Amy Hamm: Tribunal punishes doc for conscientious objection to puberty blockers

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The latest: a family physician who declined to administer a single injection of a puberty-blocking drug to a 14-year-old transgender-identifying patient was found guilty of discrimination and ordered to pay $20,000 for “compensation for injury to … dignity, feelings and self-respect,” plus $8,100 for the cost of the claimant’s “expert report” and — most outrageously — was instructed to “cease the contraventions and refrain from committing the same or similar contraventions.”

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Note that I do not include the physician’s name, as he wished to protect his professional reputation with a publication ban on his identity. The BCHRT refused to do this.

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At the request of the claimant’s mother, the physician referred the claimant, who’s referred to in the ruling as “Child Q,” to the Gender Clinic at B.C. Children’s Hospital in 2020, where Lupron, an injection used to suppress puberty, was prescribed. The teen did not wish to self-administer the drug and instead preferred that a physician do it. Administrative staff at the doctor’s office booked an appointment for one of the injections without the physician’s knowledge. When he realized what the appointment was for, he declined to administer the drug.

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The doctor “was learning for the first time that the purpose of Child Q’s appointment was to receive a Lupron injection. He understood — wrongly — that this was part of a process for ‘gender reassignment therapy.’ He says that he had never had any experience with that branch of medicine. He testified that, because of his religion, he finds it ‘conflicting and difficult’ to be involved in any part of ‘gender reassignment,’ ” reads the ruling. In other words, the adjudicator claimed that puberty blockers don’t count as “gender-assignment therapy.” The physician testified that the patient’s mother “stormed out of the room” before he could offer any alternative. The child received the injection at a walk-in clinic later that day.

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The family subsequently filed complaints with the College of Physicians and Surgeons of B.C. (CPSBC) and the BCHRT. In 2023, the CPSBC reprimanded the physician for “refusing to provide care related to gender transition to a patient on the basis of conscientious objection, without offering assistance to this patient in order that they could receive this care from another provider.”

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The claimant was seeking $50,000 for the professed purpose of “making discrimination against transgender children in health care expensive.” The claimant also wanted the BCHRT decision to be “prominently” posted, in perpetuity, anywhere the physician works. Surprisingly, Devyn Cousineau, who wrote the decision, agreed with the impugned physician that this “would serve no purpose other than to punish him.” (Apparently publishing his name, fining him and demanding that he provide “gender-affirming care” in the future, under legal threat, was punishment enough.)

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The claimant’s lawyer was non-binary-identifying trans activist Adrienne Smith, who also chaired the federal NDP convention last spring. Videos of Smith explaining the NDP’s equity card system, which allowed for delegates to jockey for speaking priority based on gender identity, skin colour or disability status, was criticized and mocked worldwide. Cousineau, meanwhile, is the same tribunal member who oversaw Canada’s infamous testicle-waxing discrimination cases. At the time, Cousineau notoriously wrote in a procedural ruling that transwomen receiving testicle waxing can constitute “critical gender-affirming care.”