Friday, May 01, 2026

Israel condemned for seizure of Gaza-bound aid flotilla

IN INTERNATIONAL WATERS


01.05.2026, dpa

Photo: Matthias Oesterle/ZUMA Press Wire/dpa

By dpa correspondents

Germany, Italy and Spain were among countries that condemned Israel's seizure of an international flotilla carrying aid for the Gaza Strip in international waters off the coast of Greece and the detention of dozens of humanitarian activists.

The governments in Rome and Berlin on Thursday called on Israel to fully respect international law and "for restraint from irresponsible actions." Germany and Italy were following "with great concern developments" regarding the flotilla, they said.

At the same time, Berlin and Rome defended the international community’s efforts to "provide humanitarian aid to Gaza in accordance with international law and standards." Italian Prime Minister Giorgia Meloni also demanded the "immediate" release of all Italians "unlawfully detained." Both Italian and German citizens are on board.

In a separate joint statement, 11 countries including Spain and Turkey said "the unlawful detention of humanitarian activists in international waters constitute flagrant violations of international law and international humanitarian law."

The 11 countries called on the Israeli authorities "to take the necessary measures" to ensure the immediate release of the detained activists, condemning "in the strongest terms the Israeli assault on the Global Sumud Flotilla."

The Turkish Foreign Ministry earlier had called the attack on the flotilla an “act of piracy” in violation of humanitarian values and international law.

Israel has said its navy has intercepted more than 20 vessels from the flotilla west of Crete, roughly 1,000 kilometres from Israel. The Israeli Foreign Ministry said around 175 activists were being transported to Israel "peacefully."

The ministry said that Israel acted after the flotilla "actively attempted to block an Israeli merchant vessel," according to the Times of Israel.

Israeli Foreign Minister Gideon Sa'ar said the detained activists would be brought ashore in Greece in coordination with the government in Athens, which the minister said agreed to it. All activists were taken off the vessels "unharmed," Sa'ar added.

Greece later said it had "urged Israel to withdraw its vessels from the area and offered its diplomatic assistance by agreeing to host the passengers on its territory and ensure their safe return to their home countries."

"The Greek Authorities are in consultation with the Israeli Authorities regarding safe disembarkation in Greece," the Foreign Ministry in Athens said in a statement.

Meanwhile, the aid group described the operation in a post on X as "a violent raid in international waters."

Activists said Israeli speedboats approached the flotilla at night, with soldiers allegedly pointing lasers and semi-automatic weapons at the vessels. People onboard were reportedly ordered to assemble at the bow and kneel.

The group alleged that naval forces boarded multiple boats, "smashing engines" and "intentionally leaving hundreds of civilians stranded on powerless, broken vessels" as a storm approached. Communications were also reportedly disrupted.

More ships heading toward the Gaza Strip

Dozens of vessels carrying activists from multiple countries set sail from Sicily on Sunday toward the Gaza Strip in what organizers described as the largest flotilla yet attempting to reach the embattled Palestinian territory.

The activists aim to challenge Israel's naval blockade of Gaza, in place since 2007 and supported by Egypt, and to deliver humanitarian supplies to the territory.

They also say they are seeking to push for the establishment of a permanent humanitarian corridor.

Some of the flotilla's ships are continuing their journey following the incident on Wednesday night. Several boats were moving along the coast of Crete within Greek territorial waters late on Thursday, as shown by data from the online tracker of the flotilla's organizers and the Marine Traffic vessel tracking system.

The aid flotilla initially made no statements regarding its future plans. The organizers continue to accuse Israel of using violent force. Israel insists that the action against the flotilla is in accordance with international law.

Israel accused the organizers of the latest flotilla of collaborating with the Palestinian militant group Hamas, which still controls around half of the coastal strip.



Activists on Gaza aid flotilla detained by Israel disembark in Crete

Athens (AFP) – Dozens of activists on a Gaza-bound aid flotilla which was intercepted by Israeli forces in international waters off Crete disembarked on Friday in the Greek island, an AFP journalist saw.



Issued on: 01/05/2026 - FRANCE24

The flotilla comprising more than 50 vessels set sail in recent weeks from Marseille in France, Barcelona in Spain and Syracuse in Italy © Josep LAGO / AFP/File

Escorted by Greek coastguards, around 175 activists, the majority of them nationals of European countries, were taken in four coaches to the port of Atherinolakkos, in the southeast of the island.

As they approached the port, the activists chanted "Free Palestine," AFP saw.

Israel's foreign ministry earlier said around 175 activists had been taken off more than 20 vessels on Thursday. Flotilla organisers put the number at 211.

