Radio Canada( French) questioning affirmation model.

[334bu]

https://ici.radio-canada.ca/tele/enquete/site/episodes/864008/episode-du-jeudi-29-fevrier-2024

Surprisingly critical.

This is in French and with Quebecois accent is very difficult (at least for me It was).
It discusses the ease with which minors can obtain blockers and hormones in Canada( a 14 year old actress is prescribed these after a 10 minute interview in a private clinic) and interviews parents of. 3 detransitioners, two detransitioners and one happy transitioner as well as various medical personnel on both sides of affirmation argument.
.My French is not really good enough to do a transcript but some may find this interesting

As my French is limited to "Je m’appelle Boiledbeetle, j’habite au Pérou le plus sombre et le plus profond" and the number "Soixante neuf" I'm screwed. But I'm hoping for a translation at some point.

And presumably 'ou est mon sandwich à la confiture d'oranges'☺

I haven't had a chance to listen to it yet, but the 'blurb' says:

More and more teens around the world are choosing to change gender.
In Quebec, the health system responds very quickly to their requests for medical transitioning by prescribing blockers, testosterone and mastectomies. These young girls often present with several mental health problems, and many people question whether enough time is given to evaluating their mental state. Is it normal for a young 14 year old girl to get a prescription for testosterone in a matter of minutes? And what happens when they* change their mind?
[*The use of 'they' is only significant in English, the writer switched from 'a young girl' (singular) to 'when they change their mind' (plural), probably in error]

Good luck with transcribing the actual interviews!

And presumably 'ou est mon sandwich à la confiture d'oranges'☺

😁

Just discovered a little text box thing at bottom of screen which when pressed brings up subtitles in French. .

That does make it slightly easier to follow, it's weird how much French is recognisable in written form, although I am less than a minute in! That may change!

This is really worth a watch (it's video, not radio, so the title is a bit confusing.) The subtitles are good, so fine if you read French, though the Quebecois accents are quite challenging!

I'd be very interested to know context from any Canadians around? This is a thoughtful piece, quite like the 'Trans Train' documentary from Sweden, which was very influential there. This is the state broadcaster, isn't it? Is this a well known documentary strand? Will this cause shock waves.

The detrans case studies are shocking. All girls.

The 14 year old actress is not only prescribed blockers after a 14m consultation, it appears that she ATTENDS IT ON HER OWN.

Case study 1 - Clara had a long history of mental health problems, bullying and social anxiety, announced she was trans at 15. Her psychologist dismissed suggestions she might have BPD saying there's no such thing and people with BPD are actually trans and referred her for transition. She took T, mental health deterioriated, had breasts removed, then detransitioned at age 20.

Case study 2 - Jane declared a trans identity at 15, took T and had a mastectomy and immediately realised she'd made a mistake. She puts her error down to being gender non conforming, and hating being a girl following a sexual assault.

Case study 3 - Dad of a girl hospitalised with an eating disorder, and referred for medical transition. She told him that she identified as trans in order to be eligible to have her breasts removed because she hated them.

Case study 4 - young person very happy with transition including double mastectomy

The interviews with the medical people are very interesting, including a couple of True Believers spouting things I think they'll regret.

I made a start on an English transcript. If anyone's interested, post below and I'll see if I can finish it up tomorrow. (The stories include self harm and suicide attempts.)

Enquete - 29 Feb 2024

From mixed sex toilets to the new youth trans law of Alberta, you know that trans is a polarising and politicised subject.

This week we'll look at this topic from the medical perspective, calmly, and above all with the people directly concerned - trans adolescents and their parents.

PRES: Noone wants to prolong the suffering of young people uncomfortable in their skin, but in the rush to take medical steps on their bodies, are we taking the time to really evaluate what's going on in their heads?

PARENTS of CLARA: They told us she'll start these hormones, she'll become happy, it will liberate her. But it wasn't like that. Not at all.

JANE: quote

PRES: I'm Marie Maude Denis, welcome to Enquete.

NARRATOR: This fourteen year old girl is going to her first gender clinic appointment. She doesn't need her parents' consent. For her transition she has multiple options, like hormones and surgeries, from publicly funded medicine, or privately. How is such treatment organised by our health system, we wanted to know. We asked teens who took major decisions, with sometimes irreversible consequences.

PARENTS OF CLARA: When she came back from Christmas holidays at her Dad's, I found her hiding in the wardrobe and she was cutting herself. That's how it started.

