The booming business of gender-transition services, which includes hormone therapy, puberty blockers, and surgeries, is facing a growing challenge from former patients who regret their decisions and are suing their providers for medical malpractice.
Detransition lawsuits in the US
In the US, two young women have recently filed lawsuits against Kaiser Permanente, a major health care provider, for allegedly pressuring them into undergoing irreversible procedures that left them with physical and psychological scars.
- Chole Cole, now 18, decided to transition to male at the age of 12, and received puberty blockers, testosterone injections, and a double mastectomy by the age of 16. Two years later, she realized she had made a mistake and wanted to revert to her female identity. She claims that Kaiser Permanente failed to properly diagnose and treat her underlying mental health issues, and instead pushed her into a radical and experimental treatment that harmed her body and fertility.
- Layla Jane, now 20, had a similar experience. She started puberty blockers and testosterone at the age of 12, and had a double mastectomy at 13. She says that the doctors presented her parents with a false dilemma: would they rather have a live son or a dead daughter? She also accuses Kaiser Permanente of violating informed consent laws, as she was not fully aware of the risks and consequences of the interventions.
Both lawsuits are filed by the Centre for American Liberty, a conservative non-profit organization that advocates for individual rights and freedoms. The lawsuits allege that Kaiser Permanente violated the standard of care and acted negligently, recklessly, and fraudulently. They seek compensatory and punitive damages, as well as an injunction to stop Kaiser Permanente from providing gender-transition services to minors.
Kaiser Permanente has not commented on the specific cases, citing privacy laws, but has defended its practices as following the best available evidence and guidelines. It also says that it respects the autonomy and dignity of its patients, and provides them with individualized and compassionate care.
Detransition lawsuits in the UK
In the UK, a landmark case was brought by Keira Bell, a 24-year-old woman who detransitioned after undergoing hormone therapy and a double mastectomy as a teenager. She sued the National Health Service and the Tavistock and Portman NHS Foundation Trust, which runs the only gender clinic for children in the UK.
Bell argued that she was not mature enough to consent to the treatments, and that the clinic did not adequately assess her mental health and explore alternative options. She also claimed that the clinic did not warn her of the long-term effects of the interventions, such as infertility, sexual dysfunction, and osteoporosis.
In December 2020, the High Court ruled in favor of Bell, finding that children under 16 are unlikely to be able to give informed consent to puberty blockers, and that even older children may need court approval before starting such treatment. The court also expressed concern about the increasing number of referrals to the clinic, especially among girls, and the lack of data on the outcomes and safety of the treatments.
The ruling was hailed as a victory by detransitioners and their supporters, who say that the clinic is too quick to diagnose and treat children with gender dysphoria, without considering the psychological and social factors that may influence their identity. They also say that the clinic is biased towards affirming the children’s gender identity, rather than exploring the possibility of desistance or detransition.
The Tavistock and Portman NHS Foundation Trust appealed the ruling, arguing that it was based on a misunderstanding of the evidence and the role of the clinic. It also said that the ruling would have a negative impact on the well-being and rights of transgender and gender-diverse children, who need access to timely and appropriate care. The appeal was heard in June 2021, and the judgment is expected later this year.
The debate over gender-transition care for minors
The detransition lawsuits reflect a wider debate over the ethics and efficacy of gender-transition care for minors, which is becoming more prevalent and controversial in many countries. Proponents of gender-transition care argue that it is a necessary and life-saving intervention for children who suffer from severe gender dysphoria, and that it improves their mental health, self-esteem, and social functioning. They also point to the international and professional consensus that supports the provision of gender-affirming care, based on the principle of respect for the child’s best interests and autonomy.
Opponents of gender-transition care contend that it is a harmful and irreversible experiment on children who are too young and vulnerable to make such decisions, and that it exposes them to serious physical and psychological risks. They also question the validity and reliability of the diagnosis of gender dysphoria, and the influence of social and cultural factors on the children’s gender identity. They advocate for a more cautious and conservative approach, based on the principle of “first, do no harm”.
The debate is complicated by the lack of robust and long-term evidence on the outcomes and safety of gender-transition care for minors, as well as the diversity and complexity of the individual cases. There is also a need for more research and dialogue on the causes and nature of gender dysphoria, and the best ways to support and care for children who experience it.
