looking at "barriers for completing preoperative hair removal for penile inversion vaginoplasty" and advocating for gynecologists to take on biological males as patients. Hursh claims to "provide leadership and education across BC and beyond in this dynamic and emerging area of medicine, [with] the aim of increasing the capacity of health-care providers to provide high-quality gender affirming care."

There is a lack of consensus among Canadian physicians on pediatric gender medicine, though the physicians willing to publicly stand up for a cautious, evidence-based approach are outliers. Bringing evidence-based care for dysphoric youth to Canada is a currently a battle between politically motivated, activist physicians and physicians who risk their livelihood by speaking up.

Canadian endocrinologist Roy Eappen is one of them; in a recent op-ed, he pleaded with the American Endocrine Society—which also informs Canadian physicians—to follow the recommendations of the Cass Review.

"The last hope for change may come from the Endocrine Society's new president, Dr. John Newell-Price. Like Cass, he's from the United Kingdom, which is rapidly moving toward a more evidence-based approach to helping children who aren't comfortable in their bodies. If he's committed to medical science and ethics, he'll use the society's meeting to announce a new direction, one that puts children's health ahead of activist demands. Or the Endocrine Society can keep endangering children," wrote Eappen.

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