Who gets to decide when a 14-year-old wants to change gender? The child, the hospital, the battling parents?

A B.C. case raises difficult questions about parental rights and about how young is too young to make medical decisions. The result is a messy ethical and legal tangle

Douglas Quan Jan 18 2019 National Post

Illustration : In many ways, Max is a typical 14-year-old. He eschews soft music in favour of rock and heavy metal, likes to wear hoodies, giggles when he’s nervous and has a flair for drawing animals. He can be opinionated and sarcastic one moment, shy and withdrawn the next.

His insecurities, however, run deeper than run-of-the-mill teenaged angst.

“I have a male brain that doesn’t match up with the body I’m in,” says the Grade 9, Surrey, B.C., student, who was the female gender at birth.

“It’s like being trapped in a cage.”

Max is now at the centre of a complicated legal fight over who gets to decide the course of treatment for his gender dysphoria. Max and his mom, Sarah, with the support of the gender clinic at B.C. Children’s Hospital, want to proceed with a treatment plan that would involve injecting Max with testosterone — a key step, they say, in Max’s desire to transition from a female to a male body.

But Max’s father, Clark, who is separated from Sarah and shares joint custody of Max, believes things are moving too fast and worries about the treatment’s risks. Why can’t Max wait until he’s an adult before taking such a big step? What if Max comes to regret his decision, but the changes are irreversible? Doesn’t the father get to have a say in the matter at all?

The case raises difficult questions about parental rights, about child autonomy, about how young is too young to make serious medical decisions. The result is a messy ethical and legal tangle, where a number of deeply interested parties — all with competing points of view on this issue, and all with the child’s best interest in mind — are at odds over how to proceed.

I have a male brain that doesn’t match up with the body I’m in

The hospital maintains the decision about treatment is ultimately Max’s to make — and Max’s alone. That was a staggering notion for the father, which led him to file an application in B.C. provincial court to block the treatment. On Monday a family law judge agreed to adjourn the case for two weeks to allow Sarah time to hire a lawyer; for the time being the hospital cannot carry out any treatments.

None of the family members’ real names are being used in this story. The Provincial Court Act in B.C. prohibits the identification of any child or party to a “family or children’s matter before the court.” Sarah and Max had wanted to be identified using their real names. “If I’m not named, it’d be like I’m hiding,” Max says.

While such legal disputes are rare, experts say family conflicts over proposed treatments and parental consent are likely to increase as more young people are referred to gender clinics across the country.

Clark insists he is not anti-transgender; he bought Max a transgender pride flag last Christmas. He just worries Max is being steered down a path without considering all the options.

“I just want to do what’s best for Max. And sometimes that’s tough love.”

Clark added later: “I have no animosity towards Sarah on this issue. I think we both believe we are doing the right thing. And I believe we both have Max’s best interest in mind.”


For as long as he can remember, Max has always preferred hanging around boys. He never played with female gender-stereotypical toys, such as dolls. His family chalked it up to him being a “tomboy.”

Max’s coming out moment came in Grade 7 when he stumbled across a video on YouTube. Titled “Boy,” the Danish short film documents the struggles between Emilie, a transgender boy, and his mother. The film opens in a clothing store. The mom picks out a dress for Emilie, but Emilie prefers military-style clothes.

“It just kind of clicked right away,” Max says.

After watching the film, Max stood in front of the mirror — just as Emilie does in the film — and cut his hair, which at the time stretched to the middle of his back.

By the time he started Grade 8, Max had undergone a “complete overhaul” of his identity, Sarah says. School staff were notified that he preferred to be known by his chosen name, not by the female name he was given at birth. Max had also started binding his chest.

While these changes helped, Max says the transformation still felt incomplete.

“Even if I’m open with who I am, I’m still insecure.”

There are times, he says, when he’ll go silent because his voice comes out sounding too effeminate. He often gets distracted by how “girlie” his hands look.

I didn’t quite understand transgenderism, didn’t know if I fully believed in it

Sarah says the dysphoria has led Max to try to take his own life and engage in self-harm.

CONTINUE READING ARTICLE : https://nationalpost.com/news/canada/who-gets-to-decide-when-a-14-year-old-wants-to-change-gender

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