All names changed.

Clara is an only child now 24. She was a model student, serious and very sensitive.

CLARA I had challenges with my mental health right from the age of 8. I put a belt around my neck.

From childhood, Clara was troubled with anxiety, compounded by bullying when she hit puberty.

CLARA I got lots of comments about my appearance. I thought my face was deformed. I hated to see myself in the mirror.

In 2025, on the internet, she came across what she thought was the cause of her discomfort.

CLARA: At that time there were loads of young people blogging. I encountered the idea that someone's gender was defined by how they felt inside. I didn't see myself as a woman any more than I felt a man.

PARENTS: AT first she said she was agender. I don't identify as a girl, I don't identify as a boy. I thought, Yes, Ok, that's the problem. If that's what she wants to work on, we'll go along with her. So, I did some web research.

Suzie found a psychologist specialised in GD. AT 15yo Clara became her patient.

PARENTS From the first appointment we were told it was vital, straight away to call her by her boy's name, to take steps to start hormones, like a race against the clock.

Responding immediately to the needs of young trans people is one of the pillars of the approach taken in Quebec.

ANNIE PULLEN SANSFACON The longer a young person has to wait before medical intervention, the more you see their mental health degrade.

APL is former Chair in research into trans children and their families. She favours the so-called trans affirming approach.

APL: For us, the affirmative approach is that the only person who can determine someone's gender identity is the person themselves. That's the basis of it.

This is also the method used by Clara's psych, who quickly issued referral letters for the name and sex registration change of her client.

SUZIE: I said, well if that's all, I'll call her by the name she wants. I just want to save her. Then she brought me all this evidence, like that my daughter faints or throws up when she has her period, ah, that's her body rejecting her feminine side. And then at I thik the third visit, she says to me 'Mum, actually, I'm a trans boy because I'd rather be an effeminate boy than a butch woman.'

But it's not that simple. Clara is unstable, impulsive and hypersensitive. Some other professionals sugeest she has characteristics of BPD. Her parents suggest this to the psych.

DAD Well, couldn't it be BPD? I wanted to see her reaction. She said BPD doesn't exist. People with BPD are really trans.

In Quebec to start a medical transition you need one letter of recommendation. Clara got one, and moved on to the first stage.

CLARA First of all, you get Lupron. That's hormone blockers. It stops puberty.

Lupron is a medication which puts the brakes on the production of hormones during puberty and allows the young person to think about their gender identity. Since 2010 prescriptions to adolescents have multiplied by six according to RAMQ data. Régie de l’assurance maladie du Québec (RAMQ). And a study shows that 9 out of 10 ados taking blockers continue towards a medical transition.

CLARA My periods stopped immediately.

Clara moved on to the next step - T. She is 15 and in Quebec there is no minimum age for it. In 2013, 10 girls 14-17 received prescription for T, in 2023, 97.

CLARA I got hairier, and my voice began to change. But I didn't like what I saw any better than before.

SUZIE They told us, you'll see, when she starts taking it she'll be really happy, she'll be liberated. But it wasn't like that, not at all.

DAD We could see the changes, but we couldn't see any benefit to her health. Nothing changed. It was just miserable. All the time we've got at the back of our minds - she might kill herself.

__

(haircut chat)

Jane always thought of herself as a bit more masculine than average, a kind of long haired tomboy. Then at 14.

JANE I was watching a livestream and it was all about a coming out story and how the parents had been supportive when they said they were trans. I went 'what's that, transgender?' And when I saw the definition I thought, Oh, there's something there that seems to match me.

That was in summer 2020, and an incident confirmed her choice.

JANE I was sexually assaulted. And I think that tipped ths scales for me, I said to myself, oh, if I was a boy, that wouldn't have happened to me. Plus I was just disgusted at the idea of being a women because of what happened.

Jane knew what she wanted then. Testosterone. Her doctor referred her to a specialist. She ended up at Meraki the gender clinic affiliated with McGill Uni. After Sainte Justine, it's the biggest in Quebec. She's referred directly to an endocrinologist, the hormone specialist.

INTERVIEWER: Jane, who evaluated you to work out if you really had GD?

JANE: Weeeell. Maybe my endo, he asked a few questions. But really that's all there was.

JANE (old video) This morning in half an hour I'll take my first shot of T

Jane gets her T prescription in April 22, after two appointments. She's 16.

