Guest post: Censorship at a Canadian Medical Journal

January 2, 2022 • 11:15 am

I received a long email from reader Leslie MacMillan, and I suggested that he turn it into a post for our readers. He kindly agreed. I asked him to write me a brief biography, which is below:

Leslie is a retired physician who worked as an academic clinician-teacher and in hospital practice.  Now in obscurity, he enjoys dinner with his family at a reasonable hour, playing the piano, and indulging his grandchildren.”

And here’s his contribution:

Canadian Medical Association Journal yields to external religious pressure, censors published letter

by Leslie MacMillan

The Canadian Medical Association Journal (CMAJ, “the Journal”) has retracted a Letter to the Editor following orchestrated religious pressure that accused the Journal and the author of “Islamophobia”.

“Islamophobia” is one of those words hurled at people without a definition of what it means.  Unlike many slurs, though, this one does have a definition.  “-phobia” means “fear of”.  A phobia can be irrational or it can be well founded.  Islamophobia, then, indicates only a fear of the implications of the tenets of Islam or the intentions of its adherents.  It cannot by the fact alone be equated with hate speech or, obviously, racism.  Yet it so often is.  Sometimes speakers will say, “tantamount to hate speech”, pulling their punches and evading the implication of an accusation of an offence under the Criminal Code of Canada and some other countries.  Fear can be thought of as unease or suspicion that professed views of love and tolerance are not sincere; it is then rational to withhold trust, the trust that liberal societies need to function.  If one is accused of Islamophobia, one ought to be able to respond, “Yes, I am.  Here’s why.”

For the cover page of its 8 Nov 21 on-line issue, the Journal used this stock photo.  There was no contextual link to any one article in the issue.  It seems to have been a generic free-standing cover photo in that it appears on the sidebar for each of the articles in the issue.

Dr. Sherif Emil, a senior academic surgeon in pediatrics at Montréal Children’s Hospital and McGill University wrote to the editor of the Journal objecting to depicting such a young child wearing a hijab.  He quoted Yasmine Mohammed, a Vancouver activist who has championed equality for Muslim women:  “The cover of @CMAJ features a little girl in hijab. How disheartening to see my so-called liberal society condone something that is only happening in the most extremist of religious homes.”   Emil then acknowledged his respect for the women he sees in his practice who wear the hijab—mothers and some adolescent patients.  He continued (direct quotations indented hereafter):

But respect does not alter the fact that the hijab, the niqab and the burka are also instruments of oppression for millions of girls and women around the world who are not allowed to make a choice. We are currently being reminded of this daily, as we see the tragic return of the Taliban in Afghanistan, and its effect on the subjugation of women and girls. Girls as old as those in the picture are being sold into marriage to old men — institutionalized child rape. The mentality that allows this to happen shares much with the one that leads to covering up a toddler. But even in so-called moderate Islamic countries, such as the one I grew up in, societal pressures heavily marginalize women who choose not to wear the hijab. In addition, women in these countries who are not Muslim and do not wear the hijab are often subject to intense harassment and discrimination. I know that because some of these women are in my family. I respect the women who see the hijab as liberating. But we must also remember the women and girls who find it oppressive and misogynistic.

Ironically, the article [which he interpreted the photo as referring to] explores evaluating interventions to address social risks to health. A young girl such as the one depicted in the image is typically also banned from riding a bike, swimming or participating in other activities that characterize a healthy childhood. She is taught from an early age, directly or indirectly, that she is a sexual object, and it is her responsibility to hide her features from the opposite sex, lest she attract them. A heavy burden for modesty is placed squarely on her shoulders.  So many women have been traumatized by such an upbringing, which, I believe, frankly borders on child abuse. Is that not a social risk to health? Are these children not a vulnerable population?

This link includes a citation to the tweet by Ms Mohammed quoted in the letter.  (Link found and posted by Retraction Watch commenter Andrew.)

The letter appeared in the Journal’s 20 Dec online issue under the heading, “Don’t use an instrument of oppression as a symbol of diversity and inclusion”, a form of words of the editor’s choosing, not the author’s.

Advocacy groups claiming to represent the interests of Muslims in Canada and Québec vigorously protested the publication of the letter and called for its retraction.  Dr. Emil received abuse personally on Twitter as well, as noted by Retraction Watch (q.v.)

