Free, rapid access counselling services are now available to children, youth and their caregivers in Humboldt. The launch is part of the Government of Saskatchewan’s $1.7 million in new annual funding to Family Service Saskatchewan to expand its Rapid Access Counselling Program.
Read the full news release on the Government of Saskatchewan website.
https://www.saskhealthauthority.ca/news-events/news/throne-speech-2023-build-and-protect
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Jennifer Bercier says “an invisible line with a huge barrier” separates Manitoba First Nations like hers from the rest of the province, after her daughter lost all of her disability support and services upon turning 18.
The mother from Opaskwayak Cree Nation says the disability services that her 20-year-old daughter, Kaylie, received under Jordan’s Principle — a federal policy which ensures First Nations kids can swiftly access essential products and services — ended on her 18th birthday.
“There are no transition services, so you face barriers again, even though your disability doesn’t leave you,” Bercier said at a Thursday news conference in Winnipeg.
Kaylie’s story is one of 32 that informed a new report released Thursday by the First Nations Health and Social Secretariat of Manitoba, which found First Nation adults with disabilities in Manitoba aren’t provided supports and services they need, particularly on-reserve.
The 117-page report, called Supporting the Gifts of First Nations Adults Living with Exceptionalities, makes 31 recommendations in several areas, including health care and social service systems, community infrastructure and resources, education, employment and caregiver support.
Bercier said for people like her daughter, who lives with an intellectual disability, there are no occupational therapists or respite services available in Opaskwayak.
Kaylie also does not have access to day programs or employment support services on the northern Manitoba First Nation, meaning Bercier or her husband will have to quit their job and stay home with their daughter once she ages out of school next June.
“She’s a bright young girl,” said Bercier. “She wants to be part of the community, but there’s nowhere for her to go.”
Though all First Nations adults with disabilities in Manitoba are eligible to receive assistance through the provincially operated Community Living DisAbility Services program, those living on reserve are not, the report states.
Existing services for First Nations adults with disabilities living on reserve are “substantially underfunded, under-resourced and understaffed,” the report says, leaving their basic needs neglected and often forcing families to disconnect from their home communities.
Since the long-term care of First Nations in Manitoba is a shared responsibility between the provincial and federal governments, the report recommends funding for a First Nations-led approach to resolve jurisdictional issues around who pays for services for First Nations adults with disabilities.
“These recommendations are directed at the government of Canada,” Cathy Merrick, grand chief of the Assembly of Manitoba Chiefs, said at the Thursday news conference.
First Nations people in Manitoba deserve care and supports that value their wellness, while addressing the root causes of the disparities they face, she says. That includes the effects of colonialism, intergenerational trauma and ongoing poverty.
The report is a step toward creating a world where First Nations adults with disabilities “can survive, thrive and lead fulfilling lives,” Merrick said.
“I expect that our treaty partner thoroughly examines these findings, and sincerely addresses the comprehensive needs of First Nations, to achieve and sustain genuine reconciliation.”
Another recommendation from the report calls for the creation of a program for First Nations adults akin to Jordan’s Principle, which only applies to minors.
Joni Wilson said a lack of disability support for her son, Aidan, forced her to move from Peguis First Nation to Winnipeg when he was younger — but Jordan’s Principle made it possible for them to move back.
“However, we knew that once he turned 18, all services would end and we’d be right back to the same situation,” she said at the news conference.
Wilson’s family is behind one of two human rights complaints filed against the federal government in 2021 regarding gaps in services for First Nation adults with disabilities living on reserve that allege systemic discrimination.
“We are Manitobans, we are Canadians, and nowhere else would there ever be a denial of services for any other ethnic group,” she said. “This shouldn’t even be a thing in this day and age.”
Joëlle Pastora Sala of Winnipeg’s Public Interest Law Centre, which funded the report, says the other complaint was filed by a coalition of 25 families with similar experiences to Bercier’s and Wilson’s.
“Interestingly, Canada has not denied the allegations of discrimination, and it’s our understanding that the Canadian Human Rights Commission is continuing to consider the complaints,” she said, adding that an update to the complaints is expected in the next week.
