Alberta Premier Danielle Smith repeatedly claims the effects of puberty blockers are irreversible and threaten an adolescent’s ability to have children in the future, justifying the province’s current restrictions as necessary to protect LGBTQ+ youth.
“I encourage you to look up what puberty is,” Smith told reporters at a news conference in Edmonton last September.
“Puberty is the process a child goes through to become sexually mature so they can have babies. Puberty blockers, by very definition, stop that process. Someone cannot have children if they don’t become sexually mature.”
The United Conservative Party premier argues that delaying access until age 16 “doesn’t interfere with their ability to have kids” and is a necessary safeguard, warranting her government’s use of the constitution’s notwithstanding clause to shield it against judicial scrutiny.
In December, the UCP government invoked the controversial Charter’s notwithstanding clause to shield a set of three laws that regulate names and pronouns in school, ban transgender girls from amateur female sports, and restrict gender-affirming health care for youth, including prohibiting Alberta doctors from prescribing puberty blockers and hormone therapy for those less than 16.
The Calgary Journal took up Smith’s challenge to reporters and looked up what puberty blockers do and do not do.
Evaluating the scientific evidence
In informing her policy, Smith relies on “common sense” and research by The Cass Review, which Yale Law School criticized for including little input from practitioners, clinicians, and psychologists who work directly in the gender-affirming care field.
While the Cass Review was interpreted by some governments as a turning point in policy, the independent report commissioned by England’s National Health Service (NHS) calls for caution and further research on care rather than outright bans on treatments.
Its conclusions, however, have received widespread criticism, including opposition from the World Professional Association for Transgender Health, the Canadian Pediatric Society, and the American Academy of Pediatrics, who question the review’s process and content.
Several peer-reviewed medical research consistently describes puberty blockers as a safe, reversible and life-saving intervention.
One study concluded that since the 1980s, puberty blockers have shown to be “effective, safe, and reversible in pausing the effects of puberty.”
Research from the Canadian Pediatric Society in 2023 also found that pubertal development will resume in youth once pubertal suppression is stopped.
The study also highlights that puberty blockers have been associated with lower odds of suicide.
Similarly, another study published in the National Library of Medicine stressed that access to puberty blockers improves mental health, as their research found a strong association between access to these medications and lower suicidality.
Access to puberty blockers becomes increasingly important when youth experience gender dysphoria. According to MyHealth Alberta, the condition involves feeling emotionally distressed when one’s gender identity — “inner sex” — does not align with their sex assigned at birth.
The government information site says that gender dysphoria is not limited to adults, since children may “have similar feelings…including feeling upset about parts of their body that don’t match their gender identity.”
Non-binary and transgender people are said to experience gender dysphoria most often.
For transgender youth, their motivation behind pursuing puberty blockers is to delay the irreversible development of puberty.
In a 2021 academic review published following the UK Bell v. Tavistock ruling, which overturned a UK ban on youth under 16 taking the medication, researchers argued that puberty suppression is intended “to allow the adolescent time to carefully consider whether or not to pursue further transition.”
Medical research continuously demonstrates how the effects of puberty blockers are reversible, including a 2025 academic review highlighting “the current consensus among professionals in the field is that the effects of puberty blockers are reversible.”
Another academic review on decision-making and long-term impacts found that fertility concerns occur later in care, particularly when youth are moving from puberty blockers to gender-affirming hormones.
Decisions around fertility preservation are complex and involve parents, clinicians, and youth over a long period of time.
Regardless, research emphasizes that fertility risk is associated with later care that youth may pursue, and not with puberty blockers alone.
Fertility is discussed, and care is thorough
Corinne Mason and Leah Hamilton are Mount Royal University researchers studying the impacts of anti-LGBTQ+ legislation on youth and their families in Alberta.
The pair just completed their pilot study, Queer Parenting in the Time of Parental Rights.
Together, they’re now pursuing a province-wide study based on long-term focus groups, interviews and surveys with parents of queer and trans youth.
By talking with parents, Mason and Hamilton are examining the impact of the “parental rights” movement on families and how anti-LGBTQ+ legislation is harming youth.
Mason, a professor in MRU’s faculty of women’s and gender studies, says Alberta’s current political rhetoric surrounding fertility prioritizes a hypothetical future at the expense of youth’s present well-being.
“This hypothetical — will I have a biological family later — it’s been given primacy over the ability of trans kids to become trans adults,” Mason said in an interview with the Calgary Journal.
They say that framing reflects a narrow, traditional understanding of family, one that queer families have never relied on.
“We all make family in all kinds of ways,” said Mason. “Through donors, through surrogacy, through adoption, through chosen families, through blended families. In all kinds of ways, we’ve created our families.”
