Alberta First Nation invokes 150-year-old treaty to bypass province's trans care ban

Saddle Lake Cree Nation is using Treaty 6's medicine chest clause to provide gender-affirming healthcare the province just made illegal — and the government says it won't fight back.

Told by Claire Lawson · 12 September 2026

On the 150th anniversary of Treaty 6, Saddle Lake Cree Nation did something the Alberta government probably didn't see coming: they invoked a 150-year-old promise to provide what the province just banned.

On September 9, 2026, the First Nation announced it will use Treaty 6's medicine chest clause — the bit that promises full healthcare coverage to signatories — to create what it's calling a "safe haven for gender-affirming care" on its reserve lands in central Alberta. Invoking the clause "places these services outside provincial jurisdiction," the band council said in a release. Which means a 15-year-old who can't get puberty blockers anywhere else in Alberta can now get them on Saddle Lake land, and there's nothing Danielle Smith's government can legally do about it.

Here's what that actually means. Last year Alberta invoked the Charter's notwithstanding clause — the nuclear option that lets governments override rights protections — to push through three pieces of legislation targeting trans people. Bill 26 bans doctors from prescribing puberty blockers or hormone therapy to anyone under 16. Bill 27 forces teachers to out kids to their parents if they change their name or pronouns at school. Bill 29 kicks trans women out of women's sports. In June 2025, the Court of King's Bench took one look at the evidence and temporarily halted the restrictions, with Justice Allison Kuntz writing that the ban could cause "irreparable harm to gender diverse youth." The government's response was to activate the notwithstanding clause and prevent any further judicial review.

Saddle Lake's law does three things the province can't. First, it exempts any clinician practising gender-affirming care on reserve land from being sanctioned by their regulatory body — so a doctor can prescribe puberty blockers to a 14-year-old on Saddle Lake territory and the College of Physicians and Surgeons of Alberta can't touch them. Second, it welcomes healthcare professionals licensed anywhere in Canada to practice on the First Nation's three reserves, which Chief Dale E. Steinhauer says removes barriers that have kept healthcare professionals off reserve land for decades. Third, it explicitly rejects what Steinhauer calls Alberta's "dehumanizing" legislation, drawing a direct line between colonial policies that experimented on Indigenous children and sterilised Indigenous women, and what's happening to trans kids right now.

"This is what we would have wanted when our children were being experimented on and our women were being sterilized," Steinhauer said at the September 9 press conference in Fort Pitt, Saskatchewan. "It is your duty as regulatory bodies to uphold our Treaty, which you all recognize in your land acknowledgements."

The Alberta Medical Association's psychiatry sections aren't mincing words either. In a November 2025 statement, they wrote that "when government overrides evidence-based care and judicial findings, it threatens the independence and safety of health care for all Albertans." Not just trans kids. Everyone.

And here's the bit that makes this more than symbolic: Premier Smith's office says Alberta won't challenge it. Spokesperson Sam Blackett told Alberta Native News the government "respects First Nations sovereignty" and considers healthcare on First Nations land a matter of federal jurisdiction. Then he added, "However, this government stands behind our legislation." So they're standing behind a law they won't enforce on one-third of the province's land base, which is a hell of a way to govern.

Saddle Lake has set up a GoFundMe to cover legal costs in case the province changes its mind — it's raised about $30,000 of a $60,000 goal as of publication. But the real cost isn't legal fees. It's what Dr. James Makokis, a two-spirit physician from Saddle Lake, said at the press conference: "When I grew up on my reserve and I went to school in town, I also felt that. I also felt ashamed and depressed and suicidal." Makokis said that even though their parents were supportive.

What Saddle Lake just did is create a place where a kid doesn't have to feel that way — not because the province decided to be kind, but because a First Nation used a treaty the Crown signed 150 years ago and has spent 150 years trying to ignore. The band council says it's providing "a legal and operational blueprint for First Nations nationwide to protect communities made vulnerable by colonial violence."

Which means every other First Nation in Treaty 6 territory — and there are sixteen of them in Alberta and Saskatchewan — could do exactly the same thing tomorrow. And every trans kid in Alberta now knows there's somewhere they can go where the law actually protects them instead of hunting them.

That's not a safe haven. That's a fucking lifeboat.

Correction, 27 September 2026: the announcement was on 9 September 2026, not 2025, and Justice Kuntz's words were "gender diverse youth".