Turkey's foreign ministry said some 20 Turkish nationals in the flotilla who had been grabbed by the Israeli forces and taken to Crete would be repatriated. It said "certain participants from third countries" would also be sent to Turkey.


The flotilla comprising more than 50 vessels set sail in recent weeks from Marseille in France, Barcelona in Spain and Syracuse in Italy.

Its aim, according to the organisers, was to break the blockade of Gaza and bring humanitarian aid to the Palestinian territory.

Israel controls all entry points to Gaza. It has been accused by the United Nations and foreign NGOs of strangling the flow of goods into the territory, causing shortages since the start of Israel's war against the Palestinian militant group Hamas in October 2023.

The Gaza Strip, governed by Hamas, has been under an Israeli blockade since 2007.

Israeli foreign ministry spokesman Oren Marmorstein on Friday said: "All the flotilla activists are now in Greece except Saif Abu Keshek and Thiago Avila."

In a post on X, the ministry called the flotilla "another provocation designed to divert attention from Hamas's refusal to disarm". It also said the flotilla was serving "professional provocateurs".

It said Keshek was "suspected of affiliation with a terrorist organisation" and that he and Avila, suspected of "illegal activity", would be brought to Israel for questioning.

Several European governments with nationals among those arrested have called on Israel to free the activists and called its action a flagrant contravention of international law.

But the United States backed Israeli authorities, calling the flotilla a "stunt" and saying it expects allies to deny port access, docking, departure and refueling to vessels participating in the flotilla.

A State Department spokesman said Washington was exploring imposing "consequences" on those who support the flotilla.

The war in Gaza, triggered by the Hamas attacks on Israel on October 7, 2023, has led to severe shortages of food, water, medicine and fuel.

In the summer and autumn of 2025, a first voyage by the Global Sumud Flotilla across the Mediterranean towards Gaza drew worldwide attention.

The boats in that flotilla were intercepted by Israel off the coasts of Egypt and the Gaza Strip in early October.

Crew members, including Swedish activist Greta Thunberg, were arrested and then expelled by Israel.

burs-pdw/

© 2026 AFP

Gaza aid flotilla reaches Crete after Israel intercepts vessels

01.05.2026, dpa

Photo: Ilia Yefimovich/dpa

By Takis Tsafos, dpa

Around 30 vessels from the flotilla seeking to bring aid to Gaza have reached Crete, tracking data showed on Friday, after Israel intercepted some of the ships earlier this week, sparking international condemnation.

Parts of the Global Sumud Flotilla have entered the bay of Ierapetra, a port town in south-eastern Crete, according to tracking site Marine Traffic and the flotilla's online tracking tool.

It was initially unclear how long the activists would remain in Ierapetra, but Greek media reported that they have been brought to the small port of Atherinolakos on the south-eastern edge of Crete, from where they are to travel on to the island's administrative capital Heraklion.

Dozens of vessels carrying activists from multiple countries set sail from Sicily on Sunday toward the Gaza Strip in what organizers described as the largest flotilla yet attempting to reach the embattled Palestinian territory.

On Thursday, Israel said its navy had intercepted more than 20 vessels from the flotilla west of Crete, roughly 1,000 kilometres from Israel, with around 175 activists arrested. The Global Sumud Flotilla described the operation as "a violent raid in international waters."

The move sparked strong criticism including from Germany, Italy and Spain.

Greece said it was ready to take in those arrested to enable them to travel home.

The Israeli Foreign Ministry said that two activists were being brought to Israel for questioning, with one man suspected of having ties to a terrorist organization. The second person is accused of carrying out "illegal activities," the ministry said, without giving further details. 

It was also unclear how they would be brought to Israel.

The Global Sumud Flotilla had previously told dpa upon request that its vessels had reached safe waters and were currently regrouping.

The group said it was fully prepared to continue its journey "to break the illegal blockade of the Gaza Strip."


US condemns 'pro-Hamas' aid flotilla, threatens supporters

01.05.2026, dpa

Photo: Ilia Yefimovich/dpa

The United States on Thursday condemned an international flotilla attempting to carry aid to the Gaza Strip, calling it a "pro-Hamas initiative" attempting to undermine President Donald Trump's peace plan for the Middle East.

Dozens of vessels carrying activists from multiple countries set sail from Sicily on Sunday toward the Gaza Strip in what organizers described as the largest flotilla yet attempting to reach the embattled Palestinian territory.

