The case of Fox Varian, who was awarded $2 million in damages after suing the doctors who facilitated her gender transition while she was a minor, has reopened the debate about the lack of rigor in diagnoses of gender dysphoria and the irreversibility of treatments in adolescents. This court ruling highlights the negligence involved in ignoring pre-existing conditions such as autism or anxiety, and reinforces the need for a paradigm shift in medical protocols: scientific evidence and bioethical prudence must prevail in the face of the growing number of people who detransition after undergoing premature interventions.

The Varian case 

Fox Varian, 22,  sued  the doctors who performed her gender reassignment surgery when she was a minor, alleging negligence. She won the lawsuit and was awarded $2 million in damages. 

When the young woman was only 16 years old, and despite being a minor, psychologist Kenneth Einhorn authorized the transition and Dr. Simon Chin performed the surgery in which he removed her breasts.

During the trial, held in New York State, Varian’s lawyers argued that the psychologist and surgeon failed to follow the necessary protocols to save her from trauma and surgery. They also stated that it was the psychologist who proposed the idea of ​​transitioning the young woman after diagnosing her with gender dysphoria. 

Varian’s mother has stated that she felt intimidated by the psychologist into authorizing her daughter’s surgery because he told her that otherwise she would commit suicide. 

The lawyers also argued that other mental health issues such as depression, anxiety, social phobia, and autism were not taken into account before deciding whether to perform the operation. 

Furthermore, the doctor who performed the double mastectomy only met briefly with the young woman twice before the surgery. Three years after the operation, Fox Varian detransitioned.  

Background 

As we have  previously published  in our Observatory, in 2022 we already warned of the growing number of transgender people who regretted undergoing gender transition treatments. 

Cases like that of Keira Bell, who  sued the hospital  that prescribed hormone blockers for her at age 16, for not objectively informing her of the consequences that could result from this treatment, or that of a repentant transsexual who exposed the  lies of gender ideology . 

As an example of the growing trend that opposes the generalization of gender transition procedures, the case of the British National Health Service (NHS) should be mentioned, which, in 2024, announced that  it would stop prescribing  puberty inhibitors in its clinics to minors who wish to undertake a gender transition. 

Bioethical assessment 

There are already many court rulings condemning health professionals and related entities to compensate patients who have reported not being correctly diagnosed and properly informed about the consequences of gender reassignment therapies, suffering their consequences. 

The surgical interventions performed for this purpose and the associated hormonal treatments, whose objective is to modify the phenotypic appearance to resemble the opposite sex, entail numerous side effects, both physical and psychological, which often worsen the quality of life of the patients who suffer them.  

Intervention in adolescents, as in the case at hand, presents greater risks, associated with hormonal blocking therapies and their consequences on their normal physical and mental development. 

Many of the countries that began applying these therapies more than 20 years ago have drastically modified their protocols, limiting access to hormone-blocking treatments and pharmacological and surgical reassignment. 

In a  previous report,   we already showed evidence of how counterproductive pharmacological and surgical gender transition interventions can be in patients with dysphoria, reinforcing the need to provide psychological or psychiatric treatments to those affected. 

Many laws regulating these interventions, such as the Spanish one, continue to propose the exact opposite of what the most recent studies show. These studies have warned of the destructive effects of these interventions and their limited capacity to address the suicidal tendencies of many of those affected, who, as a  recent study shows , require psychological and psychiatric treatments that are not readily available in many cases. Gender transition processes are promoted through pharmacological or surgical interventions, which have not proven effective in reducing suicide rates if appropriate psychological or psychiatric interventions have been applied beforehand. However, the administration of hormonal, blocking, or transition treatments, as well as surgical procedures, presents numerous  side effects and complications , as we have previously reported, many of which are irreversible and contribute to worsening the quality of life of these patients. 

It should be the accumulated scientific evidence on these interventions that promotes a paradigm shift in intervention protocols in these cases, and not the accumulation of court rulings filed by those who have suffered their negative consequences, irreversible in many cases.  

Julio Tudela. Ester Bosch. Bioethics Observatory. Catholic University of Valencia