The CMAJ editor responsible, Kirsten Patrick, apologized particularly for her choice of words in the heading.  The uproar, a lengthy happy-talk on why hijab is not oppressive, and the Journal’s efforts at damage control, are reported in a long CTV news article of 20 Dec from which I’ve taken a small snippet:

[Lina] El Bakir [Quebec advocacy officer for the National Council of Canadian Muslims] argues that publishing the letter was irresponsible, especially during a pandemic when doctors who wear a hijab are dealing with prejudices in their daily practice. . . .

A pre-written response to the CMAJ, included on the national council’s website as part of an online letter-writing campaign, cites a few sections in the Canadian ‘Medical Association’s Code of Ethics and Professionalism that medical professionals must adhere to.

“This article falls short of these standards,” the response states.

“We are asking CMAJ to retract this article immediately and issue a public apology before it does any further harm to a demographic that has been targeted by some of the most violent forms of Islamophobia in this country.  [Emphases mine,–LM]

The Canadian Medical Association itself, which owns and publishes the Journal, piled on with an official and gratuitous swipe at the author.

Islamophobia and other forms of hate [there’s that incorrect conflation again –L.M.] must not be tolerated in the health care profession or in our society. Like CMAJ, the Canadian Medical Association deeply regrets the harm caused by the publication of an opinion letter in CMAJ on Dec. 20, 2021.

CMAJ is operated independently of the Canadian Medical Association with its own governance structure and editorial board. While we will always uphold the editorial independence of CMAJ, we feel a responsibility to speak out and express our sincere apologies for the harm caused.

On 23 Dec., the Journal buckled to this pressure and not only retracted the letter but removed it from its website.  It made no visible effort to send the commentary to the author, publish some of it, and invite a response before doing so.  Click on the screenshot or read the text below.

The letter “Don’t use an instrument of oppression as a symbol of diversity and inclusion” (DOI:; author: Sherif Emil)1 published in the Dec. 20, 2021, issue of CMAJ has been retracted by the interim editor-in-chief of CMAJ because the editorial process for the article was flawed and biased, and the letter should not have been published.

CMAJ acknowledges and is deeply sorry for the considerable hurt that many people across Canada have experienced from reading this letter. A formal apology from the interim editor-in-chief has been published at

Retraction Watch criticized the removal, contrary to guidelines from the Committee on Publication Ethics, which recommended marking it as retracted (as the PubMed copy is)

The author of the letter has posted his own conciliatory statement at the Canadian Healthcare Network here.

CTVnews reported further on 24 Dec:

Tabassum Wyne, executive director of the Muslim Advisory Council of Canada, [said] she was glad the CMAJ “took the necessary steps to correct that mistake” and hear from diverse voices. . . .The council had a virtual meeting with the CMAJ’s interim editor-in-chief, Wyne said, during which it was suggested that the journal look at anti-Islamophobia training in the future.

Wyne also expressed concerns about having anyone on the internet read the letter in an accredited journal.   “And that’s why we pushed so hard to have it retracted, and we’re happy with the results.”

It gets worse.  The CMAJ editorial group “seeks to remedy” the current lack of Islamic representation on its Editorial Advisory Board.  The Muslim advocacy organizations clearly seek to exercise prior restraint instead of merely complaining about it afterward.

The National Council of Canadian Muslims has since thanked the CMAJ for removing the letter, saying it appreciates “the efforts of the editor in chief for taking action and doing the right thing” and looks forward to working with her to “ensure this never happens again.”

(This CTVnews article misleadingly shows a photo of someone protesting Québec’s  laïcité law, la Loi 21.  This affair has nothing to do with that law and the author says he disagrees with it anyway.)

If the CMAJ follows through on this, there will be religious oversight of what an academic medical journal is permitted to publish.


I have written the CMAJ and the CMA criticizing them for their lack of integrity in this episode. I encourage readers, particularly Canadian physicians, to do the same, even if you are not members of the CMA (as I am not), and even if you would not have published the letter in the first place were you the editor.  The Journal has received comments from readers mostly criticizing the decision to retract and censor —see the retraction e-letters link below—but I don’t see awareness of the undertaking to invite Muslim advocates to exercise prior restraint on publication.  This hidden censorship is especially dangerous.  I recommend that letters specifically call this out so the CMAJ knows you are watching.