JANE I told myself, you're so brave, not everyone could do this. I saw it as something that would free me from feeling awkward in my body.

After four months on T and several suicide attempts Clara is admitted to the Riviere des Prairies hospital. her parents want to know, does she actually have BPD?

DAD: When we told them at the hospital that they'd told us that BPD didn't exist, and that those people are actually trans, the psychologists there practically jumped, they went 'WHAT? She said what? This hospital is full of people with BPD'.

The hospital reviewed the diagnosis of dysphoria. The psych there recommended therapy and stopped the T injections. But when she left hospital, Clara started to inject it again and went straight back to her original psych.

MUM: The appointments, each time I would ask 'What did you talk about?' 'Oh that i have the legal right to go to the men's toilet. So I asked, did you talk about anything else? That doesn't sound like therapy? I said, enough, I'm not paying for legal advice on trans rights and what activism you can take part in. I'm sending you for help. So, that was the last appointment, clearly she was no use at all.

Jane was moving to the next step - mastectomy.

JANE Sure, the fact that I saw other boys around bare chested by the pool, I felt like I was half a boy, not authentic.

ONe and a half years after her first dose. Jane paid for her breasts to be removed by a private clinic. It was last august, she had just turned 18.

Clara was 17.

CLARA I passed as a teen boy and wearing a binder was uncomfortable.

MUM: Driving to the operation I definitely said to her 'are you sure' Because you know I don't want you to have any regrets. She said, 'If I detransition I can always get new ones'.

Thank you. I only managed a few minutes before I got too lost having to pause to work out each sentence. I shall watch it again with the transcript tomorrow.

worrieddragon - Thank you for the transcript. I would very much like to see the remainder if it's practical for you.

@RethinkingLife @Boiledbeetle

MAN: I'm convinced that if I hadn't asked those questions, they would have progressed very quickly. I have no doubt about that.

PRES: It would all be easy if scientists were in agreement about the right steps to take when an adolescent expresses the wish to undertake a transition to the other sex. But as you'll see, debate is fiery.

The team is in NY to secretly attend a scientific conference. They come from all over to exchange views about their field - trans youth. [SEGM logo visible] But these health professionals have to be discreet. Because in the US their ideas are controversial, and sometimes they may be threatened.

SPEAKER: Yes, I've been threatened with complaints, cancellation... even death.

INT: You've had death threats?

SPEAKER: Yes.

The irony here is that this renowned psychologist is herself transgender. She's evaluated hundreds of trans adolescents.

ERICA ANDERSON: Too many health pros accept tht young people can diagnose themselves when it comes to gender. You can't just give a referral letter for hormones to a young person after one session.

She's not the only one to think so. Erica Anderson is following the rules of WPATH. This rules are clear - the adolescent must be evaluated physically, psychologically and socially. EA is one of the stars of this conference. Another is Lisa Littman. In 2018, this US doctor became interested in a new phenomenon.

LISA L: So, I started to notice that in my own community one adolescent after another was announcing that she was trans. A fifth, a sixth, a seventh. And I thought that was interesting.

Littman's study looked at a new idea: rapid onset gender dysphoria. Young people who's GD appeared suddenly, without warning signs in their childhood, and who were influencing one another in social networks. Littman's research relied upon hundreds of interviews with parents. For other researchers, such as APS, this makes them invalid.

APS: The whole idea of ROGD is based on the views of parents. I tell you, parents, they have no idea what's going on in their child's head. When you talk to the children, many of them have known since they were younger, but didn't know how to live it.

LL: I think it was poorly received, primarily because it encouraged caution. These new cases needed to be evaluated a lot more carefully. We couldn't just treat them like previous populations.

Previous populations were those who had always existed before the explosion in numbers in the last few years.

SAMUEL VIESSIERE, PSYCH PROF: Epidemiologically, it was in a large majority little boys claiming to be girls. While in LL's research, it seemed to be much more young girls declaring a trans identity in adolescence.

This radical shift calls into question the model followed for the last 30 years, the Dutch protocol.

SV: This was an attempt, an experiment really, taking on board the views of adult people who had transitioned and said they had really suffered in childhood, to see if you could avert that suffering by intervening sooner.

The idea was to react and prescribe quickly to relieve the suffering of teens who feel that they've been living in the wrong body since they were little. That's what they started doing in Sweden.

MIKAEL LANDEN (Karolinska): It went that way to begin with, it was just a few children a year in Sweden so it seemed reasonable. But then the cases started to shoot up.