The Israeli Navy has said it intercepted more than 20 vessels from the Global Sumud Flotilla west of Crete, roughly 1,000 kilometres from Israel. The Israeli Foreign Ministry said around 175 activists were being transported to Israel "peacefully."

Countries including Germany, Italy and Spain condemned Israel for seizing the vessels in international waters and called for international law and standards to be respected.

The US Department of State, meanwhile, condemned "the Global Sumud Flotilla, a pro-Hamas initiative and a baseless, counterproductive effort to undermine President Trump’s Peace Plan."

Department spokesman Tommy Pigott said that the flotilla is organized by "the Popular Conference for Palestinians Abroad, which was designated as a specially designated global terrorist in January for operating at Hamas’ behest."

Pigott went on to say that "the United States expects all our allies, particularly those who have committed to supporting President Trump’s successful 20-Point Plan [for demilitarizing Gaza], to take decisive action against this meaningless political stunt by denying port access, docking, departure, and refueling to vessels participating in the flotilla."

Since a ceasefire was declared in October last year, Israel has controlled around half of the Gaza Strip, while Hamas has largely re-established control in the remainder. Disarmament of Hamas under a US-led peace plan has not been implemented.


Israel intercepts Gaza-bound aid flotilla, detains 175 activists


30.04.2026, 

By Sara Lemel, dpa

The Israeli navy has intercepted more than 20 vessels from an international aid flotilla bound for Gaza off the coast of the Greek island of Crete and detained dozens of activists, authorities said on Thursday.

The Israeli Foreign Ministry said around 175 activists were being transported to Israel “peacefully."

Meanwhile, the group calling itself the "Global Sumud Flotilla" described the operation in a post on X as "a violent raid in international waters."

The group alleged that naval forces boarded multiple boats, "smashing engines" and "intentionally leaving hundreds of civilians stranded on powerless, broken vessels" as a storm approached. Communications were also reportedly disrupted.

The interception took place west of Crete, roughly 1,000 kilometres from Israel. While an intervention had been anticipated, the timing and location reportedly came as a surprise. Israeli media said the flotilla was stopped early due to its size.

The Israeli military provided only a brief statement, saying it was enforcing the naval blockade of the Gaza Strip, which it says is in place for security reasons. It added that it was acting under instructions from Israel's political leadership.

Activists said Israeli speedboats approached the flotilla at night, with soldiers allegedly pointing lasers and semi-automatic weapons at the vessels. People onboard were reportedly ordered to assemble at the bow and kneel.

Dozens of vessels carrying activists from multiple countries set sail from Sicily on Sunday toward the Gaza Strip in what organizers described as the largest flotilla yet attempting to reach the coastal enclave.

The activists aim to challenge Israel's naval blockade of Gaza, in place since 2007 and supported by Egypt, and to deliver humanitarian supplies to the territory.

They also say they are seeking to push for the establishment of a permanent humanitarian corridor.

Israel has previously blocked similar attempts to breach the blockade. During an earlier effort last year, Israeli special forces boarded the largely privately owned sail and motorboats making up the flotilla and prevented them from reaching Gaza.

Israel accused the organizers of the latest flotilla of collaborating with the Palestinian militant group Hamas, which still controls around half of the coastal strip.

The Foreign Ministry in Jerusalem spoke of “professional provocateurs” and accused them of seeking to sabotage the transition to the second phase of US President Donald Trump’s Gaza peace plan, diverting attention from Hamas’s refusal to lay down its arms.

The Turkish Foreign Ministry called the attack on the flotilla an “act of piracy” in violation of humanitarian values and international law.

Amnesty International official Erika Guevara Rosas said it was "appalling that activists participating in a peaceful solidarity mission to break Israel's unlawful blockade of the Gaza Strip and deliver medical supplies to people facing a catastrophic humanitarian crisis - deliberately imposed by Israel - have been arbitrarily detained once again."

Despite the raid, several ships from the flotilla were believed to be continuing their journey on Thursday, according to data from the organizers' online tracker and the Marine Traffic vessel tracking system.

There were initially no statements from the organizers regarding the further plans of the ships participating in the flotilla.

Greece describes events

A government spokesman in Athens said the Greek coastguard's search and rescue command centre received a distress signal from a vessel in international waters more than 60 nautical miles west of Crete.

A coastguard patrol boat was immediately dispatched. During radio contact, the captains of the vessel in question and other nearby ships stated that there was no danger and that they “neither required assistance nor wished for support from the Greek authorities,” the spokesman added on Greek television.

The coastguard also noted that 17 boats had been abandoned by their crews and were drifting in the region. The salvage of the vessels would begin shortly, with further details to be provided in due course, government sources in Athens added.

