Advocates concerned Alberta conscience rights bill could put trans people at risk

Advocates say a bill before the Alberta legislature, purported to defend the conscience rights of health-care professionals, could effectively legalize discrimination against transgender people. 

Bill reopens debate on physicians' conscience rights

Holly Tomm, president of the Trans Equality Society of Alberta, says Bill 207 would make it legal for doctors to discriminate against trans patients. (Craig Ryan/CBC)

Advocates say a bill before the Alberta legislature, purported to defend the conscience rights of health-care professionals, could effectively legalize discrimination against transgender people.

Critics say the bill strips the requirement for health-care professionals to refer a patient to another physician if the patient's needs conflict with their personal or religious beliefs.

"This bill, as it stands, is going to create a situation where there will be legal, government-sanctioned discrimination," said Holly Tomm, president of the Trans Equality Society of Alberta.

"It needs to be stopped."

The private member's bill was tabled by United Conservative Party backbencher Dan Williams on Thursday. Williams told the legislature that Bill 207 is meant to ensure health-care professionals don't have to choose between their convictions and their jobs.

Tomm said it could give doctors who have personal or religious beliefs that deny trans people's identities the legal grounds to deny services or a referral to another doctor.

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"When your beliefs affect my rights, that becomes harm," Tomm said.

Right to timely, effective care

To qualify for gender affirming surgery in Alberta, a trans person must get a diagnosis of gender dysphoria from one of five psychiatrists in the province with a specialization in transgender psychiatry. Gender dysphoria is when a person's gender doesn't align with the sex they were assigned at birth.

Tomm is concerned the bill would make it legal for a physician to refuse referring a patient to those psychiatrists, or even directing the patient to another doctor who is willing to give the referral. 

She said it could have implications around access to hormone therapy.

Even in cases where a patient's needs are not trans-specific, Tomm said she fears a physician could deny general care.

"You, as a citizen of this province, are being denied your right to timely and effective health care based on somebody else's beliefs," Tomm said. 

Conscientious beliefs

The bill passed first reading on Thursday, with all UCP members present voting to advance debate, including the Health Minister Tyler Shandro. A spokesperson for Shandro's office said the minister and his staff did not advise or help draft the bill.

Apart from the potential effects on trans health care, Tomm and other critics have said the legislation could have broad impacts on LGBTQ patients, as well as access to abortions, contraceptives and medically assisted death.

The bill says a regulating body, such as the Alberta College of Physicians and Surgeons, cannot compel a health-care professional to "directly or indirectly" perform a service or make statements contrary to their "conscientious beliefs." 

The bill also seeks to amend the Alberta Human Rights Act to include conscientious beliefs as prohibited grounds for employment discrimination.

In a video posted on Twitter, MLA Williams said he introduced the bill in light of recent Ontario case law attacking conscience. In May, Ontario's highest court ruled doctors in the province must give referrals for medical services that clash with their religious beliefs.

Tomm and other critics say Bill 207 is an attempt to undo the same standards of practice enforced by Alberta's health-care regulators, including those that govern doctors and psychiatrists.

"It's a huge problem," said trans advocate Jan Buterman, who was involved in a lengthy lawsuit after he was fired from the Catholic School Board when he notified the board he was transitioning. 

Buterman said the bill opens the door to discrimination, while thwarting complaints. 

If the bill were to become law, any complaints related to a health-care provider's decision to refuse service based on conscientious belief must be dismissed by the regulatory body.

"Effectively, it strips the ability of the patient to make a complaint," Buterman said. 

Tomm said she expects the law, if passed, would be challenged swiftly in court because Alberta and federal human rights prohibit discrimination on the basis of gender identity.

Trans people would be left vulnerable to discrimination as challenges made their way through the courts, Tomm said.