Across the western world, the adolescent rate shot up at the beginning of the 2010s. Same in Finland, where psych Riittakerttu Kaltiala was in charge of the country's first youth GD programme. She quickly saw that some of her new patients were not doing well.

RK: We noticed that many of them had a lot of psychiatric problems, especially depression, anxiety and autism.

In 2019 she decided to evaluate the mental health impact of cross sex hormones on the young patients she was seeing at the clinic.

RK: Those who were doing well psychologically before hormones also did well during transition. But those who were already having trouble at school, in relationships or in their family, they continued to have problems. We could see that hormones were not a miracle trick to solve all kinds of different problems.

APS I don't agree that it doesn't sort anything out. There was a RCT published not long ago which showed the exact opposite. They saw a marked difference between those who had access immediately and those who did not.

In the battle of the studies, pretty hard to see who's the winner. In Sweden, psych and researcher ML wanted to get a clearer view. His team evaluated 195 different studies to judge the effects of hormones on trans youth.

ML What we found was that there is no solid evidence for benefits, or that it reduces symptoms of anxiety, depression or suicidal ideation. Which means that overall, we can't recommend this treatment.

I think that's about half. I'll get another chunk done this evening.

@worrieddragon thank you so much for your hard work.

Ugh, how casual some of them are about experimenting on children. Thank you for all your hard work on this @worrieddragon

worrieddragon I appreciate this, not only for your excellent translation but because it sounds like grim listening.

Honestly, it gets worse. Smugly chuckling clinicians incoming.

It's just horrifying seeing these people who obviously think they're lovely, caring people, doing the worst, most dreadful things to these young people and absolutely unable to consider that they might have got anything wrong.

That's why Riittakerttu Kaltiala is my absolute hero. Implemented the Dutch protocol in Finland. Could see it wasn't working. Did the studies on outcomes. Changed course. Very courageous.

It's interesting to compare this with the(also worth a watch - subtitled here) In that one, if I remember, there were a couple of detransitioner case studies, but the real headliner was the child whose growth and bone density were very badly affected by the blockers. The headline here is the extreme speed that very young patients are treated and the complete absence of any diagnostic process, or safeguards at all. Anorexia? History of suicide attempts and self harm? Not just no obstacle, but even seen as reasons to hurry things along. The young woman who seems less ill (but is very clear that her sexual assault was a key driver of her desire to transition) says there was no evaluation at all - she was referred straight from Gp to endocrinologist for hormones.

19m 45 - 27m

Sweden and Finland have both now withdrawn puberty blockers apart from exceptional cases. Both countries have also restricted cross-sex hormones to over 16s. Mastectomies are banned for minors. In Quebec the doctors council is reflecting on the question of trans health care.

ANTOINE: They talk a lot about the Scandinavian model in Quebec. Well, they should look to Scandinavia for a guide on gender treatment too.

To protect his daughter, Antoine has asked us to hide their identities with changed names. Amelie asked to transition when she was in hospital for something else, at Sainte Justine.

A: When my daughter was admitted, it was nothing to do with GD. She had an eating disorder.

Amelie was anorexic. She'd experienced early and difficult puberty

ANTOINE When she started secondary school she already had a woman's body and it was there I think that she started to struggle, to dislike her body, saying 'I think I'm fat' She was really uncomfortable in her skin, particularly about her breasts. She lost weight and it became obvious that she had an ED.

She spent two months at the ED clinic at St Justine. Her parents went to all the appointments. According to them, GD was never formally diagnosed.

A: What's most worrying is that there was no psych evaluation, no-one looked at her history, or really diagnosed her. Nothing like that.

However, two different doctors offered her puberty blockers

A: They gave us a leaflet about a drug called Lupron Depot, puberty blockers. And they said she could consent to it because it's risk free and completely reversible.

Amelie is 15. In Quebec, she has the right to take this decision herself, whether or not to take blockers.

A My daughter couldn't eat. She was in distress, so much anxiety, depression, suicidal thoughts. IT was so, so clear that this was not a person who was capable of consenting to something like this.

Antoine pushed back against the doctors and the option of taking Lupron was dropped.

A I'm sure that if I hadn't asked the questions I did, then she would have been prescribed the blocker very quickly. I've no doubt about that at all.

After further spells in hospital, the emergence of BPD symptoms and further suicide attempts, Amelie finally revealed what she really wanted.

