Matthews: Here come the gender-detransitioner lawsuits

Nearly half of the states have passed legislation restricting or banning what’s referred to as “gender-affirming care” for minors. Most of those laws have been challenged in court, with some judges upholding the bans, while others have blocked them. Regardless of where the courts, including the U.S. Supreme Court, may end up, the real check on gender-affirming care for minors may come from the multimillion-dollar lawsuits now being filed against the physicians and health care centers that provide the care.

The dramatic growth in gender dysphoria — defined as “the feeling of discomfort or distress that might occur in people whose gender identity differs from their sex assigned at birth” — should raise eyebrows. A Reuters/Komodo Health Inc. analysis reports, “In 2021, about 42,000 children and teens across the United States received a diagnosis of gender dysphoria, nearly triple the number in 2017…. Overall, the analysis found that at least 121,882 children ages 6 to 17 were diagnosed with gender dysphoria from 2017 through 2021.” Gender dysphoria is not a contagious disease, so a tripling of the numbers in five years implies social contagion, not biological.

Based on insurance data from millions of minors ages 6-17, the study found that some 4,780 adolescents began puberty blockers, and 14,726 minors began hormone treatment, which forces their bodies to begin taking on characteristics of the gender they want to assume. The report adds, “Hormone treatment may leave an adolescent infertile, especially if the child also took puberty blockers at an early age.”

In other words, there are very serious, often permanent adverse consequences from this “care.”

And then there’s the surgeries. Komodo identified 776 mastectomies — euphemistically referred to as “top surgeries” — and 56 genital surgeries on children ages 13 to 17 between 2019 and 2021. The numbers are surely much larger today.

We are talking about children, who often go through fazes during adolescence, seeking medical interventions that will affect their health and bodies for the rest of their lives. You might expect the medical profession to be very skeptical of this path. But the American Academy of Pediatrics has a policy statement, updated last August, recommending: “that youth who identify as TGD [transgender and gender diverse] have access to comprehensive, gender-affirming, and developmentally appropriate health care that is provided in a safe and inclusive clinical space.” 

In addition, “that insurance plans offer coverage for health care that is specific to the needs of youth who identify as TGD, including coverage for medical, psychological, and, when indicated, surgical gender-affirming interventions.”

Yet here’s something I find hard to reconcile with this support. Forty-one states have passed laws outlawing the ritual/cultural practice of female genital mutilation (FGM), which the U.S. State Department defines as “cutting and other procedures that injure the female genital organs for non-medical reasons.” It continues, “the U.S. Government considers FGM/C to be a serious human rights abuse, and a form of gender-based violence and child abuse.” By law in most states, children cannot consent to the practice, even if they and their parents want it. 

And yet, while the medical community and virtually all liberals and conservatives oppose and abhor FGM, the left has aggressively embraced transgender care for children, including surgeries, claiming those actions are based on “medical reasons.”

Well, a growing number of detransitioner lawsuits are going to test these claims and practices. 

Isabelle Ayala was 14 years old when she was committed to a hospital for suicidal thoughts. She met with a doctor, who she says claimed she met the criteria “to consider hormonal transition.” In a lawsuit filed by the law firm of Campbell Miller Payne PLLC, which is specializing in representing detransitioners, Ayala, now 20, says that instead of addressing her mental health needs, she was taken down a path of “gender-affirming medicalization.” She is suing her doctors and the American Academy of Pediatrics. 

She’s not the only one. Luka Hein, who is represented by the Center for American Liberty, is suing health care providers at the University of Nebraska Medical Center. There currently appear to be nearly 10 lawsuits. But more are coming because many patients believe they were encouraged to take the gender-affirming medicalization route without being fully informed of all the life-long implications and negative consequences.

Gender-affirming care is becoming big business. Revenue from sex reassignment surgery is currently about $2.5 billion, and is estimated to grow to $5 billion by 2030. And that’s just for surgery.

It’s way too early to tell whether the growing number of detransitioner lawsuits will succeed, but I suspect many of them will. Juries are likely to be very sympathetic to the claims of minors, who clearly needed mental health care but received life-altering medication or surgeries instead. Multimillion-dollar jury awards may be the best option for making the gender-affirming medical complex more accountable.

Merrill Matthews is a resident scholar with the Institute for Policy Innovation in Dallas, Texas. Follow him on X @MerrillMatthews.