A trans advocacy group in Montreal says McGill University’s student health clinic has refused hormone replacement therapy (HRT) to some U.S. students because of fears of repercussions from the Trump administration.
The Montreal Trans Patient Union (TPU), an advocacy group for trans health care in Montreal, has held regular meetings with doctors from the Student Wellness Hub over the last few years to discuss how to improve care for trans patients.
TPU member Emma Gimbert was at the most recent meeting in March, where she says doctors from the wellness hub mentioned a change in policy.
“They said they wouldn’t be prescribing HRT to American citizens who were under 19 because of the executive order that Donald Trump issued,” Gimbert said.
That would be executive order 14187, issued in January 2025.
The order’s stated purpose is to “protect children from chemical and surgical mutilation,” and it includes consequences for health-care professionals and organizations in the U.S. who provide gender-affirming care to people under the age of 19.
Gimbert was surprised Trump’s order would be a concern for doctors at McGill.
“If you told me a month ago that a U.S. executive order would be influencing how doctors do their job across the border, I would have been like, no, that can’t be the case,” Gimbert said.
“But I guess now that’s the reality.”
A TPU administrator, who asked not to be identified because they are a U.S. citizen and fear being targeted by U.S. authorities or anti-trans activists if they speak publicly, was also at the March meeting and told CBC the new policy is ridiculous.
“These are American laws. American laws don’t apply in Canada,” they said.
A group advocating for trans rights says some American trans students are being denied hormone replacement therapy by the university’s medical clinic. The Montreal Trans Patient Union says it’s because of a Trump administration policy.
Whistleblower form
In addition to Gimbert and the administrator from the TPU, also present at the March 16 meeting were the medical director and the administrative director of McGill’s wellness hub, along with two doctors and a nurse practitioner who provide gender-affirming care.
Gimbert said the doctors at the meeting said they had already refused HRT to two U.S. students under the age of 19.
The administrative director and the medical director of the wellness hub, who were present at the meeting with the TPU, declined to comment when reached by CBC.
According to Gimbert and the TPU administrator, the doctors said they were refusing the treatment based on legal advice from the Canadian Medical Protective Association (CMPA), a group that provides legal guidance to Canadian doctors.
“The doctors said the reason for this was specifically the fact that the form the U.S. released had provisions for targeting Canadian doctors and taking down their information,” the TPU administrator said.
The U.S. Department of Health and Human Services has an online whistleblower form where people can report medical professionals who violate Trump’s executive order.
And while the order only covers medical professionals based in the U.S., a drop-down menu on the original form released in April 2025 included an option to identify health-care professionals from Canadian provinces and territories, in addition to U.S. states.
The drop-down menu was updated shortly after to include only U.S. states, although it still includes an option to submit either a U.S. zip code or a Canadian postal code when reporting the address of a health-care provider.
Gimbert said the doctors at the meeting raised two specific concerns about providing HRT to U.S. students under the age of 19.
“First was that there would be some possibility of legal action against the hub,” she said.
Gimbert said she believes it’s highly unlikely that someone in Canada would report McGill doctors to U.S. authorities, and equally unlikely that U.S. authorities would try to enforce an American law in Canada.
She said the second concern was more understandable.
“The other possibility they brought up was that it might be difficult for doctors at the hub to cross the border because of the current political climate,” Gimbert said.
Academics at Canadian universities who may be at odds with Trump administration policies have been warned about possible risks of entering the U.S.
Policy unclear
In a statement to CBC, McGill refused to say whether U.S. students had been denied HRT, or to clarify the wellness hub’s policy for providing gender-affirming care to U.S. students under the age of 19.
“Access to gender-affirming care is available to McGill students, including international students,” McGill’s statement said.
“The medical aspects of this care are provided by licensed physicians. These decisions are not made by the university,” the statement said.
The statement confirmed that doctors at McGill are guided by advice from the Canadian Medical Protective Association (CMPA). McGill suggested CBC ask the association about its guidance provided to physicians regarding patients from the U.S.
The CMPA told CBC that legal advice given to its physician members is considered confidential.
“The CMPA does not set policies, clinical guidelines, and standards or duty of care for physicians,” its statement said.
“Since your question relates to clinical decisions made about the provision of care, it would not be appropriate for the CMPA to comment.”
Gimbert said McGill and the wellness hub need to be more transparent.
“I think it’s definitely important for them to acknowledge what’s been going on because the way they’re currently treating this, it’s kind of covert,” Gimbert said.
“We know this is something that they’re aware of. It’s just not something that they’re publicly talking about.”
More students could be affected
All international students who attend McGill are obliged to pay into a health-care plan that gives them access to care at the wellness hub.
“If you’re an American or an international student, the wellness hub is really your only option for getting HRT in a timely way,” the TPU administrator said.
They said McGill’s policy doesn’t make sense.
“I mean, we don’t say that 18-year-old Americans can’t buy alcohol here because the drinking age in the U.S. is 21,” they said.
Celeste Trianon, a trans rights advocate in Montreal, said HRT, which promotes physical changes in people to align their sex characteristics with their gender identity, is crucial for trans patients.
“For example, testosterone has the effect of masculinizing the voice and creating masculine features in the face. It basically lets someone become a man,” Trianon said. She said estrogen helps with breast growth and with rounding facial features.
“These hormones have very much physiological effects on the body, but also have effects on the mind, improving trans peoples’ mental health quite significantly,” Trianon said.
Gimbert said even though only two U.S. students appear to have been denied HRT so far, many more could be affected in the future.
She said most undergraduate trans students usually request HRT from the wellness hub in the fall after being admitted.
“This rule wasn’t in place at the start of the year last fall, to our knowledge,” she said.
“But now that it is in place, we definitely expect that number to grow.”
Data from McGill’s website says more than 1,000 undergraduate students from the U.S. were admitted last fall, and Gimbert said it’s reasonable to expect that several students admitted from the U.S. next year will be trans, under 19, and looking for gender-affirming care.
‘Situation of concern’
The Quebec College of Physicians told CBC it didn’t have enough information to comment, but in a statement, a spokesperson for the college said doctors practising in Quebec must respect their code of ethics.
The spokesperson referred specifically to Article 23, which states that a physician may not refuse to treat a patient for reasons including race, sex, religion, sexual orientation, morals, political beliefs or language.
Doctors can refuse care if they don’t feel they have the knowledge base to provide a particular treatment, but they’re required to refer the patient to someone who can provide care.
The college spokesperson also said it would be “a situation of concern” if McGill was denying care to trans students from the U.S. under age 19 based on U.S. law.
The Canadian Medical Association (CMA) also said it couldn’t comment on this specific case without more information.
“The CMA strongly believes health decisions must be made by patients and their families, in partnership with their health provider — not by politicians,” a CMA spokesperson said in an email.
The U.S. Department of Health and Human services did not respond to CBC’s request for comment.
