Is CASW's stance on social transition in schools justified?

Decide for yourself.

A little over one month ago, the Canadian Association of Social Workers (CASW) put out a statement on 2SLGBTQIA+ children and youth. The statement, which you can read in full, states that CASW “advocates for the safeguarding of the rights of 2SLGBTQIA+ youth in Canada”. I'm all for that; why wouldn't I be? It's my community too. CASW goes on to criticize provincial governments (New Brunswick and Saskatchewan in particular) who they claim “have sought to diminish and threaten the dignity of trans, gender fluid and queer children and youth”. These are strong statements deserving of scrutiny.

What have these provincial governments done to earn such censure? Saskatchewan and New Brunswick have developed policies that seek to update parents when their children are choosing to change their gender presentation (e.g. pronouns, name) at school. What these changes have to do with LGB students who are included in the 2SLGBTQIA+ that CASW states are being threatened is unclear since sexual orientation is not mentioned in either provincial policy.

These policies replace previous policies which required school officials to use students’ preferred name and pronouns without informing parents, unless students granted permission. CASW condemns the policy changes because, they state, they violate students’ right to self-determination and undermine their human rights: “Policies or guidance that dictate that someone must out a trans, gender fluid or queer child or young person to their parents are both dangerous and a violation of CASW’s code of ethics.”

What CASW neglects to mention in its analysis is that socially transitioning a youth is not merely a social act; it is a clinical intervention. And clinical interventions come with potential longterm medical repercussions that should not be taken lightly. This is acknowledged in the early literature on transitioning minors: the Dutch Protocol that is touted as having started a global movement urged caution and recommended that social transition not start until age 16. Even the World Professional Association of Transgender Health (WPATH), which seeks to represent itself as the leading authority on trans-related healthcare, recommends comprehensive assessments of children and adolescents prior to initiating any medical interventions. The policies in Saskatchewan and New Brunswick are a first step in removing teachers from clinical decision-making — which is not and never should have been their role.

Photo by Priscilla Du Preez 🇨🇦 on Unsplash

The limits of ethics codes

According to CASW, the purpose of a code of ethics is to provide “a consistent set of values, principles and standards of conduct” to help with making “informed and appropriate decisions in the complex situations [social workers] encounter in the line of work.” A characteristic of codes of ethics is that they are often lacking in specificity and open to interpretation. CASW's code is no different. For example, does the right to self-determination come with any limits? CASW’s ethical guidelines seem to imply as much: “In all cases where clients' right to self-determination is limited by duty of care (e.g., client intent to self-harm), the law (e.g., child abuse), or court order, social workers assist clients to negotiate and attain as much self-determination as possible.”

And when those limits to self-determination are reached, this is what CASW’s guidelines recommend: “Social workers may wish to reserve the right to disclose some information provided by a young child to parents when such disclosure is in the best interest of the child.”

But is seeking to change a name or pronoun a form of self harm or of self expression? And is disclosing information to parents that may not be supportive, truly 'in the best interest of the child'? These are difficult questions to answer.  As the debates continue to swirl around whether gender affirming care, including social transition, actually improves mental health, school officials, social workers, parents and children are left to stake their particular positions. Where facts are sparse, opinions proliferate.

Here's my opinion: the policies do not dictate outing students. What they do ask for is parents' signed consent should a student under 16 want to update their school documentation to a new name/pronoun. Since parents are responsible for their children's wellbeing, this seems like a reasonable expectation. Schools may or may not be aware of what has occurred in a child's life, that may be contributing to a transgender identification. Some individuals who transitioned and later detransitioned have shared that trauma (often sexual trauma) led them to do so, for example. Other studies also suggest that many youth will naturally resolve their gender dysphoria by the time they reach adulthood without needing medical intervention, if left alone. This is a positive outcome, surely; but it is made harder if schools enable social transitions without including parents or medical professionals in the decision-making process. Parents hold knowledge of their children that schools may not. They must work together.

But let us return to the policies themselves. What do they actually say?

What the policy changes actually say

Here is an excerpt Saskatchewan’s policy (a PDF of the policy is online):

“Given the sensitivity of gender identity disclosure, when a student requests that their preferred name, gender identity, and/or gender expression be used, parental/guardian consent will be required for students under the age of 16. For students 16 and over, parental consent is not required. The preferred first name and pronoun(s) will be used consistently in ways that the student has requested. In situations where it is reasonably expected that gaining parental consent could result in physical, mental or emotional harm to the student, the student will be directed to the appropriate school professional(s) for support. They will work with the student to develop a plan to speak with their parents when they are ready to do so.”

What about New Brunswick’s policy changes?

“Self-identification

Section 6.3.1 and 6.3.2 will read as follows:

(6.3.1) School personnel will consult with a transgender or non-binary student who is 16 and over to determine their preferred first name and pronoun(s). The preferred first name and pronoun(s) will be used consistently in ways that the student has requested.

(6.3.2) Transgender or non-binary students under the age of 16 will require parental consent in order for their preferred first name to be officially used for recordkeeping purposes and daily management (EECD, school district, and school software applications, report cards, class lists, etc.). If it is not possible to obtain consent to talk to the parent, the student will be directed to the appropriate professional (i.e. school social worker, school psychologist) to work with them in the development of a plan to speak with their parents if and when they are ready to do so. If it is not in the best interest of the child or could cause harm to the student (physical or mental threat), the student will be directed to the appropriate school professional for support.”

To review: Youth over that age of 16 are able to sign off on a name/pronoun change without parental consent. For youth under the age of 16, parental consent is needed but where a youth feels unsafe in getting their parents’ consent, the school will work with the student to get that consent. This is quite a distance from CASW’s claim that teachers will be required to out students who are not yet ready to be outed. Instead, it is a collaborative approach that recognizes that parents and families play an important part in a student’s ongoing wellbeing and should be included in decisions that a student makes that might impact their longterm wellbeing.

Both provincial policies seek to balance students’ desire for autonomy with the important role parents and schools play in supporting their children’s longterm health. And that is a key point in this conversation: social transition is not a harmless endeavour in today’s social media-infested world. Anyone who has perused Tiktok can tell you that kids are self-diagnosing with mental health conditions, including gender dysphoria, at increasing rates -- and some are making medical decisions with lifelong repercussions. Parents and schools are wise to be cautious.

My perspective as a member of the 2SLGBTQIA+ community (-ies) and as a social worker

To me the provincial positions that Saskatchewan and New Brunswick have taken seem both responsible and respectful, considering that we have limited data suggesting that social transition actually improves wellbeing.

If we are truly serious about safeguarding 2SLGBTQIA+ youth, we would recognize that some LGB and straight youth are being misled to believe they are trans rather than supported in accepting themselves for who they are and addressing underlying mental health issues (e.g. depression, anxiety, trauma). Kids who are gender nonconforming, or who have other social difficulties (e.g. connected to autism), or who are seeking a sense of belonging by experimenting with their gender presentation, are facing a cultural moment where their difficulties are too often explained away with a false narrative -- that gender transition will solve their problems.

All of this trial and error would be fine, if exploration didn't also mean youth potentially being pushed to medicalize their nonconformity with lifelong, irreversible repercussions, such as hormonal/surgical complications, loss of sexual function and sterility. These interventions are offered at younger and younger ages without a solid evidence base.

Codes of ethics exist because complex problems require complex decision-making processes. Few issues have proven more complex than gender. Having key ethical principles to guide us can help. But ethics only gets us so far. We need solid scientific evidence. And in the field of gender medicine, good quality research evidence is few and far between.

In the meantime, schools, parents and social workers would do well to work together. The kids are not alright.