Second constitutional challenge launched in defence of gender-affirming care in Alberta

The Canadian Medical Association, along with three Alberta doctors, has filed a constitutional challenge to Alberta’s Bill 26, which dictates how physicians can deliver gender-affirming care to patients under 18.

Association president Dr. Joss Reimer said the provincial government’s decision to ban specific treatments could result in patients not receiving the best care possible.

The legislation, which passed last December, prevents doctors from prescribing hormone therapies or puberty blockers to people under 16. Doctors are also banned from performing gender-reassignment surgeries on those under 18, even though such procedures are exceptionally rare.

“Medicine is a calling,” Reimer said. “Doctors pursue it because they are compelled to care for and promote the wellbeing of patients.”

However, the association’s court filing argues that Bill 26 prevents doctors from following that calling and violates physicians’ right to freedom of conscience under the Canadian Charter of Rights and Freedoms. 

In a press release issued earlier this week, the association said the legislation renders doctors powerless to provide independent expertise, clinical guidance or gender-affirming treatment options. 

“This legislation has put me and many of my colleagues in a state of moral crisis,” said Dr. Jake Donaldson, a Calgary-based family physician providing gender-affirming care to about 40 adolescents. 

“These patients are a vulnerable group that already face significant and disproportionate discrimination, violence and mental health challenges,” he said, adding Bill 26 forces physicians to stand on the sidelines and watch their patients suffer.

The Alberta government argues that the new rules will protect children. 

“The changes we’re introducing are founded on compassion and science,” Alberta Premier Danielle Smith said when the bill was introduced last October. “Both of which are vital for the development of youth throughout a time that can be difficult and confusing.”

Advocates for the 2SLGBTQ+ community dispute those motivations, asserting that Bill 26 targets and harms trans youth.

A coalition of affected families and organizations, including Egale Canada and Skipping Stone, is also challenging the legislation’s constitutionality in court.

In a statement posted to Egale Canada’s website, Bill 26 is described as “a clear violation of the constitutional rights of gender diverse youth in Alberta.” 

Alberta has also banned trans people from competing in women’s sports divisions and requires parental consent for name or pronoun changes in school settings. New Brunswick imposed similar legislation in 2023, although Premier Susan Holt repealed it when the provincial Liberals formed government in 2024.

Similarly, Saskatchewan used Canada’s Charter of Rights and Freedoms’ notwithstanding clause to pass legislation targeting trans youth.

South of the border, American President Donald Trump has imposed sweeping anti-trans measures, including an executive order erasing the existence of trans, non-binary and intersex citizens from federal websites.

Trump has also endeavoured to defund gender-affirming care for youth, and rescinded dozens of his predecessors’ executive orders—including Lyndon B. Johnson’s 1965 affirmative action order, prohibiting federal contractors from discriminating based on race, colour, religion, sex, sexual orientation, gender identity, or national origin.