`SLOW DOWN' ON TRANS TEENAGERS, EXPERT SAYS
Cautions against rushing medical transitioning
Canadian health care faces similar issues around treating transgender teenagers as a controversial British clinic and needs to “slow down” and not move patients so readily to medical transition, says a leading expert in the field.
As the number of youth presenting with gender dysphoria soars and their demographic makeup changes markedly, the health care system should examine why those trends are happening while taking a thoughtful, “neutral” approach to each young patient, said Dr. Joey Bonifacio.
Gender health care made headlines recently with Britain's decision to close the so-called Tavistock clinic for gender issues and replace it with a network of smaller centres. An independent review suggested it was giving short shrift to patients' nongender mental health problems, and that evidence was unclear about the long-term effects of puberty-blocker drugs, often the first step in gender transition.
“I do have the same concerns the Tavistock clinic faced,” said Bonifacio, a pediatrician whose practice at Toronto's St. Michael's Hospital focuses on gender identity.
“I think it just moves us to, let's slow down and make sense of what is going on,” he said, though Bonifacio opposes closing down any clinics here. “All of these decisions ... concerning social, medical or surgical transitions, these are big decisions and they deserve the time, they deserve the respect that's needed.”
He acknowledged that patients already face long wait times, but stressed that doctors and other professionals must thoroughly address any mental health issues children experience on top of gender dysphoria — the sense of not belonging to one's birth sex — before beginning gender transition with hormone treatment and, eventually, surgery.
“She didn't seem to appreciate or recognize the importance of maintaining the integrity of the investigation,” Campbell said.
Wortman, who killed 22 people in his rampage, did not have a firearms licence. The information about the weapons Lucki wanted released was kept confidential until November, 2020, when the National Post detailed the information after receiving a government briefing note via an access to information request.
The four weapons he used had all been obtained illegally, three of them having been smuggled in from the United States. Wortman was killed in a shootout with police after the killing spree. Three people were later charged with supplying him with ammunition, but there have been no charges related to the weapons.
Campbell said the commissioner wasn't alone in wanting more information made public, but he said he was confident that Lucki had said it should be released because of the pending gun control legislation.
“There was pressure for information from all sides, whether it be the public, the media, government, within the organization itself, but it was clear during that meeting that the commissioner had said that she had made a promise, and that it was tied to the legislation,” he said.
Lia Scanlan, a civilian RCMP employee from Nova Scotia, who was also present in the meeting said she had exactly the same recollection as Campbell. She said she wasn't 100 per cent sure on Lucki's words, but it was clear she had made a commitment to the government.
“At the end of the day, whether we're saying, promise, pressure, influence — they all lead to the same end result,” she said.
Lucki has previously testified before the committee and said she regrets some of the language she used during the meeting, but she said she would not interfere with an investigation and denied that there had been any political interference in the investigation. Former public safety minister Bill Blair has also denied any political pressure to release information about the guns.
Four key pages of documents were initially withheld by Justice Department lawyers and later turned over. The department's deputy minister, François Daigle, insisted there had been no political involvement and the four pages had been retained for greater scrutiny of potential legal issues before they were handed over.
Following the witness testimony on Tuesday, Conservative MPS pushed for the committee to call more witnesses, including Blair's chief of staff and other bureaucrats and officials.
MP Stephen Ellis, who represents many of the communities where the shooting took place, said there is more that needs to be uncovered.
“I would suggest that, as the story evolves, there are others out there who do know the answers to these questions,” he said. “Somebody's not telling the truth. And that is very, very disappointing to me and I think it's very disappointing to Canadians at large.”
Liberals on the committee pushed against a broader witness list and ongoing hearing. MP Pam Damoff said none of the witnesses have provided any evidence of political interference in the investigation.
“The information we've received in the two meetings that we've held already with the minister, the commissioner, who were both clear very, very clear in their testimony that there was no political interference,” she said.
Lucki is set to testify before the Mass Casualty Commission in Nova Scotia at the end of this month.
THERE WAS PRESSURE FOR INFORMATION FROM ALL SIDES.