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The U.S. government has encouraged people to report on doctors in Canada who provide gender-affirming care to children—signaling a chilling new cross-border reach in its anti-trans agenda.
In mid April, the U.S. Department of Health and Human Services (HHS) posted a form on its website soliciting “tips” about the “Chemical and Surgical Mutilation of Children,” echoing the language of Donald Trump’s executive order attempting to block gender-affirming care to those under 19 years old.
The website promised to protect “whistleblowers” and contained a drop-down menu that included the provinces and territories of Canada, as well as Canada’s Armed Forces—effectively allowing reports to be filed against health care providers located north of the border.
When pressed for an explanation by Pivot and The Breach, the U.S. Health department removed Canada from the form. After repeated media inquiries, an HHS employee confirmed that Canada had been erased from the form without providing a reason for the initial inclusion or the removal.
Prior to the change, the department refused to answer direct questions about whether the inclusion of Canadian jurisdictions was deliberate, and, if so, why Canada was targeted.
Canada’s initial inclusion in the whistleblower form sparked fears that the reports could be used to establish watch lists, detain Canadian health care providers at the border, or even take legal action against Canadian health care professionals.
All of this could also make it harder for American citizens to obtain care in Canada, in particular to circumvent bans imposed in the United States on gender-affirming care.
It remains unclear whether HHS is actively investigating Canadian doctors. The department has not responded to follow-up questions. The Breach and Pivot have filed a Freedom of Information request to seek clarification.
In April, the U.S. Department of Health and Human Services (HHS) quietly posted a whistleblower form on its website for reporting health care providers—including those in Canada—who provide gender-affirming care to children. The Canadian jurisdictions were removed after repeated media inquiries from Pivot and The Breach.
Gender-affirming care for minors is legal and available in Canada, and the United States has “no legislative power” in Canadian jurisdictions, points out Florence Ashley, a lawyer and bioethicist.
According to the Government of Canada’s website, genital surgeries are never offered to people under the age of 18, in accordance with the standards of care of the World Professional Association for Transgender Health.
GrS Montreal, a clinic offering gender-affirming surgeries, states on its website that the minimum age for mastectomy (torso masculinization) is 16—also consistent with the association’s standards.
For children, gender-affirming medical care is typically limited to puberty blockers and hormones.
Canadian sovereignty challenged?
Trans rights activist Celeste Trianon said that the original version of the form amounted to a violation of Canada’s sovereignty.
“I believe this is the first time the United States has infringed on the sovereignty of Canadian doctors, certainly through a whistleblower form,” she said.
“HHS is trying to use its influence to attack health care providers, not just in the United States, but here in Canada as well. This isn’t just absurd; it’s a covert threat to trans people in Canada, including those who fled the United States because of Trump’s anti-trans policies, and we’re next.”
Trianon added the threat would likely spark greater outrage if it concerned a different community.
“If it were any other group being targeted, we would be in a moment of national scandal right now. But since trans people, including trans youth, are seen as disposable, our society chooses to ignore it all. When are we going to act? Standing up for the rights of trans people is defending our Canadian values.”
The trans right activist also pointed out that attacks on trans rights in the United States don’t stop with children and can have “collateral damage in adult access” as well.
In response to questions from Pivot and The Breach, the Quebec Ministry of Health stated that “the actions of the United States government regarding gender-affirming care for children do not influence the guidelines that Quebec has established for this care.”
Quebec also emphasized that, to date, no genital surgeries have been performed on minors, even as a committee has been established to assess exceptions.
A spokesperson from the Canadian Armed Forces said in a preliminary call on April 17 that “this maneuver does not make sense and [that] the United States has no legislative power here.
What other countries do and say does not influence us.”
In a follow-up email a week later, the Forces said: “Providing all members of the Defence team with a healthy, respectful and inclusive work environment, free from harassment, discrimination and bias, is a priority for our institution. Diversity of perspectives and lived experiences contributes to our success as an organization.”
A Health Canada spokesperson said the Canadian government is reviewing the matter further, following a request for comment.
A U.S. crackdown
The HHS whistleblower form followed an executive order from the Trump administration on January 28, 2025.
The order, which was called “Protecting Children from Chemical and Surgical Mutilation,” aimed at ending access to gender-affirming care for children, a focal point of Trump’s second presidential campaign. It is currently blocked in some states.
Most major medical associations in the United States, such as the American Medical Association, the American Academy of Pediatrics, and the American Psychological Association, support access to such care for minors and oppose restricting it.
An exodus of trans and non-binary Americans to Canada has begun to take shape since President Trump’s inauguration, with some even seeking asylum.
The McLean Clinic in Mississauga, Ontario, facilitates cross-border mastectomies for U.S. citizens. In a blog post published on April 14, 2025, the clinic wrote: “There’s a burgeoning trend showing many Americans crossing the border to get their top surgery procedure done in Canada.”
“The truth is that this isn’t surprising news anymore,” the blog post continued. “Year after year, the U.S. government reveals that an increasing number of citizens travel out of the country to seek medical treatment, including gender-reassignment procedures.”
The McLean Clinic declined to respond to requests for comment.
The recent attempt to target trans health care across the Canada-U.S. border mirrors the situation inside the U.S. around abortion access, where people seeking abortion procedures often travel between states to receive care where it isn’t banned.
Some states are reportedly seeking to make interstate travel for abortions illegal, creating what has been called a new legal minefield and abortion’s next battlefront.
In a similar vein, the United States may seek to criminalize minors who travel across the border into Canada to access gender-affirming care.
The Trump administration is also reportedly pressuring the United Kingdom to repeal certain laws protecting LGBTQ+ people, arguing that they limit freedom of expression, in exchange for a trade agreement.
With Canada locked into a tariff war with Washington, the country could face similar pressure tactics, despite Prime Minister Mark Carney’s support for trans rights.
www.pbs.org