Pastora Sala says the federal government needs to create services and programs for First Nations adults with disabilities that promote inclusion and cultural connectivity throughout their lives.
“We know that First Nations adults with disabilities are already falling through the cracks and living in the streets without any support and services,” she said.
“Overall, the report is clear: disability-related supports are not available in the community of choice for First Nation adults with disabilities in Manitoba, including in First Nation communities.”
It didn’t take long for the new leaders at Alberta Health Services to put their stamp on the organization.
Eight days after the appointment of a new board of directors was announced, AHS says that six senior executives are no longer in their roles.
That list includes Mauro Chies, who was just appointed permanent president and CEO in March.
AHS announced that Sean Chilton will be the new acting president and CEO. Chilton had been a vice-president and chief operating officer.
Last week, Premier Danielle Smith announced sweeping changes to dismantle the province’s health-care delivery system, restructuring it into four new service delivery organizations reporting directly to Health Minister Adriana LaGrange.
She appointed Lyle Oberg, a doctor and former Progressive Conservative cabinet minister, to chair the board of AHS, which will continue to operate in a diminished capacity within the new, restructured system.
He said in a statement announcing the executive changes on Thursday that the transition over the next 18 months requires new ideas, voices and leadership.
Two vice-presidents will no longer continue in their roles; Dr. François Bélanger, vice-president of quality and chief medical officer, and Colleen Purdy, vice-president of corporate services and chief financial officer.
Also out are Tina Giesbrecht, the general counsel and corporate secretary, Geoffrey Pradella, the chief strategy officer, and Dean Olmstead, the chief program officer of capital management.
When asked if any of the former senior leaders will remain at AHS in different capacities, a spokesperson emailed CBC News on Friday to say the six individuals are no longer with the organization.
The spokesperson wasn’t able to give specific answers to questions about the estimated cost of severance pay.
“Severance will be disclosed publicly as part of the annual compensation disclosure for 2023,” the spokesperson wrote.
Chies’s contract, which is posted on the AHS website, says that “in consideration of the executive’s 35 years of continuous service with AHS and its predecessors,” Chies would receive a termination payment equal to slightly more than 24 months of his base salary. His 2023 salary, according to the contract, is $583,443.
Lorian Hardcastle, an associate professor of health law at the University of Calgary, said she can’t comment on the specific individuals affected by Thursday’s announcement.Â
But she said the news, coming so quickly after last week’s structural changes, adds to the sense that there is a lack of stability in the delivery of health-care services in the province right now.  Â
“The planned reforms risk adding a great deal of instability to the health-care system, which is only exacerbated by such a significant shakeup to the board’s composition,” Hardcastle said.
Along with the appointment of Chilton, AHS also announced eight members of the executive team. Not included in that list is the name of the new chief medical officer, to replace Bélanger.
Alberta Health Services did not respond to questions from CBC News about whether another chief medical officer will be appointed, or if the position would be changed or eliminated.
There was a “staggering” annual rise in measles cases and deaths in 2022, according to a new report from the World Health Organization (WHO) and the U.S. Centers for Disease Control and Prevention (CDC).
Cases jumped by 18 per cent to an estimated nine million, and deaths rose to 136,000 — mostly among children — the health agencies said in a joint statement on Thursday.
There were large or disruptive outbreaks in 37 countries last year, the majority in Africa, compared with 22 in 2021.
“The increase in measles outbreaks and deaths is staggering, but unfortunately not unexpected given the declining vaccination rates we’ve seen in the past few years,” said John Vertefeuille, director of the CDC’s global immunization division.
The COVID-19 pandemic massively disrupted routine immunization efforts worldwide, and the bounce back has been slow.
Measles is one of the most contagious viruses in the world but is preventable by two doses of vaccine. However, 22 million children worldwide missed their first dose in 2022 and an additional 11 million their second dose, a slight improvement on the previous year.
However, the situation has not recovered at all since the pandemic in low-income countries, where the risk of dying of measles is highest, WHO said. Coverage rates there are at 66 per cent on average, compared with the 95 per cent the United Nations agency says is needed to prevent outbreaks.
That is an “alarm bell for action” for countries and all global health stakeholders, said WHO’s director of immunization, Kate O’Brien.Â
In Canada, there are only a handful of current active measles cases, and 10 cases in total have been reported so far in 2023, the latest federal data shows.
