Saddle Lake Cree Nation in Alberta Invokes Treaty 6 to Protect Gender-Affirming Care

Alberta has restricted access to puberty blockers and hormone therapy for transgender youth, and it’s invoked a provision of the Canadian Constitution called the “notwithstanding clause” that allows governments temporarily to override certain constitutional rights. Saddle Lake Cree Nation is responding with reliance on Treaty 6, a source of authority that Alberta can’t override with the clause.

On September 9, during a gathering marking Treaty 6’s 150th anniversary, Chief Dale Steinhauer announced that Saddle Lake would assert its inherent and treaty-protected authority to provide gender-affirming health care on its reserve lands. The Nation is working to recruit clinicians and raise funds for legal defense and to develop its own health law.

“No longer will our children and families have their rights taken away,” Steinhauer said. “When one group’s rights are removed, we are all affected.”

Saddle Lake is grounding its position partly in Treaty 6’s “medicine chest” clause. First Nations have long understood the clause as a continuing commitment to provide comprehensive health care, not a promise frozen around the contents of a nineteenth-century medicine box.

In an interlocutory ruling in Wuskwi Sipihk Cree Nation v. Canada, a Federal Court prothonotary concluded that the First Nations’ claim could proceed and observed that, understood in its contemporary context, the medicine chest clause “may well require a full range of contemporary medical services.” The court did not finally decide the scope of that right, and the question remains unsettled.

Alberta prohibits regulated health professionals from prescribing puberty blockers or hormone therapy to patients under 16 for treating gender dysphoria or gender incongruence, subject to limited exceptions. Youth ages 16 and 17 require parental or guardian consent and approval from a physician and psychologist.

Saddle Lake’s announcement doesn’t settle whether Alberta’s regulation of health professionals applies on reserve. That question implicates provincial law, treaty rights, and the Nation’s asserted inherent jurisdiction. Saddle Lake says that clinicians working under its law will be protected from professional sanctions, but that claim may be tested if provincial regulators attempt enforcement.

Saddle Lake’s actions show that Alberta can’t invoke its own authority to abandon trans and Two-Spirit children and expect a Treaty Nation to do the same.

Additional Resources

Alberta First Nation wants to set up safe haven for gender-affirming care, Lexi Freehill and Lisa Johnson for CBC News (Sept. 10, 2026)

Treaty 6, with medicine chest clause

Section 33 of the Canadian Charter of Rights and Freedoms, commonly called the “notwithstanding clause”

Section 35, Part II of the Constitution Act, 1982, “Rights of the Aboriginal Peoples of Canada”

Section 1.92(1) of the Health Professions Act, prohibiting prescriptions for minors for the purposes of hormone therapy, including puberty suppression and hormone replacement therapy for the treatment of gender dysphoria or gender incongruence except in accordance with an order of the Minister.

Alberta Ministerial Order 31/2025, detailing circumstances where access to hormone therapy, including puberty suppression and hormone replacement therapy for the treatment of gender dysphoria or gender incongruence is permitted for a minor

The Governance of Indigenous Health, Constance MacIntosh, in Joanna Erdman, Vanessa Gruben & Erin Nelson, eds., Canadian Health Law and Policy, 5th ed. (LexisNexis Canada 2017)

Akwesasne Governments Reject “Lake America” Across the International Border

From a statement posted by the Saint Regis Mohawk Tribe and published on Sept. 4:

AKWESASNE — (Seskehkó:wa/September 1, 2026) The Saint Regis Mohawk Tribe (SRMT) and Mohawk Council of Akwesasne (MCA) stand together in opposition to the recent Executive Order issued by the current United States administration seeking to rename Lake Ontario as “Lake America.”
 

The name Ontario is widely understood to be derived from an Iroquoian word, often transcribed as ontarí:io, or similar spellings in historical records. The word has been interpreted as meaning “great lake”, “beautiful lake”, or “sparkling water”.
 

More importantly, the name predates the creation of Canada and United States. European explorers adopted an existing indigenous name for the lake and the name was later applied to the province when Ontario was established in 1867.
 

