Note - December 19, 2017: This material was subject to legal complaint by Dr. Kenneth J. Zucker, which has been resolved.

On Tuesday, Toronto’s Centre for Addiction and Mental Health announced it will shutter its controversial Child, Youth and Family Gender Identity Clinic.

For almost 40 years, the clinic treated children as young as three years old who were gender-different in some way, using a range of psychological techniques to, essentially, try to convince them not to be. As detailed in more than 100 publications, children were seen as disordered if they differed from expectations and parents were enlisted to modify their child and especially to steer them away from being transgender.

This approach is now linked to a range of dismal outcomes, including a staggering rate of suicidal behaviour. No wonder, when young people are given the message that who they are is unacceptable to the people they love and depend on. Current best practices advise that young people be supported to explore their gender and that parents learn how to offer acceptance.

The previous CAMH model is also inconsistent with provincial and international human rights guidelines, and in June of this year Ontario Bill 77 made it an act of misconduct for a health professional to attempt to alter the gender expression or identity of a minor.

In response to community complaints, CAMH announced in February that the clinic would be subject to an external review. On Tuesday, a report was made public citing a list of serious ethical concerns. It was made known on the CAMH website that the clinic will be winding down and an apology was issued from medical director Kwame McKenzie for the service having been so out of step with current thinking.

Over the next few months, I expect we will see a wave of disbelief and outrage that this treatment ever happened in the first place. Why was this going on in 2015 in a progressive city like Toronto?

But to the people who shake their heads over this news, I would like to propose that it’s actually not so shocking. In fact this publicly funded service that tried to prevent transgender people from existing is the predictable result of a larger social reality.

When lives are devalued, stripped of their worth, their autonomy, their rights, it tends to be the logical conclusion of historical events and long-standing power relations. Institutionalized abuse happens with the permission of those in power as well as the support of everyday people.

Harsh critiques of the CAMH children’s gender clinic began to emerge in the public realm nearly 20 years ago, yet clinic head Dr. Ken Zucker received promotions, honours and international invitations. Articles that described the treatment in detail were published in well-respected journals. The University of Toronto and the Ontario Institute for Studies in Education sent their students to train at the clinic.

Research conducted on these children received funding and ethical clearance. Books written by these clinicians received favourable reviews by otherwise critical thinkers. Bioethicists publicly defended the practices. For quite some time, this treatment got a silent pass from the international medical community, the fields of psychology and psychiatry, and major professional health organizations, including but not limited to CAMH.

Yet the troubling treatment that occurred at this clinic was the logical outcome of a society that unquestionably accepts white Western ideals of gender, treats children as the property of adults, and invests psychiatric and medical professionals with an astonishing level of trust and authority, even when those professionals show disdain for the people they are supposed to support. When trans people are understood to be somewhere between tragic and contemptible, it is seen as “helping” children to avoid this outcome by any means necessary.

To CAMH’s credit, after meeting with community advocates like Rainbow Health Ontario and myself in January, they moved quickly to announce a review and listened carefully to what that review had to say. They have acted wisely in the past year and the upcoming community consultations are a major step toward establishing a service that will support families, and hopefully receive government funding to do so.

But the lesson is not that there was a problem and now it has been solved. Indeed, many in the community are already asking what will be done for the young people who were harmed by this treatment. If we learn anything from the Truth and Reconciliation Report on the tragic legacy of Aboriginal residential schools, a document released on the same day as the CAMH report, it is that when certain lives are not valued, we are, as a society, capable of doing terrible things. The lesson is to pay attention to those who are marginalized and devalued and to intervene now rather than be shocked in the decades to come.

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Jake Pyne is a Trudeau Scholar and Vanier Scholar at the McMaster University School of Social Work and Gender Studies and Feminist Research Program.