🇨🇦 Some comments on the state of free speech in Canada in light of the @WeAreFairCop and #IStandWithScottow cases. In Canada it is unlikely that anyone would be criminally charged for 'misgendering'. The hate crime provisions in the Criminal Code are very restrictive it would /2
require much more than using the wrong pronouns to justify a charge. Section 319(1) applies to statements made in public which are likely to provoke a breach of the peace. Section 319(2) is broader and could cover statements made on social media but charges under this section /3
require the approval of the attorney general. Charges are very rare. The police would not be able to make an arrest on a complaint of a private individual. The limitations on free speech in Canada generally fall into three categories: 1. Non-publication orders made in criminal /4
or family cases involving minors which can be enforced by contempt of court charges; 2. Civil or administrative action under provincial human rights codes (Morgane Oger is big on this); 3. Non-governmental action by workplace, professional or academic sanctions.
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🧵The Cass Review and reviews in Sweden and Finland have recommended that puberty blockers only be used in a research setting. However, Cass was clear that any research studies would need ethical approval and the case for further research on children is not there. 1/
Before any more children are put at risk, the existing data on puberty blockers needs to be studied properly. A first step should be publishing the data from the Joanna Olson-Kennedy study which have been withheld for political reasons. 2/cnn.com/2024/10/25/hea…
The first children treated with puberty blockers for gender dysphoria are now young adults and we should have data on their health.The data linkage study the Cass Review proposed should be completed before any new clinical trials are authorized. 3/transgendertrend.com/adult-gender-c…
1/ The US Supreme Court decision on gender affirming care for minors will probably have less impact on gender medicine in general than anticipated. The bans only affect about half the states and only apply up to are 18. There are two other factors that will be more important.
2/ The first is litigation, which is starting against some of the biggest names in medicine. There are also investigations by state governments and congressional investigations will follow.
3/ Don't expect many doctors to be bankrupted; they have insurance to cover damages and legal costs. But insurance premiums will go up and more time in court and before congressional committees means less time seeing patients.
1/ Here's what Trump has said about stopping medical transition of minors. Some of it makes sense but other parts are questionable and probably unconstitutional.
2/ "I will sign and executive order instructing every federal agency to cease all programs that promote the concept of sex and gender transition at any age." Easy to do, and will make it easier to work for reform at the state and local level. Note that it includes adults.
3/ "I will then ask Congress to permanently stop federal tax dollars being used to promote or pay for these procedures ...."
Easily done and would cut off support for gender medicine under Medicare, Medicaid, prisons and military health plans.
1/ Some thoughts from Canada on how the US election will impact the gender debate. Rachel Levine will be fired and most of Biden's executive orders on the application of Title IX to sports and trans health care will be repealed.
2/ The Supreme Court will hear the Skremetti case on state bans on youth gender medicine before Trump takes office. If the case goes as expected, the result will be to leave the issue of youth gender medicine to the states.
3/ This will create a situation where half the states ban medical gender transition of minors and in the other half parents who won't consent to medical transition risk losing custody of their children. Neither side is likely to provide adequate mental health support.
1/ The authors of the Canadian Paediatric Society position statement on gender affirming care have now published a response to the recent letter to the editor calling for a review of the position statement in light of the Cass Review. academic.oup.com/pch/advance-ar…
2/ The response repeats falsehoods such as the claim that the systematic reviews commissioned by the Cass Review excluded studies which were not randomized control trials when in fact the systematic reviews considered and evaluated all types of studies. cass.independent-review.uk/home/publicati…
3/ The response relies heavily on a critique of the Cass Review by Dr. Meredithe McNamara et al. distributed by the "Yale Integrity Project." The first peer reviewed rebuttal to this paper has just been published. adc.bmj.com/content/early/…
1/ The proposals by @ABDanielleSmith to protect gender-questioning youth in schools and healthcare are generally consistent with best international practice and evidence but there are still a few problem areas. .
@ABDanielleSmith 2/ Banning gender reassignment surgery on minors should be a non-issue. Activists claim it never happens but it does. Someone too young to get a tattoo shouldn't be able to get an elective double mastectomy. nationalpost.com/news/young-det…
@ABDanielleSmith 3/ The proposal to restrict puberty blockers and cross sex hormones to children over 16 is close the the current policies in England, Sweden and Finland. These countries do make an exemption for patients enrolled in a research program.segm.org/Swedish-2022-t…