A What my daughter really wanted was a mastectomy. She wanted rid of her breasts. She told me that she'd read on line that the way to get a mastectomy was to say that you're trans.

Amelie is insistent, and gets an appointment at the clinic to discuss her mastectomy. This is March last year.

A That was when I got serious. I said, 'That's enough' She said I can have this, from 16 it can be done and paid for by RAMQ. And one of the dr's first questions was 'Has she been to hospital before?' I couldn't believe it. She's suggesting this surgery and she doesn't even know that my daughter has been hospitalised multiple times. The doctors knew absolutely nothing about her medical history. I thought it was deeply irresponsible to offer any surgery to my daughter in the state she was in. So that night, 4am, I started to write a letter.

The letter was addressed to the Complaints council of Sainte Justine. Antoine said he was deeply troubled by the absence of safeguards for vulnerable teens. He condemned the haste to offer a medical treatment without even checking for evidence of GD. We've met other parents who've experienced similar situation with their 13 year old daughter. They also feel that parents' voices are not being heard.

MAN: There's a whole narrative of fear
WOMAN: It's all based on that.
MAN: And the guilt-tripping. If you don't go along with this, you're putting your child in danger. If you don't go along with it all, you're a bad parent. It's all laid out in advance.

The guide that St Justine gives to parents says that quick action is needed to prevent suicide. The guide has been written by an NGO and is used by multiple hospitals. [image of leaflet 'families in transition'] It contains this statistic, stated also by APS on the TV show 'Tout le monde en parle/Everyone's talking about it' last autumn.

APS Parental support will help mental health. There's a study that shows that strong parental support for a transition reduces suicide attempts by 93%.

INTERVIEWER What's the impact of a stat like that?

APS Support your child. Be with him or her, be ready to move forward and go with them into it. That's strong parental support. It's the number one protective factor for young trans people.

SV As far as I know there are no studies which clearly show a reduction in suicide attempts with an affirmative approach. You can imagine it must be terrifying, as a parent, to be told this.

Once again, the experts disagree. Except on one fact. Trans teens have more suicidal ideation than others. 60% of them.

ML However, perhaps half of these patients who seek treatment for their GD have other psychiatric conditions, which are associated with suicidal ideation. And so we need to consider that.

We went through coroners' reports of suicide in Quebec going back 15 years. There were five reported suicides of young people which mentioned GD. Four of them had diagnosed mental health problems as well as their dysphoria.

Four months after sending his letter, Antoine received a reply. - M. your comments, along with others from patients and their families, raised questions for all the members of the clinic. Since then, clinicians are better equipped and the clinical approach to children and their families has been significantly changed.

A: I was expecting a dry reply, to be honest. But I really got the impression that some reflection had happened. They said clearly that they wouldn't proceed with surgery unless my daughter wanted to initiate steps when she reached adulthood.

PRES: After the break: an operation which didn't meet expectations.

27m - 36m30

CLARA I still couldn't look in the mirror because I still thought I looked deformed.

PRES A gender transition starts, in general, with puberty blockers, followed by hormones. and then comes the question of surgery. And that's something that's been experienced very differently by different young people. They'll tell you about it.

To talk about sexual identity we have Francoise Susset, psychologist. If there's a standard-bearer for the rights of young trans people in Quebec, it's FS.

[INSET INTERVIEW FOOTAGE]

Mme Susset describers herself as an 'engaged psychologist'

[INSET] There's lots of misinformation around which will alarm parents and families.

She works at the Meraki clinic and offers a number of training courses about dealing with trans patients.

[INSET] Quite often I get teen boys and girls in my office who turn up with a file that's, like, 5 cm thick. Every diagnosis has been shoved into this file. Everything except GD. [chuckle]

She talks about the mental health problems often diagnosed in young trans people.

[INSET] Let's talk about BPD. Why? Because it's the diagnosis most often confused with GD. And it's often really overdiagnosed among trans and NB people.

This four hour training is offered to her colleagues in the medical association of Quebec.

[INSET] I've never seen a treatment as dramatic as testosterone or oestregen for a trans person. There is no antidepressant which is this effective.

ELIOS It takes time. Blockers, hormones, it takes a lot of time. It's a slow effect which is going to help me feel better in my life. It lets me feel more comfortable in my own skin.

Elios started transition at 15. He spent his childhood uncertain about his mental health and his gender identity.