Mason says this complex reality is missing from current government discourse, which tends to position biological reproduction as the default way to build a family.
When biological reproduction is a goal for youth, however, Mason says fertility is addressed repetitively and deliberately.
According to Mason and Hamilton’s research, parents of youth who have access to gender-affirming care say that conversations with medical teams about risk already include conversations about reproduction, ones that unfold over time rather than as a single decision.
“Our research shows that this issue is not passed by quickly,” said Mason. “They are conversations that happen not just once, but in multiple appointments over a long period of time.”
Mason highlighted that fertility risks are discussed when relevant within the care, particularly if a youth considers moving from puberty blockers to hormone therapy, and families are supported through those decisions.
“There are options, and those options are given to families, to youth and their parents in a consensual, medical, caring setting around what to do and how to think about the future for reproduction,” said Mason.
“We did not have to suppress the care in order for those questions to be answered.”
Hamilton, a professor in MRU’s faculty of business, communication studies and aviation, believes Smith’s claims erase the effectiveness of gender-affirming care alongside the experiences of queer families.
“If we want to talk about parental rights, you didn’t consult with this group of parents,” said Hamilton. “Their children’s rights, their rights as parents, and the rights of their children’s physicians have been taken away.”
Hamilton adds the idea that restricting access to puberty blockers protects children contradicts both academic research and lived realities.
“Puberty blockers save lives. They buy youth time,” Hamilton stressed.
Contradictions in Alberta’s own policy
Under Smith’s leadership, the Alberta government has repeatedly pointed to a lack of long-term research to justify restricting puberty blockers for transgender youth.
But research gaps such as these are not unheard of in pediatric health care.
Ethical testing practices in the medical field often limit long-term or experimental studies on youth, which means uncertainty exists across pediatric medicine — not just within gender-affirming care.
This uncertainty hasn’t stopped the governing UCP from continuing to allow access to puberty blockers for cisgender youth — people whose gender identity aligns with their sex assigned at birth
This therapy typically includes helping children experiencing precocious puberty (or early puberty) commonly through the prescription of leuprolide, a puberty blocker.
Mason said this exception undermines the government’s claim that the medication is inherently dangerous or irreversible. They point to the continued availability that often helps cisgender girls experiencing early or intense puberty.
“If you are worried about sterilizing people,” wondered Mason. “Wouldn’t you be concerned about sterilizing young girls?”
Hamilton said the distinction written into current policy reveals what legislation is really targeting.
“There’s nothing that gets the public riled up more than rhetoric of protecting children,” said Hamilton. “This government has weaponized that type of language to instill fear, anger and outrage in the public, even if that is rooted in misinformation and disinformation.”
‘Why is the threshold death?’: Queer researchers
Mason and Hamilton’s research documents what families say has happened since Alberta announced and passed its anti-LGBTQ+ legislation.
“Every single person I speak to has said that the legislation has basically put gasoline on a fire,” said Mason.
“Kids aren’t leaving their houses. They’re not going to school. They’re being homeschooled because of fear. They’re changing schools because of increased bullying and harassment. They don’t know who’s safe anymore.”
Mason said the focus on hypothetical future fertility is distracting from the immediate harm transgender youth are facing.
“There’s great evidence around the decrease of suicidality in relationship to their ability to access puberty blockers. And again, why is the threshold death for trans people and not for anyone else?”
They question why this evidence hasn’t shifted current policy.
“I find it very frustrating that every time I’m talking about trans youth, I end up saying, ‘They’re dying,’” said Mason. “It’s true. Research shows this.”
The facts about puberty blockers
Smith dismisses critics who say she’s misleading the public about puberty blockers, such as in an interview last September, in which she was unequivocal about puberty blockers leading to sterilization.
“When you give puberty blockers to a child who’s not gone through puberty, they don’t become sexually mature, which means they can’t have children,” said Smith. “And we just happen to be of the view that those are decisions that are made when you’re a grown-up.”
But experts say that’s misleading, warning that misrepresenting the evidence risks causing real harm to the very youth Smith said she’s trying to protect.
The governing UCP’s framing also fits a broader conservative strategy seen in the U.S, where debates over gender identity and “parental rights” have become a central political talking point.
By enforcing restrictions disguised as child protection, political parties can mobilize socially conservative voters.
The current medical consensus does not describe puberty blockers as irreversible, nor inherently sterilizing. Fertility risks have always been present in conversations about gender-affirming care, and include youth, their parents, and their physicians.
The Calgary Journal requested comment from the premier’s office, but did not receive a response by our deadline.
Read the Calgary Journal’s fact-check about Smith’s claims about transgender athletes here.
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