According to the Israeli Foreign Ministry, those arrested are to be taken to Greece in the coming hours.


Right-wing violence in Germany hits highest level since 2016

01.05.2026, dpa

Photo: Bernd Weißbrod/dpa

German police recorded the highest number of right-wing motivated violent offences last year since 2016, according to a government response to a question from the opposition Left Party.

The response, seen by dpa, showed that Germany's federal states had reported a total of 1,598 such offences for 2025 to the Federal Criminal Police Office (BKA) by the cut-off date of January 31, 2026.

In most cases, investigations were launched on suspicion of bodily harm or grievous bodily harm.

The previous year, the states recorded 1,488 right-wing motivated violent offences, while in 2023 police registered 1,270 violent offences with a right-wing background.

The figures for the previous year can still change because of late reports. This is partly because reports first have to be passed from the states to the BKA, but also because the political motivation behind an offence sometimes only becomes clear later.

Looking at all right-wing motivated offences recorded in 2025, there was a slight decline, from 42,788 to 42,544 offences.

Typical politically motivated offences include denigrating the state and its symbols, incitement to hatred and insults.

Violent offences include homicides, bodily harm, breach of the peace, dangerous interference with road traffic, deprivation of liberty and offences involving resistance to law enforcement officers.

Ukraine launches fresh drone attacks on Russian oil port of Tuapse

01.05.2026, dpa

Photo: Kay Nietfeld/dpa

Ukrainian drones have once again caused a fire at the oil terminal in the Russian Black Sea port of Tuapse, authorities said on Friday.

There were no deaths or injuries, the crisis management team for the southern Russian region of Krasnodar told the state news agency TASS.

According to the report, more than 100 firefighters are involved in fire-fighting operations. 

This was the fourth Ukrainian attack on the oil facilities within the last two weeks.

The Russian Defence Ministry reported that 141 Ukrainian drones were shot down over Russian territory. However, air defences were once again powerless against the strikes in Tuapse.

The previous attacks caused severe damage. Most of the reservoirs have now been burnt out, and the infrastructure for transferring oil to ships has also been damaged. 

Russian President Vladimir Putin recently warned that the attacks could potentially pose an environmental hazard, but insisted that the authorities have the situation under control. 

Official data shows air pollution levels are significantly elevated and some of the oil has leaked and entered the sea.

Ukraine, which has been defending itself against Russia’s invasion for more than four years, is deliberately targeting not only military sites but also facilities belonging to the Russian oil industry. 

This is intended, on the one hand, to hamper the Russian army’s fuel supply and, on the other, to undermine the Kremlin’s war financing.

Meanwhile, Russia again attacked Ukraine with drones during the night. 

According to official reports, two apartment blocks in the port city of Odessa caught fire following drone strikes. 

Two people were injured, the Ukrainian civil protection agency reported. Twenty-five people, including two children, are receiving psychological support following the shock of the strikes.


Gen Z turning its back on AI isn’t irrational—it’s a verdict on everyone who failed them


Story by Nick Lichtenberg
Fortune


Gen Z is entering a not so brave new world of AI.© Ye Myo Khant/SOPA Images/LightRocket via Getty Images

America has a problem with young people and AI. Gen Z has looked clearly at what the AI revolution is doing to their lives and rendered a verdict: The institutions that were supposed to prepare them for this moment have failed; the employers that were supposed to hire them have vanished; and the government that was supposed to manage the transition has been absent without leave.

That verdict is arriving in numbers that are hard to dismiss: The more young people engage with the technology, the worse they feel about it.

Gen ’s excitement about artificial intelligence dropped 14 points over the past year to just 22%, according to Gallup polling released this week. Hopefulness fell nine points to 18%. Anger rose nine points to 31%. And here’s the data point that deserves the most attention: Even daily AI users saw bigger drops in sentiment than nonusers; excitement among that group fell by 18 points, and hopefulness tumbled by 11. Separate polling aligns with this: Gen Z rates AI satisfaction at just 69 on the American Customer Satisfaction Index—below airlines, social media, and mortgage lenders.

The paradox is telling: 62% of Gen Z and millennials believe that AI will unlock financial opportunities they can’t currently access. Something is going wrong here, on the cusp of a supposed Fifth Industrial Revolution, and, as with so many things in the wider AI discourse, this seems to be a sort of Rorschach test, reflecting back humanity’s own foibles. They believe in the technology’s potential, but don’t trust the system surrounding it to let them benefit.

