a cree nation read its 1876 treaty, found a medicine chest in it, and told alberta no

via Global News, Xtra Magazine and Them.

Alberta passed a law in December 2024 that stops doctors in the province from prescribing puberty blockers or hormone therapy to trans kids under 16. Premier Danielle Smith said the point was to preserve young people's fertility. Late last year her government reached for the notwithstanding clause, the provision in Canada's Charter that lets a legislature switch off a rights challenge, so that nobody could take the law to court and win.

So the fight moved somewhere a premier cannot follow.

what saddle lake cree nation declared

On Wednesday, at a gathering marking 150 years of Treaty 6, the Saddle Lake Cree Nation announced it is asserting its own jurisdiction over health care on its lands, and that gender-affirming care is part of it. Not only for its members. For any Albertan who can get there.

The legal hook is a single phrase written into Treaty 6 in 1876. The Crown promised that a medicine chest would be kept at the agent's house for the use of the people. For a century and a half, First Nations have read that clause as a treaty promise of comprehensive health care, and Saddle Lake is now reading gender-affirming care into it. A nineteenth-century sentence about a box of supplies, aimed at a twenty-first-century ban on hormones.

Chief Dale Steinhauer did not hedge. "Canada cannot make laws for us or on our behalf," she said, per Xtra. "Actions speak louder than words. Treaty and our laws in our jurisdiction must be considered."

And, per Global News: "All children, including trans and two-spirit children and their family, will have safety under our treaty."

The plan is practical rather than symbolic. Saddle Lake sits a couple of hours northeast of Edmonton, near St. Paul, and its leaders know what happens if every trans family in Alberta drives to one reserve at once. So they intend to build virtual health hubs alongside in-person care, and they are drafting their own health law and fundraising to do it. The Nation says clinicians who provide care on its lands would be shielded from sanction by their provincial regulatory colleges, on the argument that those lands sit outside Alberta's jurisdiction.

That last part is the whole gamble, and it is unsettled law.

what premier smith said back

Smith's response was a shrug with a dare inside it. She told CBC News that the College of Physicians and Surgeons of Alberta "will continue to support regulated members in understanding their professional responsibilities within the bounds of applicable legislation, including laws that apply to the treaty rights of First Nations." At a press conference she got closer to what she meant: "They are an independent nation, so I'll be interested to see if they're able to attract a doctor to do that."

Which is a fair question and it already has an answer with a name on it.

a doctor prepared to lose his license

Dr. James Makokis, a Two-Spirit family physician and a member of Saddle Lake, spoke at the announcement. "It's really important for us as individual clinicians, as individual physicians, as citizens of this democratic country known as Canada, for people to stand up," he said, in comments reported by CBC News. "Sometimes that means as individuals we have to risk losing some of our own individual freedoms, and in my case that could be my medical licence."

A doctor saying out loud that he is prepared to lose his license over this is the least abstract thing anybody has said about Alberta's ban since it passed.

what is not settled

Two things to hold at once, because we are not going to oversell this. Nobody has tested whether a First Nation's health law beats a provincial one on this question, no clinic has opened, the money is not raised, and the province has every incentive to litigate. This could take years and it could lose.

But look at the shape of it. A government used the notwithstanding clause specifically so that no court could tell it no, and the answer came back from a nation whose claim does not run through the Charter at all. It runs through a treaty older than the province. You cannot switch off a treaty with a clause.

And Two-Spirit people were on this continent long before the people who wrote laws about them. Saddle Lake is not adopting anything. It is declining to forget.