However, the country also faced a drop in routine vaccinations during the COVID-19 pandemic, including immunizations for measles.
Data from Ottawa Public Health, for example, showed that in that city alone, about 15,000 children missed receiving a dose of the MMR or MMR-V vaccine between 2020 and 2022.
Britain’s medicines regulator has authorized the world’s first gene therapy treatment for sickle cell disease, in a move that could offer relief to thousands of people with the disease in the U.K.Â
In a statement on Thursday, the Medicines and Healthcare Regulatory Agency said it approved Casgevy, the first medicine licensed using the gene editing tool CRISPR, which won its makers a Nobel prize in 2020.
The agency approved the treatment for patients with sickle cell disease and thalassemia who are 12 years old and over.
Casgevy is made by Vertex Pharmaceuticals (Europe) Ltd. and CRISPR Therapeutics. To date, bone marrow transplants, extremely arduous procedures that come with very unpleasant side effects, have been the only long-lasting treatment.
“The future of life-changing cures resides in CRISPR-based [gene-editing]Â technology,” said Dr. Helen O’Neill of University College London.
Both sickle cell disease and thalassemia are caused by mistakes in the genes that carry hemoglobin, the protein in red blood cells that carry oxygen.
In people with sickle cell — which is particularly common in people with African or Caribbean backgrounds — a genetic mutation causes the cells to become crescent-shaped, which can block blood flow and cause excruciating pain, organ damage, stroke and other problems.
In people with thalassemia, the genetic mutation can cause severe anemia. Patients typically require blood transfusions every few weeks, and injections and medicines for their entire life. Thalassemia predominantly affects people of South Asian, Southeast Asian and Middle Eastern heritage.
The new medicine, Casgevy, works by targeting the problematic gene in a patient’s bone marrow stem cells so that the body can make properly functioning hemoglobin.
Patients first receive a course of chemotherapy to make space for the new cells. Then, doctors take stem cells from the patient’s bone marrow and use genetic editing techniques in a laboratory to fix the gene. The cells are then infused back into the patient for a permanent treatment.
Featured VideoDr. Sarah Patterson on what causes red blood cells to become crescent shaped.
Patients must be hospitalized at least twice — once for the collection of the stem cells and then to receive the altered cells.
Britain’s regulator said its decision to authorize the gene therapy for sickle cell disease was based on a study done on 29 patients, of whom 28 reported having no severe pain problems for at least one year after being treated. In the study for thalassemia, 39 out of 42 patients who got the therapy did not need a red blood cell transfusion for at least a year afterwards.
Dr. Sarah Patterson, an assistant professor at McMaster University and a clinical hematologist, treats people with both blood disorders.Â
“I think this is monumental,” Patterson said. “We still need to make sure that we’re looking for those long-term outcomes and that we’re being thoughtful about this, but it’s so exciting.”
Patterson said the treatment could be an option for those most sick from sickle cell disease, with multiple hospital admissions in a year.Â
“We want people who are sick enough that that can justify the use of those conditional therapies to make space in the bone marrow, but not so sick that the treatment is going to make them sicker. And that part is really tricky.”
Dr. Greg Guilcher, an associate professor of pediatrics and oncology at the University of Calgary, uses stem cell transplants in children with sickle cell disease. He welcomed the advance.
“Sickle cell disease is the most common genetic disease in the world,” he said. “We need more options because not everyone has a safe, curative option.”
Gene therapy treatments can cost millions of dollars and experts have previously raised concerns that they could remain out of reach for the people who would benefit most.
Last year, Britain approved a gene therapy for a fatal genetic disorder that had a list price of $3.5 million US. England’s National Health Service negotiated a significant confidential discount to make it available to eligible patients.
Vertex Pharmaceuticals said it had not yet established a price for the treatment in Britain and was working with health authorities “to secure reimbursement and access for eligible patients as quickly as possible.”
In the U.S., Vertex has not released a potential price for the therapy, but a report by the nonprofit Institute for Clinical and Economic Review said prices up to around $2 million US would be cost-effective. By comparison, research earlier this year showed medical expenses for current sickle cell treatments, from birth to age 65, add up to about $1.6 million US for women and $1.7 million for men.
Casgevy is currently being reviewed by the U.S. Food and Drug Administration; the agency is expected to make a decision early next month, before considering another sickle cell gene therapy.
Millions of people around the world, including about 100,000 in the U.S., and an estimated 5,000 to 6,000 Canadians, have sickle cell disease. It occurs more often among people from places where malaria is or was common, like Africa and India, and is also more common in certain ethnic groups, such as people of African, Middle Eastern and Indian descent.
Scientists believe being a carrier of the sickle cell trait helps protect against severe malaria.
White Coat Black Art26:30Ozempic: The good, the bad and the future
Despite widely publicized reports of rare but severe side effects, obesity doctors say Ozempic and drugs like it have the potential to improve medical help for a chronic illness that patients have been forced for too long to try to cure on their own.
“There are still some aspects of our health-care community that say, ‘this is not important, weight loss is not important; it’s just cosmetic and you’re really not improving the health of these people,'” said Dr. Daniel Drucker, a physician-scientist whose research helped pave the way for Ozempic, one of several brand names for a drug known as semaglutide. “But now I think that argument will be laid to rest.”
Ozempic and other drugs in its class are known as glucagon-like peptides, or GLPs. Because GLPs act to stimulate insulin secretion, the first was approved for use as a diabetes drug in 2005, said Drucker, who is a senior scientist at the Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital in Toronto.
But it was actually back in the late 1990s that Drucker’s lab, as well as that of Dr. Steve Bloom in the U.K., began to publish what they’d observed in clinical trials — that patients treated with GLP medicines for their diabetes were also losing weight.
Now new data shows that semaglutide also reduces rates of heart attacks, strokes and death in people with pre-existing cardiovascular conditions, something Drucker told White Coat, Black Art host Dr. Brian Goldman he believes will “change the conversation around the importance of treating people with obesity.”
Michael Morris, 58, says he’s been wrestling with his weight since he was a teenager.
“I’ve always gone up and down, yo-yo, every diet,” he said. When he needed a CPAP machine for sleep apnea about 18 months ago, he ended up in a program that supported him through some dietary changes to help address the apnea, along with his high blood pressure and cholesterol levels, and pre-diabetic blood sugar status. When Morris met with a doctor, he asked about Ozempic, and the two agreed he could give it a try.
Since then, Morris said he has gradually lost around 40 pounds and seen improvements in his other conditions as well.
“It’s like it changes … the way you think about food, like I’m not feeling hungry or ravenous all the time,” he said.Â
Before Ozempic, Morris said he could never tell when he was full.
“I know that’s probably hard for people to understand. I would eat stuff and then I would just keep eating, and then I got to the point where it made me feel sick. And then I’d be like, ‘Oh, I’m not doing that again.’
“I guess food, it’s like an addiction for me. And if you’re an alcoholic, people don’t say, ‘Oh, I’m just trying not to drink.’ There are programs and stuff.”
Dr. Sasha High, an internal medicine and obesity physician who works in private practice in Toronto, says it’s important to understand that not everyone experiences food in the same way.
“We know that 50 to 70 per cent of obesity is genetically determined and the genes involved are central nervous system genes, that means genes that control factors with our brain,” she said. These affect the way the brain responds to the food that’s around us, whether we have cravings for sugar or salty foods and whether we enjoy exercise. “All of that is kind of determined by our physiology.”
That doesn’t mean weight is set in stone, said High, but it does mean there’s a range of what your body shape is going to look like, determined by your genetics and then by lifestyle choices.
When she started working in the area of obesity back in 2012, High said there wasn’t much doctors could offer beyond telling patients to eat less, exercise more and count calories.
That message is disempowering for people who have contended with obesity for a long time, she said.
“The issue is not that they don’t understand that they need to do that. The issue is that life gets in the way and stressers come and we eat because we are bored and we eat because we’re sad and we eat because it’s 9:00 at night and we’ve had a stressful day.”
