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'Cut-and-pasted boilerplate': Detransitioner sues providers for approving 'unnecessary' mastectomy

Short remote consultations ignored Camille Kiefel's red flags, got her claims backwards and gave different diagnoses, yet still authorized surgery to remove her breasts, suit claims. Follows U.K. litigation that helped shutter NHS youth gender clinic.

Published: November 9, 2022 6:20pm

Updated: November 11, 2022 11:33pm

A young woman who regretted her gender transition helped shut down the U.K.'s central provider of pediatric "gender affirming care" this summer through litigation that prompted more scrutiny of the National Health Service-run Tavistock clinic.

An older American detransitioner is following Keira Bell's lead, suing mental health professionals for allegedly rushed, sloppy and categorically false evaluations that authorized her for a taxpayer-funded double mastectomy despite the red flags she presented on mental health.

Though she's not a minor, Camille Kiefel's lawsuit could make providers think twice about treating gender dysphoria in youth with puberty blockers and cross-sex hormones, as well as surgical removal of healthy breasts and genitals for all ages.

The gender-critical Women's Liberation Front is sponsoring Kiefel's lawsuit. Filed in Oregon's Multnomah County Circuit Court, it alleges malpractice, fraud and intentional infliction of emotional distress. 

Kiefel is seeking $850,000 in damages, including $250,000 for "medical and psychological care expenses" and $100,000 in lost wages. WoLF said it plans to support at least two additional similar lawsuits.

The 32-year-old ex-nonbinary Oregonian told Just the News she hopes the litigation raises awareness for physical therapies as treatment for mental health problems. Hers didn't respond to "talk therapy" — a low-risk alternative to drugs and surgery — such as somatic experiencing and dialectical behavioral therapy.

Kiefel was "shocked to find" that treatments for surgery complications actually worked faster on her mental health, she said in a phone interview, identifying Masgutova Neuro-Sensory Motor Reflex Integration, hyperbaric oxygen therapy and acupuncture. Adding meat back to her pescatarian diet also helped.

She's in the "early stages" of seeking cofounders for a nonprofit focused on physical health treatments "to prevent unnecessary transition" and help detransitioners recover from their interventions, she said, adding, "It's important to find people who would share the organization's goals and values around a more holistic approach."

Kiefel was already on the public radar among detransitioners through her testimony before Florida's Board of Medicine, which last week prohibited doctors from performing "sex reassignment surgeries" or prescribing puberty blockers and hormone therapy for minors. 

"I intend to be a resource for other government officials when considering rules around gender affirming care," she told Just the News.

Candice Jackson, the former Trump administration lawyer who also leads a WoLF challenge to California's gender identity prison-placement law, is representing Kiefel.

The U.S. and U.K. cases both involve gender clinics "funneling people into unnecessary surgeries while ignoring crucial co-morbidities," Jackson told Just the News, but unlike Bell, Kiefel "wasn't a minor when she was pushed into this."

Though Bell's case was tossed on appeal, it "woke the world up to ... the scandal of treating children according to ideology rather than clinical evidence," according to U.K. advocacy group Transgender Trend, which intervened on Bell's behalf.

NHS commissioned an independent review that found "major gaps in the research base" for treatment of adolescent girls in particular, "diagnostic overshadowing" of other mental health issues and perceived pressure on Tavistock staff to "adopt an unquestioning affirmative approach."

While NHS farmed out the clinic's functions to children's hospitals with instructions to ratchet back medical interventions in favor of "holistic care," a U.K. law firm said it's expecting 1,000 plaintiffs for a class-action lawsuit alleging Tavistock "rushed [children] into taking life-altering puberty blockers without adequate consideration or proper diagnosis."

The Deseret News noted the American law firm Girard Sharp was soliciting reports of adverse events from puberty blockers taken by American transgender minors.

Kiefel's lawsuit got a boost from self-proclaimed transsexual adult performer Buck Angel, a vocal critic of rushing children into medicalized gender care who often promotes detransitioner stories.

The complaint echoes many of the allegations against Tavistock, particularly its tendency to diagnose and invasively treat gender dysphoria at the expense of its patients' potentially more relevant physical and mental health problems.

The "severe childhood traumatic events" Kiefel experienced led her to feel "discomfort and dissociation with her body," the suit claims, citing diagnoses for attention deficit hyperactivity disorder, complex post-traumatic stress disorder, major depressive disorder, generalized anxiety disorder and polycystic ovary syndrome.

She went through nearly two decades of unsuccessful psychotherapy and associated medications, whose "serious negative side effects" compelled Kiefel to stop taking them.

Kiefel adopted a nonbinary identity in 2016 but didn't go forward with breast removal for four years, by which point she had tried "everything," including transcranial magnetic stimulation to resolve her mental health issues.

Gender identity treatment provider Brave Space directed Kiefel to licensed clinical social worker Amy Ruff, who wrote her a same-day medical transition referral after an hourlong Zoom consultation where she laid out her unsuccessful treatments, according to the suit.

It accuses Ruff of gaslighting Kiefel by claiming her mental health conditions had been "successfully managed" and would thus not "impact the medical experience or outcomes" of surgery, despite Kiefel's statements to the contrary. They also did not discuss "expectations" such as outcomes and risks as Ruff claimed, Kiefel alleges.

Quest Center for Integrative Health referred Kiefel to licensed professional counselor Mara Burmeister for a second assessment required for Medicaid coverage of the procedure. 

Burmeister wrote a surgeon a same-day letter after their 40-minute phone consultation attesting that Kiefel had "explored the potential psychosocial impacts of surgery" and made a "fully informed decision" to go forward. A formal referral followed the next day, the suit claims.

Those documents, the complaint contends, show that Burmeister knew or should have known Kiefel was a "high-risk candidate for regretting or not benefitting from" a gender-affirmation surgery and "failed to conduct an individualized, comprehensive mental health assessment," given the red flags Kiefel had raised, such as recent "suicide ideation" and desire for a "more androgynous" look.

She diagnosed Kiefel "based on cut-and-pasted boilerplate diagnostic criteria ... unsupported by" their phone conversation, inventing "clinically significant distress or impairment" Kiefel supposedly experienced from having breasts, the plaintiff claims. Burmeister also allegedly gave different diagnoses between the surgeon letter and referral.

The August 2020 surgery worsened her health and well-being, knowing she can never breastfeed and fearing that potential partners won't be attracted to her, Kiefel claims, and she now mistrusts mental health professionals. 

The defendants — Brave Space, Ruff, Quest Center and Burmeister — didn't respond to requests for their responses to the lawsuit. 

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