Alberta will prohibit hormonal treatment, puberty blockers and gender affirming surgery for children 15 years and younger, Premier Danielle Smith announced Wednesday in a video posted to social media.
Smith said the policy bans all children under 17 from having top and bottom surgery, though bottom surgery is already limited to adults.
Teens aged 16 and 17 can start hormone therapy as long as they have permission from their parents, a physician and a psychologist.
Alberta parents will need to give permission before a student aged 15 and under can use a name or pronoun at school other than what they were given at birth, Smith said.
Students who are 16 or 17 won't require permission but schools will need to let their parents know first.
Albertans who require transgender surgeries have the procedures performed in Quebec. Smith said efforts will begin to attract these specialists to Alberta so the surgeries can take place in the province.
Smith said teachers need to get any third-party instruction material on gender identity, sexual orientation and human sexuality approved by the Education ministry before they are used in the classroom.
Parents will have to opt students in to every lesson about sex education, sexual orientation or gender identity.
The law right now requires one notification, and parents can opt out.
The new policy also forbids transgender women from competing in women's sports leagues. Smith said the government will work with leagues to set up co-ed or general-neutral divisions for sports.
It's unclear which changes would be done by law or by government policy and when any of the changes would take effect.
Smith said she didn't want to encourage or allow children to alter their biology or growth because she said it would pose a risk.
"Making permanent and irreversible decisions regarding one's biological sex while still a youth can severely limit that child's choices in the future," she said.
"Prematurely encouraging or enabling children to alter their very biology or natural growth, no matter how well intentioned and sincere, poses a risk to that child's future that I, as premier, am not comfortable with permitting in our province."
More detail is coming at a news conference on Thursday afternoon.
Policy 'interfering ideologically' in healthcare: expert
Fae Johnstone, a transgender woman and executive director of Queer Momentum based in Ontario, said Alberta's policies go further than what Saskatchewan and New Brunswick are doing.
Saskatchewan made changes via legislation. New Brunswick opted to make policy changes.
The Saskatchewan Party government passed its Parents' Bill of Rights, which requires consent from a parent or guardian "when a student requests that their preferred name, gender identity, and/or gender expression be used" at school.
New Brunswick's recent changes to its policy mean it's no longer mandatory for teachers to use the preferred pronouns or names of transgender or non-binary students under the age of 16.
A teacher or school would need to obtain parental consent for any child who wants to change their name at school. A student who refuses parental involvement would be referred to a school psychologist or social worker to develop a plan to inform the student's parents.
"This is interfering ideologically in the provision of medically necessary healthcare for trans and gender diverse young people," Johnstone said in an interview with CBC News.
"And flies in the face of establishing medical best practice, while also putting in parameters around school inclusion that are actually more likely to force trans kids back into the closet or extreme cases will lead to trans kids being kicked out of their homes."
Groups that support transgender kids said they will fight back.
Calgary-based Skipping Stone Foundation and Egale Canada said they condemn Smith's policy and called it "a direct and unprecedented attack on 2SLGBTQI+ Canadians, and trans and gender diverse youth in particular."
The groups said the measures violate the constitution and will create irreparable harm. They said they plan to take the matter to court.
Other groups wish Smith went further with her policy.
John Hilton-O'Brien is the executive director of parents for Choice in Education.
Hilton-O'Brien said Smith did more than he expected. While it didn't go as far he would like, he called it "reasonable."
Hilton-O'Brien said Smith took what he believes is a middle ground to diffuse tension between schools and parents.
"What you're looking at is a powder keg," he said. "If the premier doesn't do something to diffuse it, there will be much bigger trouble than a potential group of cases in [court]. She'll be looking at mass protests."
ATA says teachers need to be 'broadly consulted'
Jason Schilling, president of the Alberta Teacher's Association, said in a written statement that teachers are primarily concerned about the safety of their most vulnerable students after this announcement from Smith.
Teachers must be broadly consulted before this policy is enacted, he added.
"We are concerned about the chilling effect placed on classrooms and schools, impacting our ability to provide safe, caring and inclusive spaces for all students," Schilling said.
"We are concerned about how students may feel forced to suppress their identities and to be afraid of reaching out to teachers as an avenue for support.
"Transgender youth are five times more likely to think about suicide and nearly eight times more likely to attempt it than other children. We must be mindful of the vulnerability of these students and their need for safety, security and support."