Note: The following is general information only. It is not intended as legal advice. Please consult your attorney if you might like to pursue a legal action.
Gender patients might be able to sue on grounds of medical negligence, battery or medical fraud if doctors conceal or distort information to induce patients to agree to treatments.
A patient may allege that she experienced mood swings, aggression, addictive or risky behaviors, social difficulties, verbal difficulties, worsening or development of new psychiatric disorders, dementia, neurological disorders or other problems as a result of transition drug treatments.
A patient may also allege that she experienced physical effects such as baldness, voice changes, and so forth, which she might have avoided if she had been properly diagnosed and treated. A patient might argue that she would have avoided such physical effects if she had been told about the risk of adverse brain and behavioral effects.
A doctor or counselor may be guilty of malpractice if he or she fails to diagnose and treat an underlying mental health or physical health condition such as autism or polycystic ovary syndrome (PCOS) in a patient with gender difficulties. A patient could argue that her desire for transition treatments might have been reduced if she were properly diagnosed and treated. Therefore, the failure to diagnose and treat may have led her to get transition drugs or surgeries that she could have avoided.
In addition, if patients are not warned about the risks of transition treatments, then they may not be able to give legally-sufficient informed consent for the treatments (see also Murray 2012). Therefore, the patient may make a claim for battery or medical malpractice. Moreover, doctors who fail to provide adequate risk information may be guilty of ethical violations, which can be reported to a medical licensing board.
A patient might be able to sue if a counselor or doctor:
- interviewed a patient inappropriately.
- failed to obtain relevant medical or school records that would have revealed an underlying mental or physical health problem.
- ignored information from parents.
- ignored standards of care.
- provided false information about suicide risks to induce parents to agree to treatments.
- used undue influence or inappropriate suggestive questioning, social influence or reinforcement techniques to get patients or parents to agree to treatments.
- failed to provide appropriate information about the risks of transition treatments.
- failed to inform patients or parents about the benefits of alternative treatments such as counseling, instead of transition. Many females who experienced dysphoria say that counseling is a helpful alternative to transition.
Doctors may be held liable for failing to provide risk information even if they claim that they withheld information because they want to “support” transgender people. Experts say:
“The practice of withholding pertinent medical information from patients in the belief that disclosure is medically contraindicated is known as ‘therapeutic privilege.’ It creates a conflict between the physician’s obligations to promote patients’ welfare and respect for their autonomy by communicating truthfully….
Withholding medical information from patients without their knowledge or consent is ethically unacceptable” (“AMA Code” 2012).
Doctors may claim that high testosterone/low estrogen treatments should be safe for biological females becuase the treatments seem safe for males. However, male-typical hormone levels are not necessarily safe for biological females. Females and males can react differently to the same hormones and drugs because they have different bodies, different sex chromosomes in their brains, and other differences that affect response to hormones and drugs. Drug treatments that are safe for males have sometimes been found to be unsafe for females. Women’s health advocates have pleaded for more careful attention to biological sex differences in medical research and practice for these reasons (see Bangasser; Becker; Cahill; Clayton; Davies; Fattore; Freire; Gillies; Hayden; Klein; Li; Loke; McCarthy; McEwen; Ngo; Rodenburg; Sandberg; Soldin; Woodruff; Yang).
If a doctor did not investigate, diagnose or treat underlying physical health problems such as polycystic ovary syndrome (PCOS) properly, then the patient might be able to sue. PCOS and high testosterone are common in females with gender dysphoria (see Auer; Baba; Becerra-Fernández; Bosinski; Futterweit; Mueller). These physical health problems may cause psychiatric or neurobehavioral problems if not treated properly (see Cesta; Cooney; Dettenborn; Matevosyan; “PCOS”; Pohl; Schwarz; Soleman; Tan; Wooderson; Worsely).
A patient might be able to sue if a doctor did not investigate, diagnose or treat autism, psychiatric disorders or cognitive disorders properly. Those conditions are common in males and females with gender dysphoria (see Becerra-Culqui; Chen; Devor; Jones; Kaltiala-Heino; Leena; Littman; Marchiano; Oswalt; Strang; “Survey”; Vrangalova; Walling).
Some 40% or more of transgender or non-binary biological females may have autism diagnoses or undiagnosed autism. High-functioning females are especially likely to have undiagnosed autism or psychiatric disorders (see also Anderson; MacDonald; Russo; Sigler).
Autism and psychiatric disorders may help to cause gender dysphoria or desire for transition treatments. Therefore, patients should be diagnosed and treated. If a doctor jumps to the conclusion that a patient needs transition treatments without exploring the possibility that autism or psychiatric disorders are causing dysphoria, then that may be malpractice.