Drucker said GLP medications work in two ways to tell patients that they’re not hungry. First, they tell the brain to physically slow the emptying of the stomach, and second, they affect the brain’s hunger signals, suppressing appetite.Â
Some of Drucker’s research was done in partnership with companies that produce or are working on weight-loss drugs, including Pfizer and Novo Nordisk.
On Nov. 11, the New England Journal of Medicine reported the results of a study on the safety of semaglutide in people with obesity who also had cardiovascular disease, said Drucker. On average, the patients received either semaglutide or a placebo for 34 months.
“It showed not only weight loss but reduced rates of heart attacks, strokes and death.”Â
However, some patients have experienced serious side effects, including stomach paralysis and malnutrition.
Pamela Cole is one of those patients. The 38-year-old from Marmora, Ont., initially responded well to the medication. But when her doctor increased her dose about eight months in, she started to get flu-like symptoms that escalated from there.
“I continued to get worse to the point I couldn’t eat anything without severe stomach pain,” said Cole. She wound up visiting the hospital four or five times in the space of two weeks, she said.
During the last of those visits, she was treated for severely low potassium levels that were impacting her kidney and liver function. A specialist eventually advised her to discontinue Ozempic, and after doing so, her symptoms resolved.
WATCH Â |Â Semaglutide linked to serious gastrointestinal problems:
In a statement, Ozempic manufacturer Novo Nordisk told CBC it stands behind the safety and efficacy of all of its GLP-1 medicines when used by appropriate patients consistent with the product labelling and approved indications.
Drucker said Cole’s experience is atypical next to research findings from eight large cardiovascular safety trials — some with more than 10,000 subjects — that ran over periods of two to six years.
“And what we see generally are favourable results. In those trials, we see a reduction in heart attacks, strokes, cardiovascular death … and we do not see an increase in cancer or an increase in pancreatitis,” he said.Â
However, he said it’s important to be cautious.
“With the newer, more powerful medicines and the expanding patient population, there is always the possibility to see something that we haven’t before.”
Dr. Nav Persaud, a family medicine physician at St. Michael’s Hospital in Toronto, told CBC in January that it wouldn’t be the first time the side effects of a weight-loss drug turned out to be more serious than anticipated.
“We have seen it happen many times where there were these heralded wonder drugs that turned out not to work or to harm and kill people,” he said.
In France, a diet drug called Mediator that started as a Type 2 diabetes treatment was taken off the market in 2009 after being blamed for thousands of deaths due to heart-valve problems.
Dr. Sean Wharton is an internal medicine specialist at Michael Garron Hospital in Toronto and assistant professor at the University of Toronto who researches obesity medicine. He likens the difficulty people face accessing medical help for obesity to the experience many people with mental health issues have with expectations that they should “just be happier.”
LISTEN｜Dr. Arya Sharma on treating obesity as a disease not a behaviour:
The Dose15:53Should I worry if my BMI is too high?
However, until weight-loss medicines become a lot more accessible, he said he doesn’t see them making a big dent in the obesity epidemic. Ozempic has been in short supply since its popularity skyrocketed — more than 3.5 million prescriptions were filled at Canadian pharmacies last year The very nature of an injectable drug that’s expensive to manufacture, ship and store means only people with the financial resources or particularly good drug plans can get their hands on it, said Wharton, who has done paid research for Novo Nordisk.
In September, the New England Journal of Medicine published Wharton’s phase-two trial data showing that a once-a-day pill called orforglipron resulted in a weight reduction of at least 10 per cent after 36 weeks in 46 to 75 per cent of participants.
Drucker said that GLP medicines won’t erase the need to address access to healthy, affordable foods, to design cities that are easier to navigate on foot or bicycle, or to promote healthy habits around diet or exercise.Â
“But if you’re sitting across the desk from someone who is living with obesity and they have a higher risk of heart disease and kidney disease and liver disease and cancer, you know, I think GLP medicines are a very useful option.”
Robyn Hodgson says she’s watched struggling young people heal, grow and ultimately thrive because of gender-affirming health care.Â
“It genuinely is profound,” Hodgson, a registered nurse and co-ordinator for the transgender and non-binary program at the InterCommunity Health Centre in London, Ont., said.Â
“I’m in my 27th year, and I’ve worked in a lot of areas — and this has been the most rewarding area that I’ve ever worked in.”