For the Kanien’kehá:ka, however, the lake is known as Kaniatari:io, often translated as “Beautiful/nice lake.” This name reflects our own language, worldview, and enduring relationship with the lake.
 

These names are not simply words on a map to our people. They carry our languages, histories and responsibilities to the lands and waters since time immemorial.
 

For Akwesasronon, the international boundary is a present-day reality that came long after our ancestors’ presence here. Akwesasne territory extends across both Canada and the United States, and is a stark reminder that our people were here long before either country was established. Replacing a name derived from one of the original languages of these lands with one intended to assert a modern national identity disregards that Indigenous history.
 

What has carried meaning for generations should not be rewritten to satisfy the politics of a moment.
 

Governments and administrations will change. Our language, our history and our relationship with these lands and waters will remain.
 

The Saint Regis Mohawk Tribe and Mohawk Council of Akwesasne will continue to recognize the history and Indigenous origins of Lake Ontario and uphold the Kanien’kehá relationship with Kaniatari:io.
 

No act of government can erase that relationship.

Our earlier post on this topic is here.

International Human Rights Update: Canada Reports on Five Years of Implementing the UN Declaration

On August 28, Canada’s Justice Department released the fifth annual progress report under its statute called the United Nations Declaration on the Rights of Indigenous Peoples Act. The statute requires the federal government, in consultation and cooperation with Indigenous peoples, to take measures necessary to make Canadian laws consistent with UNDRIP. The report covers implementation of a 181-measure Action Plan and includes an Indigenous-led Action Plan Advisory Committee.

The report is interesting because it shows how five years after Canada made UNDRIP implementation a matter of federal law, it exposes what legal implementation actually requires, and where it breaks down.

Canada’s Fifth Annual UN Declaration Act Progress Report

Seneca Nation President condemns renaming Lake Ontario “Lake America”

Map of the Five Nations, 1730 CE. Darlington map collection, Archives Service Center, University Library System, University of Pittsburgh.

From Seneca Nation President J. Conrad Seneca:

Lake Ontario derives its name from Indigenous roots. In our traditional Seneca language, its name is sga:nyodai:yoh, meaning ‘beautiful lake.’ Long before the United States existed, and before settlers brought the English language to our lands, our Seneca and Haudenosaunee ancestors traveled Lake Ontario and surrounding waterways for many reasons, including diplomacy among our nations. Now, we are seeing the exact opposite of diplomacy.

The action that President Trump is taking is starkly un-presidential and demeaning to his office and his standing as the leader of the free world. His blatant disrespect toward the Seneca people, other Haudenosaunee nations, and all Indigenous people is unacceptable.

The President cannot assert ownership over our culture or erase it through irresponsible political action. His order should be rescinded, and the name Lake Ontario should be left as it is, reflective of the Seneca people, other Haudenosaunee nations and all Indigenous people surrounding the lake.

To us, Lake Ontario is not a political pawn. It does not separate the countries of the United States and Canada. It is all Indigenous land, which has been occupied by Indigenous people since time immemorial.

In 1794, President George Washington and the Seneca and other Haudenosaunee nations signed the Treaty of Canandaigua, promising to live in peace and friendship with one another. The United States also promised our people the free use and enjoyment of our lands forever. President Trump’s aggression toward our culture with his Executive Order violates that peace, friendship and commitments of the Canandaigua treaty. This is the latest in a long history of willful attempts to disregard the United States’ commitments to the Seneca and other Haudenosaunee nations. President Trump needs to be reminded of those commitments.

I would also remind the President of the tenets of the United States Constitution, where Article 6 clearly states that treaties are the ‘supreme Law of the Land,’ and need to always be honored as such.

We will always call Lake Ontario by the name derived from the language of our ancestors – the name that, like the strength and influence of the Seneca people, will live on forever, long after the intrusive political tirades of individual men.

All Native Nations need to stand united to vocally and forcefully reject this change. We are also calling on all federal, state and local representatives – regardless of political party – to stand with the Seneca Nation and oppose the President’s Executive Order.

