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Nov 1·edited Nov 1Liked by J. Edward Les, MD

**Edit: This is from Leslie. Substack gets us mixed up even though I sign in with my own e-mail address.

I agree that a more far-reaching ambition would be better. I’m disappointed that children currently taking GNRHa’s will not have to stop them. (Fortunately no one is going to be started on them after 16 anyway.) But politics is the art of the possible and I don't mean to damn Premier Smith with faint praise. Not at all. She knows her Government’s legislation (assuming it passes into law) will be Charter-challenged by the activists who are well-funded enough to take it to the Supreme Court. She needs a clear victory that the law does not violate made-up Charter rights invented by activist judges and shouted about by federal Cabinet Ministers. One test often applied in adjudicating Charter claims is, Is the legislation the minimum required to accomplish a legitimate state goal or has the government over-stepped in its curtailment of liberty or body autonomy or gender rights or whatever? Her Government, I think — I’m a civil libertarian, not a lawyer— , will be able to show that the legislation was targeted to what was necessary to protect minors and that self-regulation of the medical profession by itself has failed to do so.

True, her Government can Charter-proof the law by invoking the Notwithstanding Clause. But this is politically risky and lapses after 5 years. It would, also, be valid only in Alberta. If she wins at the Supreme Court it will set a precedent that other provinces can screw up their courage and pass similar laws. And if she loses, she can still use the Clause.

The rest is up to us, in medicine. We have to get our colleagues to stop doing this work in adults, or in anyone. Eventually they will pretend they never endorsed it anyway....and will say to themselves as they are trying to fall asleep, “WTF was I thinking?”

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I agree with you wholeheartedly re the "art of the possible". Yet it needs to be said that harmful meds and practices are harmful meds and practices, even if "you've started them already". And since I'm not beholden to any political agenda, I might as well be the one to say it :). I hope, like, you, that this is a stepping stone - a huge one - to the whole toxic enterprise being shut down.

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Speaking of lawyers, you may want to take a gander at this post by retired lawyer Peter Sims on the same issue:

"Alberta Challenges the Gender Identity Establishment; A Review of the Legislation Package": https://justdad7180.substack.com/p/alberta-challenges-the-gender-identity

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> "Poison is poison."

Indeed. Though often a question of dosage. But nice analogy and good point here:

Edward: "I do have a major quibble with the government’s new legislation, which will allow those youth who have already begun taking puberty blockers and cross-gender hormones to continue taking them. That strikes me as analogous to banning the prescription of thalidomide after realizing it was causing birth defects but allowing pregnant women already on the drug to keep ingesting it."

Amen to that. But a monstrous premise undergirding the whole "idea" that kids with "gender non-conforming" behaviours and traits should have their genitalia mangled to more closely resemble those of the other sex. Because that is what "gender affirmation surgery" boils down into. Nice to see you using scare quote marks around such terms.

But I think you should also be using those same scare quotes around your "sex reassignment" -- absolutely no one changes sex, and it's part and parcel of a "Big Lie" to even suggest that's possible -- "sex education (indoctrination?)", indeed.

However, contributing to that clusterfuck is generally sloppy language over what "sex" and "gender" actually mean. The British Medical Journal put it better than most, even if they were a bit vague on the specifics -- devils, details:

BMJ: "Sex and gender are not synonymous. Sex, unless otherwise specified, relates to biology: the gametes, chromosomes, hormones, and reproductive organs. Gender relates to societal roles, behaviours, and expectations that vary with time and place, historically and geographically. ...."

https://www.bmj.com/content/372/bmj.n735

Why you might want to rattle some cages over in the "bull pen" of National Post writers, one of whom, Sharon Kirkey, seems unclear on that rather profound difference -- though she quotes the DSM who seem equally clueless:

"Amy is reverting to her birth gender ... gender dysphoria is defined [in the DSM] as an incongruence between a person’s experienced or expressed gender 'and the one they were assigned at birth.' ...."

https://nationalpost.com/news/young-detransitioners-abandoned

If "Amy" had had her ovaries removed as part of that so-called "gender-affirmation surgeries" -- a rather common "cure" -- then she would have been rendered sexless with no way back from that state. Absolutely no one is "assigned a gender" a birth, particularly as "gender" is hardly more than a set of sexually dimorphic personality traits. In which case, does a midwife, with a babe in arms, put on a sorting hat and say, "Hmm, definitely destined to be an introvert" ... 🙄

Some reason to argue that that is where the rot starts -- with the conflation of sex and gender, and with quite unscientific definitions for both. Which Ms. Kirkey and the DSM are contributing to:

https://x.com/lascapigliata8/status/957968082978340864

https://www.amazon.co.uk/Born-Right-Body-identity-perspective/dp/B0BMSZST7L

In other news and ICYMI, a bit from my other comment here, a post by retired Canadian lawyer Peter Sims on the same issue:

"Alberta Challenges the Gender Identity Establishment; A Review of the Legislation Package": https://justdad7180.substack.com/p/alberta-challenges-the-gender-identity

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I read Peter Sims' excellent summary, very well written and a great summary of the issues.