Gender-affirming health care — an approach that affirms a trans person’s gender identity instead of trying to change it — is endorsed by medical associations in Canada and around the world, including the Canadian Psychological Association and the Canadian Pediatric Society.
But it’s also a type of health care that’s widely misunderstood, especially as it pertains to the treatment of young people, say the medical professionals who provide it and the patients who receive it.Â
“So many people make uninformed opinions,” said Silas Cain, a 16-year-old transgender boy receiving gender-affirming care in Saskatoon. “They see a headline or they hear one person talking about it and they take it as fact, which is harmful in so many different contexts.”
Here’s what transgender youth, their caregivers and their health-care providers want you to know about what affirming care actually looks like for young people in Canada.Â
Affirming care ranges from social and psychological support, like using someone’s chosen pronouns; to transition-related medical treatments, such as puberty blockers and hormones, or gender-affirming surgeries.
Hodgson likens it to how society accommodates people who are left-handed.
“We’ve tried changing handedness in the school system, and people were struck in the knuckles with rulers,” she said. “Trying to force people to live in a shell that is absolutely foreign to their experience is equally difficult.”
Featured VideoFrom being dismissed by doctors and denied treatment to eventually finding the medical and emotional support they need, CBC’s Paige Parsons finds out what it’s like to fight for health care as a trans teen — especially in a rural community.
Forcing kids into genders they don’t identify with can have negative impacts on their well-being, says Rhea Mossman Sims, a nurse practitioner at Trans Health Klinic in Winnipeg.
“They can have a significant decrease in their self-esteem and they can also have a significant decrease in their general mental health, and there is a potential for suicidality,” she said.
Canadian health-care providers broadly follow the World Professional Association for Transgender Health (WPATH) standards of care, which has guidelines for patients at different stages of their development.
For kids who haven’t hit puberty, affirming care means letting them explore their gender in a supportive environment. That can mean using different pronouns, trying out a new name, or letting them pick different clothes or try a new haircut.Â
“There is nothing medically that is done in a child [before signs of puberty],” Hodgson said.
For Cain, that started not at a health clinic, but at school when he found teachers who supported him as he explored different labels.Â
“Trying out different pronouns and different names was affirming care for me at that time,” he said. “Having a space to experiment is so important and so vital.”
Surgical options, Hodgson says, aren’t considered until “very, very late in care” — and almost never for patients under 18.Â
“I can tell you, internationally, I do not know anybody that will perform any type of genital surgery on anyone under 18 years of age.”
In some very rare cases, she says, older teenagers may be eligible for chest surgery — also known as top surgery — but only if they’ve already had “a significant duration of care,” she said.
The Morning Edition – Sask9:08Primary care physician talks myths versus realities about gender affirming care
Before puberty blockers or hormone therapy can be considered, WPATH guidelines state that all youth need to be assessed by a qualified health-care professional who has studied psycho-neurodevelopment in adolescence.
“I think that there is this assumption that people are rushing into medical care and there’s no thoughtful contemplation or support,” Hodgson said.
“It certainly hasn’t been the experience of any of the providers that I know that are doing this care, nor of the trans population that’s accessing care.”
Since 17-year-old Seelie Romard of Sydney, N.S., first started seeking gender-affirming treatment in 2021, he says he’s visited a pediatrician, a physician who specializes in gender care, and a psychologist — all before being put on a waitlist for testosterone.Â
“It took a really long time … just to make sure that I was, like, OK mentally, that I was in the right place, that I was informed,” Seelie said.Â
Patients in the early stages of puberty may be prescribed puberty blockers, which slow the pituitary gland from stimulating secondary sex hormones, putting puberty on pause.
“One of the nice things about blockers is that they can give you some time to continue to explore, rather than having to go through the puberty changes that would happen otherwise,” Dr. Tania Culham, a physician with Trans Care B.C., said.Â
Some countries have placed restrictions on puberty blockers until their long-term effects can be better studied. England has restricted their use to minors enrolled in clinical trials, and the Norwegian Healthcare Investigation Board has recommended they be considered “exploratory” and “experimental.”
