Malpractice ruling signals legal reckoning for gender procedures on minors

By Brian C. Joondeph, M.D. | Commentary, American Thinker

A major change in the medical landscape on transgender surgeries on minors arrives, and the press is trying to ignore it.

When Fox Varian stood before a New York jury last month and described the moment her bandages were removed after a double mastectomy, her words were stark: “It’s so hard to face that you are disfigured for life.” 

What the jury saw was not a political mascot or an abstract policy debate, but a young woman whose body had been permanently altered during adolescence, long before she had the maturity or perspective to grasp the lifelong consequences of that choice.

After deliberation, the jury awarded Ms. Varian $2 million in damages, finding that her psychologist and surgeon failed to meet the standards of care in recommending and performing a double mastectomy on a 16-year-old patient without sufficient informed consent.  

This marks the first time in U.S. history that a detransitioner has won a medical malpractice case related to “gender-affirming” procedures performed on a minor — and it should serve as a wake-up call for medicine, media, and policymakers alike.

It is essential to understand what this lawsuit was and was not. It was not a federal policy decision regarding funding for transgender clinics, nor was it about adult access to care. Adults have the legal capacity to make decisions about their bodies, even when those decisions involve risk, including the choice of assisted suicide.

It was a malpractice case based on core principles of medical ethics: whether clinicians followed established protocols, conducted comprehensive evaluations, and obtained genuine informed consent from a minor and her guardians before performing irreversible, non-therapeutic surgeries.  

The jury decided they did not. And they did so without considering the broader debates about gender identity. They concentrated on whether the providers acted reasonably and responsibly given the circumstances.  

No matter how advocates frame the language, these procedures are permanent. A double mastectomy cannot be “undone.” Removed breasts do not grow back; reproductive capacity cannot be restored once certain interventions have taken place; alterations to anatomy and hormonal balance affect sexual function and health for life. 

These are not whimsical cosmetic choices or minor medical adjustments; they are significant transformations with lifelong consequences. A tattoo can be partially removed or covered – once removed, sexual organs and sensations are gone for good.

Yet these facts were hidden, even from the patient’s mother, who testified that she only agreed to the surgery because she was repeatedly warned that her daughter might kill herself if it was not done. 

That kind of coercive framing — conflating irreversible surgeries with suicide prevention — is very concerning. It turns a clinical evaluation into a psychological pressure campaign. That is not informed consent. That is fear-based blackmail.

For years, detransitioners were dismissed as isolated outliers — “rare,” “anecdotal,” and background noise drowned out by narratives of affirmation and hope. But data now show dozens of civil lawsuits filed by individuals who regret the medical interventions they received as minors.

The notion that detransitioning is extremely rare and thus insignificant no longer holds up. Many stories like Ms. Varian’s, where mental health diagnoses were not thoroughly examined and both reversible and irreversible treatments were mixed up, are widespread and could even go to court.

These claims depend on the core principles of medical practice: careful diagnosis, risk disclosure, evaluation of alternatives, and especially consent that is voluntarily given with full understanding of the long-term impact.

The American Medical Association states in its code of medical ethics, “Informed consent to medical treatment is fundamental in both ethics and law.”

While this verdict has started to ripple through conservative and independent news outlets, major left-leaning publications have been notably quiet or lukewarm in their coverage. As of now, neither the New York Times nor the Washington Post has given sustained, front-page attention to what is arguably a historic medical-legal event.  

Jeffrey Epstein emails, yes. An earthquake in the transgender crusade, no.

That silence is not new. The New York Times reported that the American Medical Association now recommends delaying gender-related surgery until patients reach adulthood. They attribute the change to the “fierce backlash from the Trump administration” and only reluctantly mention the aforementioned lawsuit at the end of the article.

The American Academy of Pediatrics, watching out for the well-being of children and teenagers, continues to green-light gender mutilation surgery.

This lack of coverage exposes a deeper issue: critical medical and legal developments are being interpreted through ideological lenses instead of neutral journalistic standards. When a patient wins a malpractice case against medical professionals for performing irreversible surgery on a minor, that is news, not a footnote.

This case will not stand alone. According to court filings and reports, nearly three dozen similar lawsuits are now pending across the United States. 

Each focuses on the same fundamental question: did these clinicians follow reasonable standards of care and fully inform young patients and their families about the risks and permanence of these interventions? How will surgeons claim they are adhering to the standard of care when leading medical organizations recommend otherwise?

Ms. Varian’s victory offers two lessons for health care providers. Precise documentation, interdisciplinary assessment, and honest disclosure are just as important in court as in the clinic. Irreversible treatment decisions for minors require more, not less, caution.

Where this leads is uncertain. But if jurisprudence begins to align with informed-consent principles, pediatric gender medicine may soon look very different from what it does today. 

Sharks and medical malpractice attorneys have a keen nose for smelling blood in the water, especially when the blood involves well-funded hospitals, physicians, and psychologists. Detransitioners had, “Better Call Saul.” 

Medical malpractice carriers may deny coverage to physicians and hospitals performing these surgeries, leaving practitioners exposed to significant liability. 

Medicine has experienced paradigm shifts before. There were periods when harmful treatments were justified as progress. Lobotomies, forced sterilizations, and experimental surgeries were once defended as compassionate and scientific. History has not judged those chapters kindly.

The permanent alteration of children’s developing bodies =- often without thorough psychological assessment, long-term outcome data, or fully informed consent — will probably be viewed in a similar way.

At the very least, this lawsuit should encourage honest reflection. Medicine must be based on evidence and ethics, not ideology. We are already witnessing politically radicalized nurses delivering medical or end-of-life care, depending on their patients’ political beliefs.

READ THE FULL COMMENTARY AT THE AMERICAN THINKER

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