RE the gender/sex conflation: you've seen me assert previously that sex is binary, and that gender arises from that binary (and therefore is itself "binary"; and that while there is a spectrum of gender "expression" within that binary, from hypermasculine males to effeminate males, and from hyperfeminine females to masculine females, with overlap at the margins, that doesn't take away from the truth of the male/female binary. I've always found that to be a useful construct. Thoughts?

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Edward: "... a spectrum of gender 'expression' within that binary, from hypermasculine males to effeminate males, and from hyperfeminine females to masculine females ...that doesn't take away from the truth of the male/female [sex] binary. I've always found that to be a useful construct."

Exactly right! More or less. 🙂

But a big part of the problem is that both "sex" and "gender" are poorly defined, particularly outside of Academia, and even inside it many are kind of clueless or "ideologically biased".

So while your "hyper-masculine/feminine to run-of-the-mill masculine/feminine" spectrum provides a useful synopsis or starting point, there are some important details -- and problematic "devils" therein -- that aren't easy to elucidate or to grapple with.

But as maybe a useful example or case-in-point, consider long hair in women. That is more or less a typical trait of human females, but is not unique to them as long hair is also exhibited by some human males, particularly historically. In which case we might say that long hair is a feminine trait and that long-haired human males are "gender non-conforming".

However, there are probably hundreds if not thousands of traits -- psychological, behavioural, physiological -- that are more common among one sex than another, but are not unique to either. For example, considering the so-called Big Five personality model, women tend to be, on average, more agreeable than men, while men tend to be, on average, more conscientious than women. In which case we might say that a long-haired, agreeable, career-driven woman was feminine in two traits, but "gender non-conforming" hypermasculine in one other trait.

Not sure that that variation on a "personality model" -- mashing in a prevalence by sex -- is all that much better than phrenology or astrology, but the concept still has some significant durability and value. For example, you might take a gander at the Wikipedia article on sexual dimorphism, even the first paragraph:

Wikipedia: "Sexual dimorphism is the condition where sexes of the same species exhibit different morphological characteristics, including characteristics not directly involved in reproduction. .... Differences may include secondary sex characteristics, size, weight, color, markings, or behavioral or cognitive traits."

https://en.wikipedia.org/wiki/Sexual_dimorphism

Note the "behavioural or cognitive traits".

But as with long hair and agreeableness, those traits aren't always unique to either sex, but often only more typical of one than the other, even in species other than humans. For an amusing case of the latter, see this post by evolutionary psychologist Paula Wright where she describes three forms, three "morphs", in the males of a sandpiper bird species, one of which is characteristic of the females:

Wright: "Ruff Sex and Sneaky Fuɔkers; In other species 'genderbending' is a deceptive heterosexual mating strategy. It needs to be explored as such amongst LGBTQ+ radicals, who demand access to female spaces. ....

The males of this species are highly unique as they appear to have three different 'genders' which, unlike other species, do not appear to be triggered by environmental inputs. They are genetic."

https://paulawright.substack.com/p/ruff-sex-and-sneaky-fukers

Those are her quote marks around "gender" to emphasize that it is something of a non-standard usage, but she did so to point out the essential idea -- i.e., sexual dimorphism -- in the more common social usage.

Which kind of speaks directly to your "gender arises from that [sex] binary": "gender" is, by definition, a binary -- feminine and masculine -- because it encompasses and describes those traits that are more or less typical of one sex while, often, not being unique to either.

But if one is engaged in studying and analyzing traits that are more typical of one sex than another then it is kind of essential that one has a clear idea of what it takes to qualify as male or female in the first place. Which is something of a thorny question. Although that is, in large part, only because various transloonie nutcases, and other scientific illiterates, insist that membership in those categories is only a matter of "self-identification".

Somewhat briefly on that score, you might be interested in this tweet by developmental biologist Emma Hilton:

Hilton: "The definition of female is: of or denoting the sex that can produce large gametes. This not a matter of *observation*, this is a matter of *definition*."

https://x.com/FondOfBeetles/status/1488523777042432008

Not exactly the standard biological definition though close enough for our purposes here: if one has ovaries then one is a human female, and if one has testicles then one is a human male. But that is ALL that it takes to qualify as male or female. A long-haired, agreeable, careless male -- "gender non-conforming" times three -- is not less a male because those traits are not the ones that qualify someone for membership in that category: "sex" (reproductive abilities) is an entirely different kettle of fish from "gender" (personality and behavioural traits typical of one sex but not unique to either).

Sorry for maybe an over-long exposition, but the problem, the medical scandal of "gender affirmation surgery", is mostly the result of a general ignorance about the profound differences between sex and gender. Maybe we could collaborate on an article to the National Post to bring some enlightenment to the masses? 🙂

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Nov 1Liked by J. Edward Les, MD

Well said.

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Nov 1Liked by J. Edward Les, MD

Excellent commentary, I love your work.

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Thanks Dr. Les for standing up for children! I can only hope other Premiers will have some courage and put some safeguards in for children in every province. You said it, the activists have certainly dug their tentacles into every aspect of society and it makes them giggle with delight when they get more coverage (trans kids/surgery/keeping parents out of discussion, etc.)

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