E: At my second appt my psych said, I think you know this already, but I'm going to give you a GD diagnosis. What happened was that I made several suicide attempts, which put me in A&E. And the same year I started the blockers and testosterone.

T is a relief. But it's not enough.

E: Yes, I'm doing better. But I'm not doing well. And that's because there's another solution I needed.

That solution - a double mastectomy at 16.

E: I arrive at the clinic, I'm super stressed, nervous. I didn't want to not do it! I was just scared of what could happen. No hesitation.

Clara didn't hesitate either. At 17 she had a double mastectomy after 2.5 years of T.

SUZIE: I saw straight away maybe the next day, or the day after that, that she'd made a mistake. I felt it in her energy.

CLARA I honestly thought I still looked like I had a woman's chest. I couldn't even look at myself in the mirror. I thought I still looked deformed.

S: Start of September I think, she started to cry. And she didn't stop, crying and crying. I said are you going to tell me what's up? And she couldn't speak, she was crying too much. And I said 'Is it that you want to detransition?' And she said yes. Yes, I've already stopped T.'

At 20, Clara gets a wig, breast implants and starts to learn to become a woman again.

C: It happened naturally by spending time with other girls. I had to be socialised, but I had a lot to catch up on because I hadn't gone through the important stages of a girl's adolescence.

Like Clara, Jane realised that she'd made a mistake.

J: The regrets turned up maybe just a week later. That was really when I started to see the results, the drains came out and I saw... I had just my bandages and I saw that it was flat. It was real. That was last October.

Two months after my surgery I decided to write to them and say, it's not working, I've decided to detransition. I wanted to talk to my surgeon as quickly as possible to ask if my breasts can be reconstructed. Am I stuck like this for the rest of my life, or is there anything I can do?

The first response I got, before I'd thought about breast reconstruction, they said that I had to wait two to three years and have a psych review for at least a year. Noone reviewed me psychologically before taking my breasts off!

My surgeon said to me, that if it had been her own child, she would have asked them to go more slowly. She'd have slowed it down for her own kids because she thought it all happens too quickly and people aren't necessarily giving themselves enough time to reflect.

Before 2017, no minor girl had a mastectomy in Quebec. In 2023, there were 18.

Jane is coping OK with the consequences of taking T.

J: My voice is deeper. And lots of people comment about it being deep. There, I can do voice training to make it higher.

But less well with the mastectomy.

J: If only I could have avoided the surgery. I think about it all the time. I was in bed, having a go at myself, and I was like, 'if only I could go back in time, just, not far, just before the surgery, so I could say to myself 'don't do this. You're going to regret it'.

[INSET - FS] Among the tiny, tiny number of people who might detransition, there are very few among them who actually have regrets. Of course, people who have regrets, tend to make a lot of noise about it, don't they? [chuckles]

We don't know how many trans people have returned to their original identity. But according to the psychologist, those who have regrets mustn't obscure the positive experience of the majority.

[INSET - FS] So, what do we do? Penalise the 99.07, 99.7% of people for the tiny, tiny, tiny percentage, the infinitesimal percentage of people who might have regrets about certain aspects of their transition.

Mme Susset refused us an interview.

In her letter she states that
We have no reliable way to distinguish those people who might detransition from the large majority for whom the step... will relieve considerable suffering.

APS Well, yes, there are those who regret it. I am very sorry for those young people. You know we must try and find the best ways to accompany them on their journey. But I think everything happens upstream. And if we could do that, we'd get a lot further. And you know, it's easy, isn't it, to just blame the first person around you?

[No idea what she's trying to say here. It would work better if we intervened earlier? The problems date back further than transition? She gets visibly uncomfortable. Squirming, even.]

C: It was very hard for me to agree to do an interview with my face on show because I was so afraid of being judged. Or that people would just think well, I brought it on myself.

E: When I saw the results I started to cry, hard. I don't think I'd every cried so much from joy in my life. My Dad was full of questions like 'What's going on, are you OK?' I just said 'Dad, it's the best decision I've ever made.' People who detrans should be respected. I don't see why anyone should criticise them, say negative things or whatever. They made a mistake, that's all.

PRES How quickly can a fourteen year old girl get Testosterone in Quebec. The answer may surprise you.

Such a lot of hard work worried dragon, thank you or rather merci!

@worrieddragon

Merci beaucoup d’avoir pris le temps et la peine de transcrire tout cela. C’est très apprécié.

