Executive Summary: Key Legal and Evidentiary Issues

• The court found it had jurisdiction to enjoin proclamation of the legislation, despite it not yet being in force.

• Both individual minor applicants and organizational applicants were granted standing, with Egale and Skipping Stone granted public interest standing.

• The impugned law prohibits hormone therapy for minors unless authorized by Ministerial Order, raising serious Charter concerns.

• Conflicting expert evidence was presented on the risks, benefits, and necessity of gender-affirming care, including reliance on the Cass Review.

• The court found that denying access to treatment pending trial would cause irreparable harm to gender diverse youth.

• An interlocutory injunction was granted, preventing the law from coming into force until full constitutional review is completed.

Background and parties involved
This case arises from a constitutional challenge brought by five gender diverse minors and their parents, along with two advocacy organizations, Egale Canada and Skipping Stone Scholarship Foundation. The applicants sought an interim and interlocutory injunction to stop Alberta’s government from proclaiming into force sections 1.92 and 1.93 of the Health Professions Act (HPA), introduced by Bill 26, the Health Statutes Amendment Act, 2024 (No. 2).

The respondents were His Majesty the King in Right of Alberta and the Attorney General of Alberta. The proposed amendments would prohibit physicians from prescribing hormone therapy (including puberty blockers and hormone replacement therapy) to minors under 18 for treatment of gender dysphoria or gender incongruence, unless authorized by a Ministerial Order.

Policy provisions at issue
Section 1.92(1) prohibits regulated members from prescribing Schedule 1 drugs for hormone therapy in minors, unless permitted under an order from the Minister. Section 1.93 allows the Minister to issue such orders and to set terms and conditions for authorization. The law includes definitions of "gender dysphoria," "gender incongruence," and "minor" that align with DSM-5-TR and ICD-11 standards.

As of the date of the hearing, these provisions had not yet been proclaimed into force. The government indicated the proclamation would coincide with a future Ministerial Order, which was under development and expected to exempt: (i) minors already taking hormone therapy; and (ii) minors aged 16 or 17 with parental, physician, and psychologist approval. However, the court noted this procedure was not required by statute and that no such Order had been finalized.

Legal claims and arguments
The applicants argued that the legislative ban infringed:

• Section 7 of the Charter, by interfering with minors' right to security of the person through denial of medically necessary care and loss of bodily autonomy.

• Section 15 of the Charter, by creating a distinction based on gender identity and perpetuating disadvantages faced by gender diverse youth.

• Section 1 of the Charter, which could not justify these violations given the lack of proportionate or minimally impairing measures.

The government argued the application was premature, since the legislation was not yet in force and might be modified by regulation. It asserted the amendments were justified precautionary measures based on scientific uncertainty, citing the 2024 Cass Review commissioned by the UK’s National Health Service.

Expert evidence and factual findings
Both sides presented extensive affidavit and expert evidence. Applicants included affidavits from the minor youth, their parents, leaders of Egale and Skipping Stone, and medical professionals such as Dr. Jake Donaldson and Dr. Daniele Pacaud. These described the individualized and multi-disciplinary care provided to transgender youth, the benefits and protocols of gender-affirming treatment, and the risks posed by denying access to such care.

Respondents relied on the Cass Review and submitted affidavits from experts including Dr. James Cantor, Dr. Farr Curlin, Dr. Daniel Weiss, and Dr. Stephen Levine. Their evidence criticized the scientific basis for gender-affirming care, questioned the reversibility of treatments, and raised concerns about long-term risks, including fertility, bone health, and psychological development. They also submitted affidavits from detransitioned individuals and physicians skeptical of current practices.

The court declined to strike any expert evidence but noted that the underlying scientific disagreements could not be resolved at this stage. Instead, the court considered whether the applicants had established a serious issue to be tried, irreparable harm, and a favorable balance of convenience.

Decision and legal analysis
Justice Kuntz applied the three-part test from RJR-MacDonald Inc v Canada (Attorney General):

• Serious issue to be tried: The court found strong arguable claims under both sections 7 and 15 of the Charter. It accepted the applicants' argument that the Ban denies access to a treatment previously available, interferes with bodily autonomy, and disproportionately impacts gender diverse youth. The court held that the question of whether the Ban is overbroad or grossly disproportionate to its objective is a serious issue requiring trial.

• Irreparable harm: The court accepted that without an injunction, gender diverse youth would suffer irreversible physical changes from unwanted puberty, increased psychological distress, and diminished autonomy. These harms could not be undone if the law were later found unconstitutional.

• Balance of convenience: The court acknowledged the presumption that duly enacted laws serve the public interest, but found this presumption was rebutted. The evidence showed that very few minors regretted hormone therapy, while many would be harmed by denying it. The court held that allowing existing standards of medical care to continue posed less harm than enforcing a ban that targets only one group.

Outcome
The Court of King’s Bench of Alberta granted the interlocutory injunction on June 27, 2025. The ruling enjoins the Lieutenant Governor in Council from proclaiming section 1.92 of the Health Professions Act until the applicants' constitutional challenge is fully adjudicated.

The court also granted standing to both individual and organizational applicants and dispensed with the usual requirement for an undertaking as to damages, citing the Charter-based nature of the claim. Costs were left to be determined in the cause.

The decision does not award any monetary damages or compensation.