Schools chose the wrong side

The first institution to stand in the dock is higher education. At the exact moment AI literacy became a foundational workplace skill, most colleges went in the opposite direction. More than half of college students say their school either discourages (42%) or outright bans (11%) the use of AI, according to Gallup. Faculty are aware of the damage: 63% believe their schools’ 2025 graduates were not very or not at all prepared to use AI in the workplace, per the American Association of Colleges and Universities. But what is the first thing employers are asking for from any qualified candidate? AI literacy.

This editor has personally visited the KPMG Lakehouse, where new consulting interns are training up in how to prompt, and talked to thought leaders in human resources and economics who fear the mismatch between what employers want and what workers have to offer. AI skills are the missing link in the stagnant labor market, and Gen Z knows it—and they know they’ve been underprepared for this revolutionary moment.

A Fortune investigation last fall found the same fault line from a different angle: Nine in 10 educators told researchers their graduates were workforce-ready, while nearly half of those graduates said they didn’t feel prepared even to apply for an entry-level job in their field. Rather than adapt, some students are engineering their own work-arounds: Double-majoring has surged as a hedge against AI disruption, Fortune reported in November, and graduates who steered toward so-called AI-proof fields—psychology, education, social work—are now finding those degrees carry negative financial returns as AI moves into white-collar work faster than anticipated.

This lands inside a broader legitimacy collapse that elite universities have spent years engineering for themselves. A Yale faculty committee released a sweeping, self-critical report this week documenting the ruin—runaway tuition; an opaque admissions process that systematically advantages the wealthy; and campuses increasingly hostile to free inquiry. A decade ago, 57% of Americans said they had a great deal or quite a lot of confidence in higher education; by 2024, that figure had cratered to a historic low of 36%. The institutions most responsible for equipping the next generation to navigate a turbulent economy have spent years losing the public’s trust—and then they turned their backs on AI, the one thing Gen Z most needed to master to get a good job, maybe any job, in this market.

The jobs disappeared quietly

Whatever deficiencies young people bring out of school, they have expected the job market to eventually sort things out. It hasn’t. The unemployment rate for recent college graduates hit 5.7% in the fourth quarter of 2025, above the national rate—a reversal that almost never happens. Underemployment for recent grads sits at 42.5%, the highest since 2020.

The mechanism matters here. This isn’t primarily a story of mass AI-driven layoffs, as layoffs remain relatively low across the economy, with big exceptions in the tech industry. The story is more one of quiet erasure. At companies that have adopted AI, junior hiring fell nearly 8% within six quarters—not through firings, but through a freeze on new positions, according to a Harvard working paper tracking 62 million workers.

Gen Zers are paying a compounding price: Without early-career experience accumulating, their wages are falling further behind those of older workers than any comparable cohort in decades. Entry-level jobs are the ones AI automates first. They are also the jobs that teach young workers how to think, build judgment, and eventually move up. Eliminate the bottom rung, and you don’t just harm one generation—you hollow out the management pipeline for the next decade.

The anxiety is producing measurable behavioral responses. Forty-four percent of Gen Z workers admit to actively sabotaging their company’s AI rollout—compared with 29% of workers overall, Fortune reported earlier this month. It is a sign less of technophobia than of workers who feel unprotected and are acting accordingly. Some economists argue that the weak entry-level market is partly an overcorrection from the post-COVID hiring binge of 2021. And nearly 60% of hiring managers reportedly use AI as an excuse for layoffs and freezes because it plays better with stakeholders than the real reasons do. Marc Andreessen called it a “silver-bullet excuse.” Sam Altman branded it “AI-washing.” The honest answer is messier: AI and opportunism are compounding each other, and young workers are caught in the middle.

Washington has been somewhere else

The missing actor in all of this is the government. There is no serious federal workforce transition framework, no large-scale AI-skills retraining program, no mandate that schools treat AI literacy the way they treat reading or arithmetic. What there is instead: an administration that has spent its political capital on wielding education funding as a cudgel—freezing $2.2 billion in federal grants to Harvard over campus activism disputes—while the skills gap widens, and a generation improvises its own future in real time.

Sixteen percent of currently enrolled college students have already changed their major because of AI—a sign of a generation trying to adapt in real time, without a map. Whether schools catch up, whether employers reverse the junior hiring freeze, and whether Washington produces anything resembling a workforce policy will determine whether the current anxiety hardens into something permanent. For now, the numbers suggest it already has.