Ah de rien mes amies. I don't get to use my French very often, so it's been a rewarding mental leg stretch at the weekend and I hope it's useful. I am so angry on behalf of these young people who've been so dreadfully let down by these awful people, self-identifying as heroic medical saviours.

It's very powerful to see the smug dismissal of the 'petit petit petit nombre' of people who experience regret alongside these awful stories of very vulnerable girls, hastened down a very harmful route. And the way the pro-affirmation psych fell apart when asked about detransioners. I don't think it was my French failing me. She was just incoherent.

I'd love to know whether this is making any waves in Canada.

It's a depressing watch. These kids are being fed through a production line with absolutely no thought as to what may actually be causing their distress and with no thought as to whether there may be a better way to help these children.

The poor girl who had her breasts cut off with hardly any thought from any of the medical professionals who on realising she'd made a mistake is now having to wait years and go through intensive psych reviews in order to have them reconstructed.

Why can they not see that it would have made much more sense to do the waiting and the psychiatric evaluations prior to cutting the breasts off a teenage girl.

Anyway, last chunk. And they saved the worst till last.

36m30 - end

As we saw with Elios many young people are happy to have made a medical transition to affirm their gender. To get a hormone prescription, trans teens and their families describe a process of several meetings with a doctor or psychologist in the public network. But privately, let's see how quickly you can get that prescription.

In Quebec the number of trans teens is growing, and the waiting list for specialist clinics is getting longer. Eight months at Meraki, a year at St Justine.

[SECRET FOOTAGE] Who are you seeing today?
With doctor BEEP.
OK, we'll open a file for you.

For those who don't want to wait, or can't, there's another option. Private providers.

OK, here's a clinic of sexologists and for $115 they'll offer a consultation. And at the end of that consultation they'll give you a referral letter for hormone therapy. It says it will take one or two meetings for the letter. This is private. We got a message from a Mum who said that her daughter had told her about this doctor. This GP sees the patient and prescribes, without any reference to any other healthcare professional. The clinic is private - the patient foots the bill.

Here we meet Sacha, played by a 14 year old actress.

[SECRET FOOTAGE] Sasha prefers to go all by herself is that right?
[Sorry, just to highlight here because I'm so shocked - the 14 year old attends this clinic on her own!]

She tells the dr that she identifies as trans.

[SECRET FOOTAGE] OK, I give you this. Here's a pencil. You can go through the document and initial it, or you have to sign.

She has to read and sign a seven page document which describes the secondary effects, some permanent, of testosterone, before she can go into the doctor's office. This is the first time the dr has seen this patient. She gets straight to the point.

[SECRET FOOTAGE] So, can you tell me how long you've known that you're not in the right body? Was it childhood, or more at puberty?

Sacha responds that she dislikes her body and made herself throw up at the age of 12.

[SECRET FOOTAGE] My mum sniffed me out [?] She took me to a psych, who said I had an eating disorder. I said to myself that wasn't it. It didn't make sense in my head. But when I was 13 I came across a video of a trans person talking about how she had an eating disorder but that really it was because she was in the wrong body. And I thought, I'm just like that.

The doctor asks whether her parents are supportive.

[SECRET FOOTAGE] And do your parents know what's going on?

S: Yes, a bit.

Dr: Do they know that you're here?

S: Yeah

Five minutes into the consultation, she raises the question of surgery.

Dr: And are you thinking about having surgery in the future?

S What kind?

Dr: Mastectomy, remove your chest. There are also other surgeries. You have a uterus, inside, with ovaries. So, you can have those removed. That's something that can cause dysphoria too sometimes.

Testosterone can make a woman infertile. The subject of fertility is dealt with in one question.

[SECRET FOOTAGE]

Dr: And does fertility, I know it feels far off to you at 14, but, is fertility something you want to conserve before you start?

S: No, I've always known I don't want children.

And, finally, less than 9 minutes into the consultation...

[SECRET FOOTAGE] OK, what's next is I can prescribe hormones today theoretically. Because the logic is, in the background, there's nothing in what you've told me which would stop me giving you hormones. I'll start with a dose, it's not a mini dose, sort of half way between adult and... non-binary, let's say. No problem. The best is yet to come.

[Again, not sure it's my French. I think this person just wasn't very coherent.]

The consultation has lasted less than 17n. The effects of testosterone haven't been raised, which may seem surprising. Confronted with this, the doctor responded that the quality of a consultation shouldn't be judged by its length, but by the quality of the information exchanged.