Scholars of critical toponymy have long observed that naming geographic features is an exercise of political power as colonial and imperial governments use renaming to inscribe their authority onto Indigenous landscapes, to legitimate their territorial claims, and to displace Indigenous relationships to place. Trump’s Executive Order is explicit about doing just that. It states that the lake “has long been an integral asset to American exploration, settlement, commerce, and defense” and it notes that the US “claims most of the Lake’s volume.”

Additional Resources

The Executivce Order

The Haudenosaunee Environmental Task Force Position on the Great Lakes (Sept. 9, 2005)

Resources on critical toponymy, which treats geographic naming as an exercise of political power rather than a neutral labeling practice

John Borrows on Anishinaabe Inaakonigewin and Treaties

John Borrows has published “Anishinaabe Treaties and the Rule of Law” in the Canadian Journal of Law & Jurisprudence.

Here is the abstract:

This lecture considers conserving and upholding Anishinaabe law as it relates to the more-than-human world. It suggests that we must continually renew our broadest legal commitments to protect and preserve what sustains us. Protecting clans and the animals from which they derive is close to the heart of Anishinaabe law (ode’naakonige). This law is embodied through Anishinaabe treaties with our evolutionary progenitors, our clan relatives. These treaties with the more-than-human world were incorporated into treaties with other First Nations. From an Anishinaabe perspective, these obligations were, in turn, eventually imported into treaties with the Crown. Anishinaabe treaties with the more-than-human world continue to inform how Anishinaabe people practice constitutional law through consultation protocols, legislation, and participation in court proceedings.

New Scholarship on Emerging Indigenous Restorative Justice in Canada

The Honourable Leonard S. Tony Mandamin has published “Emergence of Contemporary Indigenous Restorative Justice in Canada” in Constitution Forum constitutionnel.

Excerpt:

New Scholarship Making the Case for Indigenous Self-Governance over Child Welfare in Canada

Ariana Kravetz has published “Rectifying Historical Wrongs: The Case for the Indigenous’ Inherent Right to Self–Govern Child Welfare in Canada” in the University of Miami Inter-American Law Review.

Aaron Mills on Anishinaabe Law and Kinship

Aaron Mills has published “First Nations’ Citizenship and Kinship Compared: Belonging’s Stake in Legality” in the American Journal of Comparative Law.

Here is the abstract:

Many First Nation individuals appear to accept that debates about belonging to First Nations political community are properly framed as debates about citizenship. Interlocutors frequently identify the ongoing significance of kinship, but fold it into their conception of citizenship. This Article resists citizenship’s orthodoxy. Kinship is not a unique feature of First Nations citizenship, but rather is its own model of belonging to a political community: a model internal to First Nations law, understood on its own terms. There are, then, two models of belonging to First Nations political community, citizenship and kinship, within and over which debates about belonging play out.

For First Nations political communities using their own systems of law, kinship is a source of fundamental legal interests, just as citizenship is a source of fundamental rights and freedoms in modern liberal democracies. However, comparativists, legal theorists, and political theorists have struggled to appreciate this reality because internal (or settler) colonialism disconnects kinship from legality conceptually and thus institutionally. Those connections must be reestablished.

To that end, this Article shows that, functionally, kinship is a full answer to citizenship. The argument is made in two interwoven parts, each of which turns on the picture of kinship as a structural feature of First Nations law, understood on its own terms. First, kinship is citizenship’s political equal insofar as it offers a justificatory account of belonging to a political community; second, kinship is citizenship’s legal equal insofar as it, too, serves as a foundation for fundamental legal interests. The gravamen of this Article is, thus, twofold. First, one is not hearing what First Nations law says about belonging if one is only willing or able to listen in the language of citizenship. Second, the stakes in one’s choice of model are significant: citizenship and kinship structure legality in fundamentally different ways.

Blast from the Past: Governmental Attacks on Akwesasne News

From The Nishnawbe News [Northern Michigan University], May 1972:

Alaska SCT Decides Cross-Border Jurisdictional Dispute over Indian Child

Here is the opinion in O’Brien v. Delaplain: