The Alberta government announced new legislation Thursday following through on its promise to ban gender-affirming surgery for those 17 and under and hormone therapy for minors 15 and under, and to require parental consent to change names or pronouns in schools. 

Premier Danielle Smith said the province has tabled two bills — Bill 26 – the Health Statutes Amendment Act 2024, and Bill 27 – the Education Amendment Act 2024 — policies that would act as a “guardrail” and “protect the future choices of minors who identify as transgender or who are experiencing gender dysphoria.”

Prohibiting 10 gender-affirming surgeries for those 17 and under

The proposed Bill 26 would prohibit health-care professionals from performing any gender-affirming surgery on minors 17 and under.

There are currently 10 gender-affirming surgeries listed under the legislation, including breast augmentation, chest masculinization, hysterectomy, metoidioplasty, oophorectomy, orchiectomy, penectomy, phalloplasty, vaginectomy, and vaginoplasty.

Officials said bottom surgery currently does not occur in Alberta on minors and top surgery is extremely rare. The province also does not have data on how often puberty blockers are being used by minors.

When Smith was asked how many gender-affirming surgeries currently occur for minors in Alberta she said they did not have the number. She said the amendment is necessary because the province is seeing lawsuits “all over the world” from young people who have transitioned. When asked about Alberta specifically, she said it was happening “in the medical profession.”

“If it’s not happening at all, then there shouldn’t be any controversy around putting the guardrails around it,” Smith said.

If passed, the amendments would make changes to the Health Professionals Acts, which is under the Health Statutes Act.

Prohibiting prescription of puberty blockers to minors, with some exceptions

Health-care professionals, including but not limited to doctors, nurses, nurse practitioners and pharmacists, would be prohibited from prescribing hormone therapy drugs such as puberty blockers and hormone replacement therapies to treat gender dysphoria or incongruence for those 15 or under.

The amendment would not ban specific drugs.

Exceptions to the rules apply to minors aged 16 and 17 who are currently taking formal therapy or have parental, physician and psychologist approval to treat gender dysphoria or gender incongruence.

Further amendments would enable the health minister to clarify procedures and add drugs that are in the scope of the legislation in the future.

The province said health-care professionals are regulated through self-governing regulatory colleges and it would be their job to enforce the policies for those who do not follow the rules.

The legislation on banning gender reassignment surgery on minors is slated to come into effect this fall and the legislation prohibiting prescriptions will come into force some time this winter.

The changes would not prevent youths from going to another province to access puberty blockers.

Alberta NDP Leader Naheed Nenshi, when asked about his thoughts on the consultation process, responded, “What consultation?”

“This government has a reflex … to not be transparent,” he added.

“What the premier has done is she’s taken away the choice from parents, doctors and children to get what might be medical best practice for them. She is denying them treatment despite the fact that they just put a Bill of Rights saying people should have the right to access medical treatment.”

Schools must notify parents of name and pronoun changes

Bill 27 proposes changes to the Education Act that would require teachers, principals and staff to get parental consent before agreeing to a student’s request to change their preferred name, related to gender identity or pronouns.

Parents of students aged 15 and under will be notified and their consent is needed before allowing the use of the new preferred name or pronouns. For students aged 16 and 17, the school board will only have to notify parents.

School boards are expected to discipline teachers who do not comply and enforce the legislation.

Officials said if notifying parents would result in emotional or psychological harm to the student, the board has to ensure the student receives assistance prior to their parents being notified.

“You can’t have everyone in the world know except the parents,” Smith said.

“We believe that you have to have consistency, and if you are going to support the mental health of a child, they have to be supported, and that’s why you cannot have parents and families out of the mix. Parents need to know what’s going on with their kids”

The amendment is not retroactive and would not apply to students who are going by their new pronouns or preferred name.

Education minister to approve content related to sexuality and gender identity

The amendments would empower the education minister to approve external presenters, learning and teaching resources related to gender identity, sexual orientation or human sexuality

The Alberta government would work with education partners to develop an approval process for how resources are selected in relation to the topics.

Parents will be able to choose whether or not to opt their child in to sexual education classes or in lessons that deal with gender identity, sexual orientation or human sexuality.

School boards will be required to establish and implement policies for parents to be notified and consent, including providing at least 30 days’ notice prior to instruction or class content, provide parents with enough information to make a decision, and allow parents the option to opt their child in for all or part of the instruction.

If passed, the legislation is anticipated to come into effect Sept. 1, 2025.

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