Contacts for responding:

This site refers to the retraction announcement, not the original letter. You can submit e-letters there.

At this site you can contact the Canadian Medical Association.

John Locke argued that it is better for a society to be governed around religious tolerance because this would lead to less social disorder than for the state to enforce adherence to one religion and, necessarily, to suppress all others.  This works only if the religions themselves are compelled by secular laws to tolerate people who reject or even mock their every teaching—otherwise you have a state religion sneaking in the back door under the guise of stamping out (in this case) Islamophobia.

Growing up in secular Canada, I was always glad that believers could enjoy their freedom of religion but was even gladder that I enjoyed my freedom from religion.  Religious differences just never came up in ordinary or professional life.  The idea that someone should be enjoined from doing something because it offended someone else’s religious views, and that could be called “harm”, was unthinkable.  Increasingly it looks as if we risk losing this freedom out of fearful acquiescence of our institutions to intolerant and censorious religious pressure.  Islamophobia (my correct definition) afflicts them, too, and they don’t even notice it.  It’s up to us to open their eyes.

20 thoughts on “Guest post: Censorship at a Canadian Medical Journal

  1. “Otherwise you have a state religion sneaking in the back door under the guise of stamping out (in this case) Islamophobia.”

    Yes exactly. Well done Les.

  2. I guess the questions are – Does Canada have freedom of religion and freedom of speech. If one of those is missing the other may follow.

  3. Religion, ANY, must not under any circumstances be awarded special treatment or considerations. All too often it is.
    This creeping intrusion particularly by Islam is insidious and dangerous to society and our democratic institutions.
    ISLAMOPHOBIA indeed.
    The Canadian Medical Association and its Journal should be thoroughly ashamed of their cringing obsequious behaviour.
    When composed I will post my formal response.

  4. The incessant attempts by Muslim organizations to create a privileged status for Islam through censorship and prior restraints explains exactly why Islamophobia is: (a) in existence, and (b) well-founded.

  5. I would say there’s a probable chance when that little girl reaches 12 years of age, she’ll be taken to a like minded doctor who will remove her clitoris. That should be a cause of concern for a Canadian medical journal.

  6. Leslie, there is a potential solution that is no more complicated than unfurling the Webb Space Telescope with its 347 single points of failure.

    Someone needs to approach Margaret ‘the Handmaids Tale’ Atwood and cajole her into becoming a patron of real-world feminist causes. The Islamists will always use a racism angle, and it has worked, hence the same result of an organisation apologising for ‘hurt and offence’ to a group that reflexively cries ‘racism’. Just the same formula as University of Auckland’s Listenergate where any critique of ‘maori knowledge’ eg creationism and nature spirits was met by cries of cultural offense.

    So you need Atwood your cultural icon stating on a news clip that this is not a racism issue, this is a feminism issue. And how do you counter Islamists whining ‘racism’? Well, I would get sympathetic Canadian health workers etc to dress in Handmaids Tale TV series outfits [ with their Handmaids Tale headscarves ] and protest outside Canadian Medical Association building. Why? Because you attack a twitter charge of Whirling Dervishes by using a visual image that has been used by US women protesting abortion restrictions. The Canadian medical association will not like Handmaids Tale women protesting, if photos are taken and slapped everywhere on media.
    And you also recruit non-headscarf wearing Afghan women refugees as allies, and get the women to explain about restrictions in Afghanistan.
    But your fulcrum of PR pressure has to be Handmaids Tale Atwood because this is the visual image that needs to symbolise the issue for true social progressivists. Hope this suggestion helps.

  7. The people trying do deny us the freedom to criticize religion are not the victims, we are. We should always make that clear. As we don’t have a word for hostility towards people who criticize religion, they silence us with the false accusation of “Islamophobia”.

  8. A thought: the creeping intrusion is not from Islam, but from a particular, traditionalist, conservative interpretation of Islam. Moderate, liberal, reformist Islam is not valorised by the Canadian Medical Association (or any other western ‘liberal’ organisations or institutions). Strange that self-styled liberal bodies are so conservative in this respect…

  9. According to the Wikipedia article on the hijab:

    The clearest verse on the requirement of modest dress is Surah 24:31, telling women to guard their genitalia and draw their khimār over their bosoms.