Culham says they are widely considered safe, noting they have been used for more than 40 years to treat precocious puberty — puberty that starts too early — and about 20 years for transition-related care.
Some research has linked them to decreased bone density over time, so providers may limit how long a patient takes them, Sims said. Doctors also supplement treatment with vitamins and dietary guidance for bone health, Hodgson and Culham said.
Patients can pull the plug any time, Culham said, and their regular puberty will resume.
“The whole point of the puberty blocker is that they are reversible,” Culham said.
Adolescents further along in puberty may consider taking estrogen or testosterone to help develop sex characteristics that better align with their identities.Â
Cain started testosterone in July and says it’s already having enormous benefits for his health and well-being.Â
“Pretty much everyone that I’ve talked to — my teachers, my therapist, doctors — they all say that I look so much happier now than I did before,” he said. “And I definitely feel much happier than I was before.”
Because hormones can have long-term effects on fertility, Sims says health-care providers don’t prescribe them until a patient has shown a persistent desire to transition, been fully informed about the side effects and been offered a chance to have their sperm or eggs preserved for future use.
“These decisions, in general, are not taken very lightly,” she said.
According to WPATH, parents should be involved in decisions to pursue medical treatments whenever possible. In fact, Culham says a “family-centred care” leads to better outcomes in all pediatric care.
“As hard as it is sometimes for people to come out to their parents or caregivers or have these conversations, I know a lot of youth take a lot of great care bringing their families, parents, caregivers along,” she said.
But that’s not always possible. In Canada, under the Convention on the Rights of the Child and Children’s Participatory Rights, some people under 18 may be designated “mature minors,” capable of making their own health-care decisions.
That’s how Tristen Roscoe, 17, of Halifax was able to access testosterone.
“I did tell her about it, but my mom wasn’t happy,” he said. “She didn’t have to, like, sign anything or give the OK, which was good because I don’t think she would have.”
Roberta Cain, mother to 16-year-old Silas, says helping her son navigate the health-care system has been a “a real balancing act” between respecting his privacy and making sure she has the information she needs to support him.Â
Ultimately, she says, it’s worth it.
“My feeling is that the staff involved want the best for the kid,” she said. “There’s no other agenda than that.”
Kids who spend hours on their phones scrolling through social media are showing more aggression, depression and anxiety, say Canadian researchers.
Emma Duerden holds the Canada Research Chair in neuroscience and learning disorders at Western University, where she uses brain imaging to study the impact of social media use on children’s brains.
She and others found that screen time has fallen just slightly from the record 13 hours a day some Canadian parents reported for six- to 12-year-olds in the early months of the COVID-19 pandemic.
“We’re seeing lots of these effects. Children are reporting high levels of depression and anxiety or aggression. It really is a thing.”
When parents said their children spend more time on screens and the grownups are stressed, then anxiety and depression scores in the kids also increase.
“Absolutely, I think this is a public health issue,” Duerden said when asked about her findings and those of others.
Just as serotonin dips when we’re hangry — hungry and angry at the same time — screen time can also strongly influence the brain’s reward system that is key to decision-making.
“It could be that there’s an actual depletion in serotonin,” Duerden explained. “There’s this imbalance and that’s how it could be mediating aggression in children.” Levels of other neurotransmitters like dopamine also matter.
But the average person doesn’t see social media, gaming or TV as a bad thing because the screens are everywhere, she said.
Duerden said when teens watch a short Disney Pixar film without dialogue, she sees core brain regions involved in social processing light up on functional near infrared spectroscopy — a type of non-invasive brain scan that shows changes in oxygenation levels or activation in different regions.
WATCH | Brain activity changes when scrolling social media:
Featured VideoWith most children and teenagers spending hours a day on a smartphone, CBC’s Christine Birak breaks down what research shows about how using social media is changing kids’ behaviour, if it’s rewiring their brains and what can be done about it.
The prefrontal cortex becomes activated when watching a character in the film experience physical pain.
The same brain region also undergoes massive changes during adolescence, which is why her lab is interested in what happens with screen use. In children, the prefrontal cortex is important to master material in school.
Michaela Kent, a PhD student in Duerden’s lab, said she’s shocked when speaking with concerned undergraduate students.
