Alberta’s Smith takes hands-off approach to First Nation’s trans care safe haven

EDMONTON – Alberta’s premier is taking a hands-off approach to a First Nation defying her government by announcing it will offer safe haven for gender-affirming medical care.

“I don’t have any authority over the First Nation,” Smith told reporters at an event in Edmonton Thursday. “I respect their sovereignty.”

Her comments came a day after Saddle Lake Cree Nation announced its plan. The nation says the plan is within their jurisdiction and that access to health care is a treaty right.

Alberta law prohibits doctors from prescribing puberty blockers or hormone therapy to transgender and gender diverse children under age 16.

Smith has said the law is about protecting children and their fertility while preserving choice. Her United Conservative government has invoked the Charter’s notwithstanding clause to shield the law from court challenges.

On Wednesday, Saddle Lake Chief Dale Steinhauer called the UCP’s laws affecting transgender, gender diverse, and two-spirit people dehumanizing. She said the First Nation won’t stand by as children and families lose their rights.

“When one group’s rights are removed, we are all affected,” Steinhauer said.

The nation, northeast of Edmonton, said it’s working to attract clinicians to provide care on its land.

It has also started fundraising to develop its health law and defend it against potential legal challenges. Less than 24 hours after launching an online fundraiser, it was more than halfway to its goal of $60,000.

Steinhauer cited the medicine chest clause of Treaty 6, signed 150 years ago, which says the Crown will keep a medicine chest in the home of each federal government agent working on or near a reserve.

That is widely understood by First Nations to be a commitment to provide comprehensive health care. Indigenous leaders have criticized the Crown for failing to live up to the promise.

Steinhauer said under a law to be drafted by the First Nation, clinicians who provide gender-affirming care on reserve land would be exempt from sanctions by regulatory bodies.

The College of Physicians and Surgeons of Alberta regulates medical practice in the province, including by issuing practice permits to physicians.

Smith, when asked Thursday about the college’s role in regulating medical care on the First Nation, said she was unsure. “It’s a First Nation, so they have sovereignty,” she said.

Her spokesperson, Sam Blackett, added later in a statement, “As the provision of health care on First Nations land is an area of federal jurisdiction, this is a matter for Saddle Lake Cree Nation to work with the federal government on.”

The federal Crown-Indigenous Relations Ministry said Thursday they were unable to immediately respond to a request for comment.

The College of Physicians and Surgeons of Alberta said in a statement it cannot offer opinions on legislation or speculate on hypothetical scenarios, but said it would duly review any complaint that is lodged.

It said it respects the rights of all First Nations and treaties, adding, “We also recognize the rights and interests of transgender minors and their parents and the significant concerns being raised about patient care and safety.”

This report by The Canadian Press was first published Sept. 10, 2026.