A B.C. family doctor has been ordered to pay $28,100 after refusing to inject a transgender teen with a prescribed hormone blocker, citing religious and cultural reasons.
Dr. Henry Ajaero, who has run a family practice in Delta since 2014, was ordered to pay the compensation in a Sept. 1 B.C. Human Rights decision, which found his conduct was discriminatory.
In March 2021, Ajaero told a transgender teen and her mother who made an appointment at his practice that he would not inject a prescribed medication called Lupron, saying “he did not feel comfortable administering it.”
Ajaero argued to the tribunal that he did not administer the injection because “doing so would go against his religious beliefs” and “because it is outside the scope of his practice.”
The tribunal ruled he failed to establish a conflict between his religious beliefs and the medical services the teen was seeking.
“Dr. Ajaero has not established that either the Religion Standard or the Expertise Standard were reasonably necessary to achieve their purposes. This is likely because they were developed quickly, in the context of a busy and stressful day, with incomplete information,” the decision reads in part.
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“This context is an explanation for Dr. Ajaero’s decision, but it does not justify his decision to deny medical services to a vulnerable trans youth because of her gender identity.”
The decision describes Child Q, the 14-year-old at the centre at the decision, as a “brave, sensitive, kind transgender girl.”
It says in late 2020, she came out as transgender and struggled with her mental health as she entered puberty. Ajaero referred her to the B.C. Gender Clinic, where an endocrinologist prescribed Lupron, a medication that pauses puberty.
According to the decision, Child Q describes the day she started the medication as “one of the best days of my life.”
Lupron needs to be injected every three to four weeks. It can be injected at home, but according to the decision, Child Q and her family preferred to have it done by a doctor.
Her first appointment to get an injection at her family doctor’s was March 5.
The decision said when Ajaero learned that the shot was Lupron, he told Child Q’s mother he would not be administering it.
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“He explained this was for religious and cultural reasons, and he hoped that was OK. Mother Q said it was not OK.”
Ajaero’s charting notes from the appointment said: “I noticed that the injection is for gender re-assignment as patient is already in the waiting room with [her] mother. I called mother into the room and explained to her that I would not be able to give the injection. Based on my religious belief and cultural background.”
Child Q and her mother never spoke with Ajaero again outside of legal proceedings.
The decision found that “while it is true that Lupron was prescribed through the Gender Clinic, and was intended to give Child Q time to consider options relating to her gender identity, it is not medication for gender re-assignment.”
“It does not, on its own, conflict with Dr. Ajaero’s stated religious belief that ‘God created man and woman.'”
The decision said Ajaero attended medical school in Nigeria, and practised medicine in Nigeria, South Africa, and rural B.C. before opening his clinic in Delta. It says he is Christian and “his religion is an important part of his life.”
Ajaero said he has around 2,800 to 2,900 patients, and works five days per week, seeing about 50 patients per day. The decision notes that at the time of the incident, Ajaero was under particular strain due to the ongoing COVID-19 pandemic.
“He testified that he had never interacted with a trans person (to his knowledge) or been involved in any ‘gender therapy.’ He had never administered Lupron for any purpose. It was apparent from his evidence that, in all the circumstances, he felt uncomfortable and unprepared,” read the decision.
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“I accept that these feelings motivated his decision to deny services to Child Q, and were not based on an intention to discriminate against her.”
Ajaero applied to limit the publication of information that could identify him and his clinic, arguing in part that doctors who provide gender affirming care have faced threats.
The tribunal denied that application, saying there is no evidence that doctors who refuse to give gender-affirming care face the same risk.
“I am not prepared to assume that the public response is the same to doctors on both sides of the issue,” the decision states.