“They can’t focus during exams because they’re so used to scrolling on TikTok or looking through their phone,” Kent said. “They’re so used to having that constant stimulation that when it comes to focus, they really struggle.”
That’s why Kent said it’s important to better understand how people of all ages can better interact with their social media.
Olivia Miller, 22, of Baden, Ont., west of Waterloo, struggled with doom scrolling, depression and anxiety as a teen.
“Being on my phone for excessive amounts of time but not really absorbing anything was a very common thing for me,” Miller said.
Miller learned about how social media apps are designed to capture attention.
On a practical level, Miller removed Instagram from her phone’s homescreen. Miller said the extra time it takes to find the app offers time to reconsider.
Miller now gives leadership talks on mental health to students.
“Even if you’re putting a two-hour time limit on an app, the second that it’s over, you’re getting a flood of notifications and you’re back in,” Miller said.
Dr. Rachel Mitchell, a child and youth psychiatrist at Sunnybrook Health Sciences Centre in Toronto, treats and studies how social media use affects mental health.
Mitchell said some children and adolescents will be more predisposed long-term to violent behaviour such as fighting, arguing and breaking rules on respecting the rights of others when using more social media over time than others.
The artificial intelligence algorithms in social media platforms are designed to attract and keep people on to expose them to more advertising.
“We need more regulation from the top down and we need more parental involvement in what kids are doing,” Mitchell said. “We need both.”
Psychiatry professor Patricia Conrod holds the Canada Research Chair in preventive mental health at Sainte-Justine Hospital in Montreal.
Conrod is concerned that the defaults on devices we use for social media tend to be set for adults. Yet they’re also an integral part of the lives of most young people. She says the features that keep young people scrolling through their feeds also make them lose some self-control and lose time.
“Just because something makes you feel good doesn’t mean it’s good for you,” Conrod said.
Conrod encourages children and teens to pay attention to how their mood changes when viewing content.
Conrod found social media use among 3,800 adolescents in Montreal followed each year from Grade 7 until Grade 11 was associated with lasting aggressivity in relationships over a year.
In contrast, watching television and playing video games were associated with being more hostile or aggressive in the short-term, like a single outburst.
Last month, Conrod published a study suggesting greater social media use was also tied to impulsivity in nearly 4,000 Canadian high school students.
“We have these two studies that were able to uniquely show that social media affected behaviour and symptoms over the long-term,” said Mitchell, who was not involved in the Montreal research.
Last week, Jay Olson, a postdoctoral fellow in psychology at the University of Toronto Mississauga, published findings on smartphone addiction patterns among adults in Canada and 40 other countries.
On average, women scored higher than men on showing signs of addiction.
For instance, in Canada among women aged 18 to 22, 56 per cent of them “would be considered clinically addicted to their phones.” That’s when use disrupts sleep, learning or relationships. The same was true for a third of men the same age.
“I think, in the future, we’ll see this time as the beginning of this unregulated experiment,” Olson said.
“We know that smartphones reduce wellbeing. The big question is by how much, for what groups, and what can we do about it?”
Olson said in his research, the most effective strategies to reduce problematic use were simple:
The older someone is, the less likely they were to have problematic smartphone use.
While those steps that individuals can take will help, doctors and scientists say they don’t go far enough to protect children and teens. U.S. Surgeon General Dr. Vivek Murthy called social media “an important driver” of the youth mental health crisis.
In the U.S., 33 states are suing Meta, Facebook and Instagram’s owner, claiming they made social media addictive to children.
Health Canada and Canadian Heritage plan to bring in legislation following roundtables, where participants concluded children are the most vulnerable to online harm, such as a toll on mental health and the risk of sexual exploitation.
“The bill is expected to be tabled as soon as feasible in order to ensure that online services providers must be held accountable for the harmful content on their platforms online and promote a safer and more inclusive online environment,” Health Canada said in a statement to CBC News.
Instead of being overstimulated by social media, Miller now starts the day by playing piano. She also goes out in nature more often, listens to bird calls and sucks ice cubes or sour candy to stay mindful, adding that what works will vary from person to person.
“Be patient with yourself because it might be a process to … build new restraints with your usage.”
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