Medical transitions are taking place more and more quickly, with younger and younger teens. Meanwhile elsewhere in the world, there are calls for caution. Quebec has appointed a review committee, but the discussion remains to be had.

SV When it comes to questions of gender, it has become impossible to question what the patient says, what the patient asserts. And this has a huge risk of undermining confidence in institutions, and in medicine.

SUZIE Transitioning children shouldn't be done lightly. I can't believe the direction this has taken. That speed has become the priority. That eight years later there's no progress, not even a consensus.

JANE When you transition there are lots of people who welcome you. Everyone wants it to go fast. No-one questions anything. But when you want to detransition, they call everything into question. All of a sudden you're right down the priority list.

Jane is training to be a hairdresser. She's saving up for a breast reconstruction surgery.

Antoine's daughter is 18. She's given up on the idea of a mastectomy and no longer identifies as trans.

Clara lives with her mum. She's just finished her second year at uni.

Elios is studying visual arts at CEGEP He is happy with his choice and wants to make the most of it.

[suicide helpline numbers for Quebec]

Thank you once again @worrieddragon you did a wonderful job.

The undercover bit was shocking. The consultant feeling she had to say you have a uterus and ovaries inside, made me think she's had that conversation with many girls who are unaware of their internal female anatomy.

And whilst there is a high chance at 14 you are correct in you're assertions you don't want children in the future you can't know that for sure. I mean I knew I didn't want children from when I was 5 but it never occurred to me that I wouldn't have them at all. I always assumed my thoughts on that would change or that fate would intervene and I'd end up having kids regardless.

It's just all so upside down.

I've spent a lot of time in hospitals and under various consultants over the years as I have a lot of different medical issues and the one thing that has always been the same is how difficult it is to get consultants to believe you and then once they do how difficult it is to get drugs or surgery to correct the problem.

So the fact that on this one issue of permanently fucking with children's bodies the medical establishments throw everything out of the window and rush these kids through at lightening speed is very concerning. You have to assume the push is coming from the companies/organisations etc that gain the most out of making healthy children life long medical patients.

I hope the girls in the programme eventually make peace with what happened and don't blame themselves in any way. The doctors who should have protected them willingly led them down paths of harm.

And as for Elios, I didn't see much trans euphoria there. I just saw a confused girl who probably didn't fair well as a teenage girl and was persuaded that this was the answer to her problems. Whereas I think just giving it 5-7 years to come out of the other side of childhood into adulthood and away from the more toxic elements of high school would have led to a better quality of life for her in the long run.

Yes, Elios still came across as quite fragile. And this programme didn't even raise the longer term consequences of testosterone - vaginal atrophy, painful orgasm, increased risk of cardiovascular disease etc etc.

And imagine taking at face value statements from a 14 year old
'Yeah, my parents know I'm here' and 'No, I know I don't want kids'. And asking 'do you want to conserve your fertility?', in those words, to a child where you also feel it's necessarily to point out that she has a uterus and ovaries inside her. How many 14 year olds would have a clue what 'conserving your fertility' might mean? The whole interaction was just $$$.

It was revealing. I'm just amazed that it got made at all, leave alone in Canada.

Du très beau travail, Dragonne inquiète! Merci beaucoup.

(First post, but I've been lurking and educating myself ever since I saw a reference to Tranada online.)

Enquête is a well respected television programme. Its investigatory journalism often leads to follow-ups from newspapers.

I had to laugh at the comment about Radio-Canada. The name dates back to pre-TV times; they just added ICI to it quite recently. It's a public broadcaster and its news and entertainment programmes have a solid audience in Québec. (It also has radio stations...)

Annie Pullen Sansfaçon is a professor of social work at the Université de Montréal. She was recently on Tout le monde en parle, a very popular Sunday evening talk show, where she sped through the usual mantras (assigned at birth, spectrum, scientific proof, puberty blockers completely reversible, suicide risk). No pushback from the host and co-host, who, to be fair, are mostly from the comedy side of things and are pretty woke anyway. One of the other guests, Stéphan Bureau, is a journalist and asked a couple of questions, but clearly wasn't familiar with the file and wasn't in a position to insist answers from APS.

There have been a couple of articles about trans matters in La Presse, a mainstream, middle-of-the-road newspaper, but they don't seem to have generated much discussion. That may change if some guy tries to take over women's sport!