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CAMH: an anti-transgender legacy

From 1968 to 2015, Toronto’s CAMH gender identity clinics for adults and children became the most notorious in the world for harmful beliefs and practices they promoted. Beginning in 2016, the mental health teaching hospital and research center replaced staff and changed protocols to reflect current scientific and ethical consensus on best practices for trans healthcare. Wait times for first appointments soon dropped from 30 months to 9 months, and clients reported improved service.

Despite these changes, there remains lingering distrust among the community, so it’s best for Canadian sex and gender minorities to review all available options before committing to care at CAMH. Speak with local community members who have first-hand experience with health services since 2016.


In 1850, Ontario opened the Provincial Lunatic Asylum at 1001 Queen Street West in Toronto. In 1871 it was renamed the Asylum for the Insane, and in 1905 renamed again to the Hospital for the Insane. In 1919, it became Ontario Hospital, Toronto.

In 1966, the province opened the Clarke Institute of Psychiatry at 250 College Street, named after asylum reformer and eugenicist Charles Kirk Clarke (1857-1924). Clarke oversaw the two largest Canadian mental hospitals before accepting a government mental-health post. In addition to his desire “to keep this young country sane,” he sought to advance the psychiatric profession’s influence in making medical and political decisions. It’s clear why they took his name off.

Typical of “professionals” who are unable to see (or worse) unconcerned about larger systems which influence their realm of expertise or narrow interests, Clarke was an early proponent of eugenics, emphasizing the importance of restrictive laws that would limit the immigration and marriage of the “defective.” [2] During his tenure, foreign-born patients made up more than 50 percent of the institutionalized population in Canada. [3]

As Katherine Wilson notes:

Psychiatric diagnosis on the basis of social, cultural or political affiliation evokes the darkest memories of medical abuse in American history. For example, women suffragettes who demanded the right to vote in the early 1900s were diagnosed and institutionalized with a label of “hysteria” (Mayor, 1974). Immigrants, Bolsheviks and labor organizers of the same era were labeled as socially deviant and mentally defective by prominent psychiatric eugenicists, such as Dr. Charles Kirk Clarke. [4]

Christened with his name, the Clarke Institute of Psychiatry opened for business in 1966. A young staff member recalls those early days:

My first impression of psychiatry in Toronto was that it was rather parochial in outlook and had a distinct British socio-biological emphasis and little interest and much scepticism about psychoanalysis. […] The Clarke, instead of being an ivory tower, seemed more like a cold cement fortress. [5]

Psychiatrist Betty Steiner was asked to establish a gender identity clinic for adults. Kurt Freund later joined the team.

Under the direction of Ray Blanchard and Kenneth Zucker, CAMH’s Child Youth and Family Gender Identity Clinic (GIC) became widely known as one of the most notorious facilities in the world in terms of controlling access to medical services for sex and gender minorities.

According to their website they offer services, including for “those who wish to manage their cross-gender feelings and the expression of those feelings while remaining in their original gender role.” This is another way to describe reparative therapy similar to groups who claim to “cure” gays and lesbians.

Much of the anti-trans thinking in the world today emanates from what used to be named The Clarke Institute, long nicknamed “Jurassic Clarke” in the trans community for its regressive policies.

In 1998, the Clarke Institute merged with several facilities to form the Centre for Addiction and Mental Health, later shortened to CAMH.

2015 GIC closure

Following provincial legislation outlawing gender identity change efforts, CAMH conducted an investigation that led to the closure of the children’s clinic.

The report prepared by independent investigators and published by CAMH contained serious errors that led to a lawsuit by clinic head Ken Zucker. The case was settled in late 2018 with a payment to Zucker of CA$586,000 in damages, legal fees and interest, as well as this published apology:

October 2018

In 2015, the Centre for Addiction and Mental Health (CAMH) commissioned an external review of the Gender Identity Clinic within the Child, Youth and Family Program. The purpose of the review was to identify best practices and determine how CAMH can best serve children and adolescents with gender dysphoria and their families. The review was not intended to examine Dr. Zucker’s behaviour or specific clinical practices.

The review produced a report that was released publicly on December 15, 2015. Unfortunately, the report contained some errors about Dr. Zucker’s clinical practice and interactions with patients. The report was released publicly without review or comment by Dr. Zucker. Among other errors, the report falsely states that Dr. Zucker called a patient a “hairy little vermin.” That allegation is untrue.

CAMH apologizes without reservation to Dr. Zucker for the flaws in the process that led to errors in the report not being discovered and has entered into a settlement with Dr. Zucker that includes a financial payment to him.

Associated people

Some of the key players involved with the Clarke Institute / CAMH are: