When speaking of transgender children and whether or not they should be able to consent to sex reassignment therapy and sex reassignment surgery, it is necessary to look at whether the country deems these individuals as competent enough to make this life-changing decision. Within Canada, all provinces and territories, with Quebec as an exception, state that a patient does not need to reach the age of 18 to give consent to any treatment (Canadian Medical Protective Association, 2016). With the topic of consent from minors, the Supreme Court of Canada has affirmed a “mature minor” doctrine. The Convention on the Rights of the Child recognizes the concept of “mature minors” which limits parental rights and allows for the minor to act on their evolving capacities toward self-regulation (Knight, 2014). An individual is deemed competent to make their own medical decisions if they are able to understand the medical information that is being presented to them and is able to reasonably foresee consequences based on their decision (Canadian Medical Protective Association, 2016).
Who decides whether the individuals are competent enough to make a decision?
Physicians are authorized to determine whether a child has the mental capacity to provide consent to their medical decision(s). Physicians use their best judgement when concerning whether a minor is deemed competent on a case to case basis. Depending on the complexity of the decision, an individual may be competent enough to make some medical decisions, but not others (Knight, 2014). If a professional is confident that a minor has the capacity to consent, it is very likely that the physician would allow the child to authorize consent on the medical decision being made at that moment in time. Even if the child is able to consent to medical treatments on their own, parental involvement is recommended as some medical decisions could pose serious risks and ever lasting effects on the individual. However, when a minor is found incapable of making their medical decisions, parents and/or legal guardians will be asked to consent on the minor’s behalf (Canadian Medical Protective Association, 2016).
Is their an age requirement for a sex reassignment surgery?
Up until this point, the topic of consent to medical decisions has been vague, allowing for one to question on whether there may be exceptions. Although, as already stated, there is no minimum requirement for sex reassignment therapy and/or sex reassignment surgery in Canada. The same guidelines and regulations apply to minors consenting to sex reassignment surgery. Again, it is up to the physician to determine whether the individual is capable of making this decision for themselves (Ontario Ministry of Health and Long Term Care, 2016).
Transgender Children 