A group of international clinicians and researchers has sent a letter to Toronto’s Centre for Addiction and Mental Health protesting the recent closure of its youth gender identity clinic and the apparent dismissal of its long-time director.

The open letter, delivered by email to more than a dozen of CAMH’s trustees, also includes a petition signed by more than 500 experts in the field of sexuality and gender diversity from around the world.

The authors accuse the internationally renowned centre of bowing to pressure from transgender activists, who had questioned psychologist Ken Zucker’s treatment approach for children and teens who were at odds with their anatomical gender.

Some members of the transgender community had suggested the clinic was practising “reparative therapy,” with the goal of dissuading young children who felt they were the opposite sex from embracing their internal gender — an accusation clinic staff vehemently denied.

Following an independent review last year of the department’s services, CAMH announced in mid-December that it was “winding down” the Child and Adolescent Gender Identity Clinic and that Zucker was no longer employed by the centre.

At the time, Dr. Kwame McKenzie, medical director of CAMH’s Child, Youth and Family Program, said services at Canada’s largest mental health centre are expected to reflect the latest and best practices in the field.

“We want to apologize for the fact that not all of the practices in our childhood gender identity clinic are in step with the latest thinking,” he said.

McKenzie would not say whether Zucker, who had headed the clinic for 35 years, was let go from his position or had resigned.

The letter criticizes CAMH for public statements made following the December announcement, which the authors say have severely damaged Zucker’s professional reputation by implying that he “had been fired for substandard professional practice, inappropriate behaviour, or both.”

Ray Blanchard, a psychologist who worked in the adult gender identity clinic at CAMH for 15 years, said he and the other nine signatories of the letter are members of a listserve communications portal for clinicians and academics in the field of human sexuality.

“After Ken’s firing, there was a large, general outcry of this listserve of people saying we as the sex research community have to do something, that this is a horrible outrage,” Blanchard said Friday, following release of the letter.

The other signatories include researchers from Canada, the United States and the United Kingdom, who said the closing of the clinic will leave many gender-questioning youth and their families with severely reduced access to specialized services.

“I think it’s worse than a mistake,” said Blanchard. “I think it was a cynical, self-serving and unfair attempt to curry favour with an activist group by firing an employee ... who was a very distinguished member of this research community.”

Zucker has not commented publicly on the controversy surrounding the clinic nor his departure from CAMH. He referred an interview request by The Canadian Press to his Toronto lawyer John Adair, who declined to comment.

Kelly Meighen, chair of CAMH’s board of trustees, said the letter and petition do not “provide an accurate assessment of what occurred.”

“As a publicly funded hospital dedicated to providing excellent patient care, CAMH examined the evidence and listened to the community,” Meighen said Friday by email.

“CAMH is and has been committed to working with our community partners to help create a sustainable system to meet the needs for evidence-based clinical services for children and youth with gender identity issues.”

McKenzie echoed that position, saying CAMH’s focus has always been on improving services for young people who feel their physical anatomy does not match their inner gender.

“And it’s not really been about individuals like Ken or others. It’s been about focusing the decisions we make on the needs of our community.”

McKenzie said he understands why some clinicians and researchers are upset that someone they worked with and looked up to is no longer at CAMH, and the centre is grateful for Zucker’s “pioneering work” in gender research.

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“What I am surprised about is that people think that our decisions at CAMH, which are based on the needs of clients in working in our community, are politically motivated,” he said. “There’s no political motivation. The motivation is for (providing) the best service response.

“I cannot see CAMH ever making any apology for listening to our communities. We won’t.”

McKenzie also questioned the assertion that Zucker’s professional reputation has been besmirched as a result of CAMH’s decision to rethink the clinic’s approach and leadership.

“I don’t recognize that at all. CAMH has had a review of the clinic and lots of people work in the clinic, and that review has spoken very highly of the research that has been produced by the clinic.”

Meanwhile, the service is being wound down and has not taken any new referrals for more than a year. McKenzie said discussions are underway with the transgender community to decide the form and direction of a replacement clinic, which may or may not be housed at CAMH.

Blanchard, who describes himself as a close friend of Zucker, said the former clinic director did not practise reparative therapy, but began by encouraging prepubescent children to feel comfortable in their physical gender.

“But if that approach failed, Ken was always ready to refer them onto puberty-blocking hormones,” he said, referring to children whose opposite-gender identity persisted over time.

The hormones halt the physical changes that occur with puberty, as a precursor to possible sex-reassignment surgery in the future.

At a young age, it’s not uncommon for children to try on different gender roles, experts say. Studies have shown that 60 to 90 per cent of gender-questioning children do not go on to become transgender in adolescence, although a high proportion end up identifying as gay or lesbian.

“Something has to go on record somewhere that when this man was fired and his reputation was stained by CAMH, that the relevant international intellectual community disapproved of this and protested it,” he said.

“I had to get on record that this was not society’s final judgment on Ken Zucker.”

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