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Removing adolescents’ healthy body parts under the guise of treating gender dysphoria could soon become a “thing of the past” as doctors reckon with the reality of financial penalties.
A detransitioner’s landmark $2 million victory in her malpractice case and the first major medical association’s new opposition to “gender-affirming” surgeries for minors will force medical professionals to seriously weigh the consequences of offering these procedures, advocates told the Daily Caller News Foundation.
“The bottom line is simple: should doctors ignore the medical evidence on gender dysphoria, they will be placing themselves squarely on the losing end of future malpractice lawsuits,” Dr. Kurt Miceli, chief medical officer at Do No Harm, told the DCNF in a statement.
A New York jury awarded Fox Varian $2 million on Jan. 30 in her medical malpractice lawsuit against the doctors who allowed her double mastectomy at age 16, making her the first detransitioner to win at trial. The American Society of Plastic Surgeons (ASPS) released a position statement on Tuesday recommending delaying gender-related surgeries until a patient is at least 19 years of age.
These developments “delivered a one two blow to this harmful industry and should hasten the unraveling of the manufactured consensus activists have promoted,” Miceli said.
Josh Payne, who co-founded a law firm that is litigating a dozen ongoing cases against medical professionals, therapists and clinics involved in transgender procedures, expects other medical associations to follow ASPS’s lead, making surgeries for minors “a thing of the past.”
“I think the New York jury award sends a bigger message: vulnerable individuals at any age – not just minors – deserve protection when they are struggling with mental health issues,” Payne said. “The standard of care is heightened in that situation. They need more safeguards, not fewer.”
“A lot of our clients were led into irreversible procedures when they were adults, and they did not realize they were harmed until many years later because their mental state was so fragile,” he continued.
ASPS previously announced in 2024 it did not endorse any organization’s recommendations for treating children with gender dysphoria, noting evidence was “low quality.”
Payne told the DCNF that “pediatric gender clinics across the country were already closing in the wake of the HHS report issued last year.”
The Department of Human Health and Services (HHS) published a review in May finding the “gender-affirming” model of care for minors lacks evidence and carries the risk of “significant harms.” The agency announced in December proposed rules that would strip Medicare and Medicaid funding from hospitals that perform sex change procedures on minors.
Children’s Minnesota indicated on Tuesday it would temporarily pause prescriptions of puberty blockers and hormone therapy to minors on Feb. 27 due to “an increase in federal actions directed at health systems like ours.” Mary Bridge Children’s Hospital in Tacoma, Washington, likewise announced in January it would close its gender clinic due to “recent developments at the federal level” threatening funding, according to The Seattle Times.
“Almost daily, another major hospital system in America is ending the tragic and irreversible practice of sex-rejecting procedures for minors,” HHS general counsel Mike Stuart said in a statement Tuesday. “The American Society of Plastic Surgeons is bravely standing with Secretary Kennedy in courageously leading on this critical issue.”
Other legislative proposals and legal challenges could also increase liability for providers.
The Department of Justice (DOJ) subpoenaed more than 20 doctors and clinics that provide child sex change procedures to investigate potential “healthcare fraud, false statements, and more” in July. Some of the subpoenas have been blocked by judges in response to challenges.
The DOJ proposed legislation in September that would create a private right of action for individuals whose bodies were irreversibly harmed by transgender procedures as children to sue the responsible medical professionals. In December, the House of Representatives voted to pass a bill that would criminalize providing sex change procedures.
More cracks in the so-called consensus appeared when the American Medical Association stated Tuesday it “agrees with ASPS that surgical interventions in minors should be generally deferred to adulthood.”
“Our colleagues at ASPS concluded that the evidence supporting gender-related surgery in minors is insufficient and of low certainty,” the organization said in a statement provided to the DCNF. “The American Medical Association respects the expertise and dedication of surgeons who care for patients every day. The AMA supports evidence-based treatment, including gender-affirming care. Currently, the evidence for gender-affirming surgical intervention in minors is insufficient for us to make a definitive statement.”
In 2023, the AMA reaffirmed its 2018 policy statement that allowed for “gender-affirming surgeries” for minors on a “case-by-case basis.”
Transgender activists have relied heavily on guidelines from medical organizations and the supposed consensus to support their positions in litigation against states attempting to ban child sex change procedures.
Other organizations, such as the World Professional Association for Transgender Health (WPATH), still have not changed course.
“As the leading global professional organization for clinicians, researchers, and experts in the field of transgender healthcare, WPATH continues to support the Standards of Care’s cautious guardrails and criteria provided for adolescents to access surgical care,” the organization told the DCNF. “These guardrails acknowledge that there is no definitive age or ‘one-size-fits-all’ approach for every patient, which is why they are built on case-by-case assessments, involve experts on adolescent development, and are designed to support thoughtful and ethical shared decision-making in a multidisciplinary field.”
Unsealed court records revealed in 2024 that Biden administration officials pressured WPATH to remove age minimums for these procedures in their guidance to align with legislative priorities. They also showed WPATH suppressed publication of evidence reviews that undermined their recommendations.
American Academy of Pediatrics (AAP) President Andrew Racine told The Washington Post on Tuesday his organization “continues to hold to the principle that patients, their families and their physicians — not politicians — should be the ones to make decisions together about what care is best for them.”
“The guidance from the American Academy of Pediatrics for health care for young people with gender dysphoria does not include a blanket recommendation for surgery for minors,” Racine said in a statement to The New York Times.
AAP and the American Academy of Child & Adolescent Psychiatry (AACAP) did not respond to the DCNF’s requests for comment.
Around 3,215 patients between 12 to 18 years old underwent “breast or chest procedures” from 2016 to 2020, according to the Journal of the American Medical Association. U.S. hospitals charged nearly $120 million between 2019 and 2023 for sex change procedures on minors, including surgeries, puberty blockers and cross-sex hormones, according to data compiled by Do No Harm.
Prisha Mosley, who is currently appealing the dismissal of her own malpractice case, wrote that she hopes “Varian’s legal victory is only the first for detransitioners who have suffered at the hands of their medical professionals.”
“While my lawsuit awaits its day in court as it is appealed to the state’s higher courts, Varian’s victory is a hopeful sign for detransitioners across the country,” she wrote for Independent Women.
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