    And say to the believing women that they should lower their gaze and guard their private parts; that they should not display their beauty and ornaments except what (must ordinarily) appear thereof; that they should draw their khimār over their breasts and not display their beauty except to their husband, their fathers, their husband’s fathers, their sons, their husbands’ sons, their brothers or their brothers’ sons, or their sisters’ sons, or their women, or the slaves whom their right hands possess, or male servants free of physical needs, or small children who have no sense of the shame of sex; and that they should not strike their feet in order to draw attention to their hidden ornaments.

    Is that the kind of nonsense – including the references to slavery and eunuchs – that the CMA and the CMAJ really want to support?

  10. Nice piece – save us from stock photos – little nothings that say everything without words. Convenient! For the writer.

  11. How ironic and sad that a sector of the left has created its own Muslim stereotype. It repeatedly uses the hijab as visual shorthand for “Muslim,” thereby turning it into a symbol. This mass representation creates further pressure on young Muslim women to conform to an image of Muslim rectitude enforced by the most regressive aspects of Muslim culture. The result: parts of the left have joined hands with the most patriarchal forces in Islam. Evidently oppressing women is okay if you’re from an oppressed ethnic group.

    It’s sickening to see progressives reinforce reactionary cultural standards that would please the Taliban. Anyone who construes the hijab as “liberating” is engaging in sophistry. Do they therefore consider the billions of uncovered women unliberated? Do they consider that the hijab wouldn’t exist if it weren’t for concerns about women’s “modesty”?

    The spinless CMAJ has evidently decided that a couple activist groups embody the opinions of the entire Muslim community, so it has embraced the ludicrous opinion that criticizing the hijab is bigotry toward Muslims. It owes Dr. Sherif Emil an apology.

  12. I finally need to join in these conversations that are based on the assumption that Muslim women only wear the hijab or other head coverings because they are oppressed by male family members and religious leaders. I am a Canadian and a card carrying Christian, member of a main stream denomination which has a big tent and values liberal, progressive and social Justice beliefs. When secularists criticize religious organizations, (fair enough) they should acknowledge that there is a wide spectrum of beliefs, practices and political and social values among Christians and other faith groups.

    As a Canadian, one of the most important values for me is tolerance. Freedom of religion , protected in both the Canadian and American constitutions, requires that governments, but not individual citizens, must demonstrate tolerance of all legitimate religions. The rule of separation of Church and State means that the secular majority in both countries is protected from any unwanted intrusion from any religion.
    I see no evidence in Canada at least that secularism is under pressure from any religious minority.

    Against the common statements that all Muslim women who cover their heads are therefore “oppressed “ and should be protected from
    their religion, I have to say that it is common on the streets of Canadian towns and cities to see Muslim women with covered heads in all walks of life. ( except of course now in Quebec which has recently legislated religious intolerance ) I have worked with women lawyers who wore the hijab. I see Doctors, nurses, teachers and university professors who chose for their own reasons to wear the hijab, or other head coverings. A high profile woman broadcaster on a national TV network wears the hijab.

    Who cares? What business is it of mine or of anyone else what these women chose to do? What business is it of mine or anyone if Jewish men wear kipas, if Hassidic women wear wigs, if Sikh men wear turbans, or if Muslim women cover their heads?

    In Canada we do have real and active Islamophobia. It is as real and visible as anti Semitic behaviour, also alive and well in Canada. And currently is more overtly violent. In the past year in Canada a Muslim family was deliberately run over and killed by a driver who publically expressed anti Muslim speech. He has been charged with murder and hate crimes. A few years ago a shooter killed a number of worshipers at a Quebec City mosque. He was convicted of murder. Every year we hear of examples of Muslim women being attacked on the streets and having their head coverings pulled off. This is racism and sexism and Islamophobia, and it is alive and well in Canada.
    So you will forgive me if I don’t get too exercised by the fact that the the Canadian Medical Association Journal has decided to add a few muslims to its editorial board.

    1. Hi Phyllis. Dr. Emil didn’t say that “all Muslim women who cover their heads are therefore ‘oppressed'”. He was careful to say that some are not, but many are. His apology letter is even more careful.