In April 2026, OpenAI released a 13-page policy paper, “Industrial Policy for the Intelligence Age,” warning that AI’s rapid advance toward superintelligence threatens to hollow out wage and payroll tax revenue and unravel the social safety net, and calling for a sweeping overhaul comparable to the Progressive Era or the New Deal.

The company’s blueprint—shifting the tax base away from labor income toward corporate profits and capital gains, floating a “robot tax” on automated labor, and creating a national public wealth fund that would distribute returns to American citizens—closely mirrors proposals from billionaire venture capitalist and early OpenAI backer Vinod Khosla, who has argued for eliminating federal income tax for Americans earning under $100,000 and taxing capital gains at ordinary income rates.

Both Khosla and OpenAI framed the urgency in stark terms. Goldman Sachs research indicates that AI is already cutting roughly 16,000 U.S. jobs per month, with younger workers hit hardest, and Khosla predicts that AI could automate 80% of current jobs by 2030. Critics, including Carnegie Endowment scholar Anton Leicht, dismiss the OpenAI paper as “comms work to provide cover for regulatory nihilism,” underscoring how far Washington remains from any concrete legislative response.


This story was originally featured on Fortune.com

In Canada, Alberta's 'Maple MAGA' dream of independence



Issued on: 01/05/2026 - FRANCE24




12:00 min From the show


In Canada's oil heartland of Alberta, separatism is no longer just a slogan. An unprecedented movement of independence supporters, aided by a reform from the western province's conservative government, has just cleared the way for a referendum to be held on October 19. This is a first in Canada since Quebec's failed independence referendum in 1995.

The Alberta Prosperity Project, a movement led by lawyer Jeffrey Rath, nurtures an old resentment: that of a western, resource-rich Canada "despised" by the ruling elite in Ottawa. One third of those surveyed across the province's population are in favour of the referendum.

As they launch their final campaign for the "Yes" side, the separatists face numerous obstacles: unprecedented federal pushback in favour of the "No" campaign and a series of lawsuits from the province's First Nations communities, who denounce foreign interference from Washington and accuse the separatists of "treason".

US-Canada relations cool at the border over Trump's tariffs and threats

The shadow of the US's MAGA movement looms large over this oil-rich area of Canada dubbed "North Texas", where many oilers and ranchers hope to turn the territory – home to the world's third-largest proven oil reserves – into an independent state.

US Treasury Secretary Scott Bessent welcomed the separatist initiative back in January, but Rath insists he's not funded by the MAGA movement.

FRANCE 24's François Rihouay and Joanne Profeta report.










'We need to reassess': The evolution of one gender care doctor in Canada



Story by Sharon Kirkey


Dr. Karine Khatchadourian is calling for a national review to reassess how Canada treats gender-distressed youth.


During a recent talk at the invitation of the University of Alberta, Dr. Karine Khatchadourian offered a candid appraisal of the evidence underpinning Canada’s approach to treating gender-distressed youth.

The field is in a highly consequential grey zone with contradictory findings at best, the Ottawa doctor told a virtual audience. The evidence doesn’t allow doctors to say with confidence whether puberty suppression has psychological benefits or not and today’s rapidly changing demographics — predominantly biological females with accompanying complex mental health problems and no known history of gender distress when they were younger — make it difficult-to-impossible to predict if someone’s gender dysphoria or incongruence will persist.

“We have to constantly be reassessing what we’re doing, what we’re treating, based on new evidence that’s coming forward,” Khatchadourian said.

Doctors are encouraged to look at emerging data objectively, be open to scrutiny and pivot where necessary, she said. However, gender-affirming care is different; a field so turbulent and charged with emotion that providers are reluctant to express doubts for fear of being alienated by colleagues and condemned by activists as transphobic.

Which is what makes Khatchadourian’s openness to share that her own messaging has changed so remarkable.

“The message to patients, providers, the public has to include that what we’re seeing now with the data is this uncertainty of the evidence,” she told the February gathering hosted by the U of Alberta-based Women and Children’s Health Research Institute. Her assessment echoes the findings of a recent series of deep systematic dives into the literature that concluded the evidence supporting gender medicine interventions is, as the editor-in-chief of the influential British Medical Journal summarized, “threadbare, whichever research question you wish to consider.”

Khatchadourian was one of the first doctors in Canada to provide hormone treatments to transgender-identifying and gender dysphoric youth, in 2014. By her estimate, some 250 to 300 gender-distressed children and teens have been under her care over the years.

After 12 years of experience, she said she now understands the population more. “I can say that, with everything I now know, as of now, I would challenge medicalizing the majority of youth that are presenting to clinics,” Khatchadourian, an assistant professor of pediatrics at the University of Ottawa, said in an interview.

“I strongly believe in this care,” she stressed.

“But it must be approached with rigour and caution, given the high stakes in this field.”

McMaster University researchers faced persecution from both extremes of the trans debate last year after publishing two systematic reviews that found the evidence is of such low, or very low, certainty that it’s impossible to conclude whether puberty blockers are helpful or harmful.

Lead author and celebrated scientist Dr. Gordon Guyatt and colleagues faced backlash from activists on one side over a funding source (the Society for Evidence-Based Gender Medicine, a group concerned with low-evidenced interventions that’s been accused of being an anti-trans think tank by transgender rights groups) and, on the other side, critics who accused Guyatt of shirking his own evidence-based approach to science by later issuing a letter criticizing opponents for using his work to justify treatment bans.

“Everybody’s been kind of frightened,” Guyatt told National Post columnist Michael Higgins . “I was not as vividly aware as to what an extreme political environment it is.”

In their letter, Guyatt and four colleagues wrote that it’s misguided to cast medical interventions based on low-certainty evidence “as bad care or as care driven by ideology.”

However, under the GRADE scoring system co-developed by Guyatt, “very low certainty” means it’s hard to have confidence where the true effect lies.

Privately, other Canadian doctors like Khatchadourian are becoming more cautious.

Writing for healthydebate.ca, scientist, gastroenterologist and U of Toronto professor of medicine, Dr. Laura Targownik, who is a transgender woman, said several providers working in the field have shared that they’re becoming “more circumspect, recognizing that they can no longer function as enablers of transition in all cases.”


Public support for gender care for minors is in “free fall,” she wrote, “not only among conservative voters, but also among those who describe themselves as moderate or liberal.”

But the issue has become such a political minefield doctors fear that any expressed concern will be weaponized and used to shut down “and rob youth” of all care, even for those who would benefit, Targownik said in an interview.

Canadian physicians want what’s best for kids, she said. But they’re also concerned about leaving kids suffering from serious dysphoria with nothing.

Several European countries and American states are already pulling back. Puberty blockers have been banned indefinitely in Britain for under 18s after the country’s health service declared them an “unacceptable safety risk.” Alberta invoked the Charter’s notwithstanding clause to uphold its bill p rohibiting doctors from prescribing puberty blockers or cross-sex hormones to under 16s.

Meanwhile, numerous medical organizations, including the Canadian Paeditric Society, continue to endorse an affirming approach to gender dysphoria.


Dr. Karine Khatchadourian estimates some 250 to 300 gender-distressed children and teens have been under her care over the years.© HYUNGCHEOL PARK

Khatchadourian was one of the first pediatric endocrinologists to train in the field of pediatric gender medicine in Canada. She was the first author of the first Canadian study (and second paper in North America) on the medical management of youth with gender dysphoria, published in 2014. Between 2022 and 2024, she was co-medical lead of the Children’s Hospital of Eastern Ontario’s (CHEO) gender diversity clinic.

While still relatively small, the number of children and adolescents identifying as transgender or gender-diverse has grown dramatically over the last decade. Pediatricians and family doctors across Canada are seeing them in their practices. Kids are being treated not only in specialized hospital-based clinics, but also by primary care providers in the community, some after virtual assessments.

In an interview, Khatchadourian said she worries that the increase in teens (mostly natal females) identifying as non-binary — neither identifying as female nor male — may be socially driven. “We know social media and peers have greater influence during adolescence,” she said.

“I didn’t see anyone identifying as non-binary ten years ago when I was training.” She questions the influx now.

“It’s so hard to know when you see a patient how much of this story is really that person’s story and how much is based on the influence of peers and social media,” she said.

“We get to a point where we accept certain definitions and certain things, but we should continuously ask why: ‘Why is this happening? What are your theories? Does this warrant medical treatment?’”

In the pre-social media era, kids who might have struggled with low level dysphoria or transient feelings might have found other ways to deal with it or allowed it to pass, Targownik said.

“But now they’re connecting with people who are telling them, ‘Hey, I did this and it’s working for me. This may be why you’re feeling disconnected from society. Maybe the reason you’re having trouble fitting in with other girls is not because you’re autistic, or because you’re marching to your own beat. It’s because you are actually a boy inside.’”

Youth can instantly connect with dozens of others who feel the way they do and start down a medical transitioning path. But Khatchadourian worries “we’re changing trajectories for these youth” based on unconvincing and limited data, and with too few mental health assessments by psychologists or psychiatrists trained in the child and adolescent medicine space.


