PROVIDENCE, R.I. (Legal Newsline) - A Dallas law firm has filed the first of what it believes will be a wave of lawsuits over gender transition therapy, accusing doctors and the American Academy of Pediatrics of conspiring to mislead parents into allowing their minor children to be treated with hormones to suppress their sexual characteristics.
The lawsuits filed by Campbell Miller Payne say doctors committed medical malpractice by performing life-altering procedures on minors based on an AAP policy statement that made unfounded and unscientific claims about the benefits of hormone therapy. One of the doctors sued, Dr. Jason Rafferty, was the lead author of the 2018 policy statement the plaintiffs claim is fraudulent and misleading.
The AAP declined to comment on pending litigation, but the organization reaffirmed its statement on gender-transition care this year. Lifespan Physician Group in Providence, R.I., also named in at least one lawsuit, didn’t immediately respond to a request for comment.
Isabelle M. Ayala sued the AAP, Lifespan, Dr. Rafferty and several other physicians, claiming her existing mental-health problems were exacerbated by hormone therapy the physicians convinced her parents to allow starting when she was 14. In a complaint filed in Rhode Island state court on Oct. 23, Ayala says she was sexually assaulted at 7 and had early-onset puberty at 8. She began cutting herself at 11 and learned about being “trans” on social media. The next year she told her mother she wanted to be a boy.
Her mother opposed any treatment but Ayala entered treatment under Dr. Rafferty at Lifespan and Hasbro Children’s Hospital after she moved from Florida to Rhode Island to live with her father in 2016. Then still a resident, Dr. Rafferty would soon launch the project that became the AAP policy statement on gender care, the lawsuit states.
Starting in April 2017, Ayala was treated with increasing doses of testosterone, even though she disclosed to her doctors that she wanted to have biological children some day. In patient notes, the doctors diagnosed her as “transgender” but said her mother was “blocking her treatment.” Doctors started her on low-dose testosterone but soon tripled the dose, at the same time prescribing antidepressive drugs.
In November, the lawsuit says, Dr. Rafferty “coached” her about “gradually working up to discussing surgery” with her parents. Two weeks later, Ayala attempted suicide and was admitted to the hospital.
She returned to Florida in June 2018 and quit testosterone a year later. But she says she still suffers from vaginal atrophy, her voice has been permanently altered, she has excess facial and body hair and the accompanying stress and worries she has compromised bone structure.
Ayala says her parents wouldn’t have consented to treatment but for the AAP position paper, which she says fraudulently stated there was scientific evidence to support for hormone therapy and even surgery when in fact no peer-reviewed studies have found it improves mental health or reduces the risk of suicide.
In the position paper, the AAP says there is “a limited but growing body of evidence that suggests” an “affirmative model integrated affirmative model results in young people having fewer mental health concerns,” citing three scholarly articles. Ayala’s lawsuit cites a “fact-checking” article by Dr. James Cantor, however, which says the statement “misrepresented the contents of its citations, which repeatedly said the very opposite of what AAP attributed to them.”
Instead of the “watchful waiting” approach pediatricians had used for years, Dr. Cantor wrote, Dr. Rafferty substituted an activist approach including using hormones to delay puberty. The article also misleadingly talks about “conversion” therapy, saying it is dangerous to adolescents, Dr. Cantor writes, when the studies cited involve attempts to “convert” adult homosexuals to heterosexuality.
The lawsuit also says doctors and the AAP continue to portray gender therapy as completely reversible when it can lead to early onset osteoporosis.
The defendants “have stated and continue to state the same fraudulent claim in their private practices as well as their public appearances and in the media,” the lawsuit says. “This is an entirely false and extremely dangerous misrepresentation to make and advocate to the public, particularly since the affected audience are children and adolescents (and their families).”