      What I object to (and maybe others here) is the rejection of any criticism of any Muslim beliefs or practices by (as you did) equating criticism of Muslim practices to shooting Muslim people in the Quebec City mosque, or equating critics to that bigoted lunatic who ran over the family in London. Those are not the same thing. Your comment perfectly crystallizes what’s wrong about this issue in Canada: equating criticism of the religious practices with hatred of the people. Nobody hates that little girl who was shown on the cover of CMAJ (least of all me or Dr. Emil). But I can freely criticize the practice of putting a little girl in a hijab (or worse) against her will. I think Hasidic men forcing women to wear wigs is also lousy. But if Hasidic women really want to wear wigs then I think they should Ru Paul the shit out of that, whatever.

      I guess many other fathers of daughters would agree with me. Hijab, spaghetti straps, anything goes, but freely chosen please. For some Muslim families in Canada that’s certainly the case. But for some it’s not. That’s all Dr. Emil was saying: that’s it not right for CMAJ to tacitly endorse a practice that in many instances is misogynistic.

      Also it’s not really true that Ginella Massa is “a high profile woman broadcaster on a national TV network [who just happens to] wear the hijab.” It would be more true to say that Ms. Massa is a journalist who became a national TV news host because she wears hijab. CBC News chose her to host “Canada Tonight” in large part as an effort to appear diverse. No slight on her: she’s an experienced and accomplished reporter. But there are hundreds of reporters like her, and she got that job (instead of someone else) in large part because she wears hijab.

      1. Thanks for responding to my post. I want to be clear that I did not in any way suggest that criticism of Islam, or Christianity or Judaism, or any other religion is equivalent to the violence that is sometimes directed at members of these or other religions. That is a misstatement of what I said in my post. In Canada is is certainly acceptable for anyone to criticize the beliefs, practices and values of any religion or faith group. As Jerry does all the time in relation to his criticism of Christians whose writing he objects to. All that is fair speech up to the point where it advocates violence or hatred against individuals or groups because they are part of a religion. Then it becomes legally a “hate crime”, which in Canada is an offence under the Criminal Code. In Canada the law of free speech and hate speech is different from that in the US.

    2. “What business is it of mine or of anyone else what these women chose to do?”

      What business is it of any individual, least of all solely that they contain Y chromosomes, to conjure up a phony choice for women to conceal themselves out of principle _for_the_rest_of_their_lives?

      Is it a magical spell that makes humans “modest”? How does it work? Maybe we should look into this. What is that saying about any other family’s daughters – they are not “modest”? Modest about what, precisely – or is that topic inappropriate for young girls?

    3. Points of information since non-Canadian readers may not be familiar with the facts:

      1. Québec’s laïcité law does not restrict the right of women to wear hijab in public. It only prohibits employees and agents of the Québec state from so doing while on the job, and the prohibition is not limited to Muslim displays. The judge who presides in a Québec Court must not give the appearance of religious bias. This keeps religion out of the state’s domain where it does not belong.

      2. One hijab-removing assault turned out to be a hoax.
      One seems to have happened, the 62-year-old female perpetrator being in custody for another offence at the time.
      And one was a family dispute:

    4. Two points to clarify facts that might not be known to non-Canadian readers:

      1) Québec’s laïcité (secularism) law does not prohibit the wearing of hijab in public places like “the streets”. It applies only to employees and agents of the Québec state, who are forbidden from wearing religious displays while at work to avoid the appearance of religious bias. Customers of the state are not so restricted. The (substitute) school teacher who was recently re-assigned after wearing a hijab does not normally wear one — she chose to as a display of identity to test the law’s enforcement. Surprise: it was. This was commented on in a feature by Barbara Kay in the National Post just today.

      2) One widely reported “hijab-removing assault” in Toronto in 2018 was a hoax. (There was a hoax case in Long Island in 2016 that had elements of the Smollett case including a claimed Trump connection.) The family of the troubled 11-year-old girl who reported it apologized to Canadians after police investigation determined that it did not happen. In the only other Canadian case I could find, in Ottawa in 2021, the perpetrator was a 62-year-old woman who was already in custody for an unrelated offense when the investigating police caught up with her. (There was a 2017 case in Québec where a father assaulted his adolescent daughter because she removed her hijab against his instructions and another the same year that was a use-of-force-during-arrest complaint in Calgary.)

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