“The expertise has not kept pace with the demand, and that worries me,” said Khatchadourian. She’s advocating for a national review in Canada — one involving those working in the field, trans-identified individuals, parents and families and, as well, de-transitioners — to ensure practices are aligned with the best available evidence.

Targownik also supports getting better data because, whether a populist or pragmatist, government leaders “are going to start asking for receipts,” she said.

“Someone is going to come and say, ‘I know you believe this care works. If you believe so strongly in this, show me that it actually works. Show me your outcomes. Show me that the kids you’re transitioning are doing well a year later, two years, five years later. Give me your best estimate of what the detransition rate in the modern cohort actually is, and the risk factors.”

There’s been a reluctance to ask those questions in the past when the practice was completely unhindered and support for gender care at its peak, she said.

Now, more countries are questioning that blanket, blind “just affirm” approach.

Khatchadourian favours aligning with Sweden and Finland’s approach, where puberty blockers and cross-sex hormones are reserved for children and teens with a history of gender dysphoria that started in early childhood and has persisted for many years.

For others, she recommends a more holistic approach, supporting youth as they’re going through identity development. She rejects accusations that she’s against gender affirming care. “Gender care means I’m addressing the distress. Of course that is a concern. ‘You have needs. I’m here to support your needs.’ But we haven’t asked the right question: What is the best way to address your needs?’

“We need to take a high level of risk approach, given the uncertainty of the evidence” and medication risks, she said. For her, the biggest stake is irreversible infertility.

“The most challenging conversations are always around fertility,” she said. “Most of the time you’re going to hear youth say they don’t want children, they don’t want biological children, or if they do at some point, they will consider adoption. You have to ask yourself, is that a mature response? Have they really given it considerable thought? Have they truly demonstrated capacity to consent?”


Early in her training, Khatchadourian spent a month in the Netherlands, the origins of pediatric gender medicine and birthplace of the so-called “Dutch Protocol” that saw doctors begin offering medical transitions for gender dysphoric teens in the early 1990s.


Back then, most of the gender distressed Dutch kids were biological males with a history of childhood-onset gender dysphoria that persisted into late adolescence.

Since then, the sex ratio has shifted dramatically, with 70 per cent of children presenting at clinics now natal females, many with co-occurring conditions such as autism, depression and anxiety that make it crucial to separate gender-related distress from other sources of distress or trauma that might mimic or add to the gender incongruence, Khatchadourian said.

“You really need good mental health providers to assess and diagnose from that lens.”

However, one study found that only four of 10 gender clinics in Canada required a psychiatric or psychological assessment before blockers or hormones were started.

Medical transitioning can begin once puberty starts, with drugs that block the physical changes of puberty. Older teens can receive cross sex hormones so that they develop the physical features more in line with their gender identity. Gender reassignment surgeries in Canada are restricted to those 18 and older, though mastectomies have been performed on girls as young as 14.

Concerns have been raised that doctors are misusing the principle of autonomy by prioritizing affirming a child’s self-declared identity and giving children the treatments they want to change their physical body to align with their expressed gender. It prioritizes the child’s goals. “But what if those goals shift,” she said.

There’s no clear picture of the natural course of gender dysphoria among the cohort of kids seeking gender-affirming care today, she said. “It’s well accepted that gender incongruence in childhood is usually a sign of later emerging same-sex attraction,” she said.

She also worries about the risk of regret in, for example, a 15- or 16-year-old biological female who has identified as non-binary for a few years who now wants a mastectomy. “These are major decisions that require careful consideration.”

There’s sometimes an urgency of expectations from parents and youth as well, she said. Many are unnerved by the dominant and stark narrative that these kids have a high risk of suicide, but the weight of the evidence suggests blockers and hormones do not decrease suicidality, she said. “This is important for families to know.

“You need to identify and treat the mental health disorders in adolescents experiencing gender dysphoria to prevent suicide.”

Khatchadourian no longer sees many young people herself, though she still has a few she follows in clinic and acts as a consultant on gender care for primary care providers for the province of Ontario. She no longer helps lead CHEO’s gender diversity clinic. “It was deemed that my expertise would be better suited to focus on other clinical and academic responsibilities,” she said, including her diabetes patients.

Considerable research has been published since she first began in the field of gender medicine. It’s a field that’s evolving rapidly. What one might have believed even a year ago might not hold anymore, she said.

“I need to trust the data,” she said. “Trust what we’re doing. And there was a lot of confusion for me with understanding the evidence.

“If I didn’t trust the evidence, how could I instill confidence in my patients?”

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