In the aftermath of a major lawsuit award, two major American medical associations have backed away from the least reversible procedures in so-called gender-affirming care for minors.

Now the biggest thing holding back the American medical establishment from fully repudiating the medicalization of gender confusion -- from puberty blockers and cross-sex hormones to surgical removal of healthy breasts and genitals -- may be short statutes of limitations for medical liability lawsits.

And the Trump administration and red-state legislation are pressing to change those statutes.

Friday's $2 million New York jury award for a detransitioner against her psychologist and plastic surgeon set off a scramble in the mainstream media to downplay its threat to the broader field while prompting predictions from detransitioners and lawyers that this was just the beginning of a legal tsunami.

“Every doctor and clinic involved in this fad should be very afraid for what comes next," Chloe Cole, perhaps the highest-profile detransitioner in America, said through her lawyers at the Center for American Liberty, which is representing several detransitioners in litigation. The verdict "gives real hope to the next generation of detransitioners seeking justice," she said.

The verdict "sets an incredible precedent" especially coming out of politically blue New York, according to detransitioner Prisha Mosley, an ambassador for the Independent Women's Forum who has testified in state legislatures. She said she hopes it encourages "others to come forward and hold their doctors accountable too." 

Mosley's lawsuit against her providers foundered on North Carolina's statute of limitations but has another chance thanks to the Legislature extending it over Democratic Gov. Josh Stein's veto. She's now waiting for an appeals court to consider her appeal.

"Detransitioners aren’t the only group harmed by their gender doctors," detransitioner Maia Poet wrote on X. Transgender people should also sue "for botching surgeries, downplaying the injuries they caused & failing to properly assess mental health comorbidities."

"I hope these butchers that are mutilating our children on the altar of transgender wokeness lose their licenses[,] are sued into poverty and burn in Hell," Rep. Tim Burchett, R-Tenn., wrote on X.

The verdict "demonstrates once again how lawsuits and lawyers - whether seeking to advance the public interest or simply to obtain money for injured clients - can be a major factor in advancing and protecting public hea[l]th," George Washington University public interest law professor John Banzhaf wrote in his newsletter Wednesday.

'Endocrine intervention' is a problem - or just surgery?

The American Medical Association closely followed the American Society of Plastic Surgeons this week in recommending against surgery for gender confusion in minors following the New York verdict for Fox Varian, who underwent a double mastectomy at 16 and now considers herself "disfigured for life."

The AMA's shift, however, was conditional.

"Our colleagues at ASPS concluded that the evidence supporting gender-related surgery in minors is insufficient and of low certainty" and the AMA respects their "expertise and dedication," according to an AMA statement a spokesperson shared with Just the News, first given to National Review but only published in part.

While the AMA "supports evidence-based treatment, including gender-affirming care," it said the evidence for surgical intervention "currently" is too low "for us to make a definitive statement. In the absence of clear evidence, the AMA agrees with ASPS that surgical interventions in minors should be generally deferred to adulthood."

The medical watchdog group Do No Harm accused AMA of misstating ASPS's lengthy "position statement," which argued unconditionally against surgery for minors and questioned whether there's a "favorable risk-benefit ratio" for both "endocrine interventions" and surgery, citing weak research as well as the Trump administration's recent youth gender medicine report.

"Waffling on such an important question of the safety and wellbeing of American children is unhelpful and wrong," Do No Harm wrote on X. The AMA didn't respond to Just the News requests to provide its full statement, which is not posted in its press center.

"Almost daily, another major hospital system in America is ending the tragic and irreversible practice of sex-rejecting procedures for minors," Department of Health and Human Services General Counsel Mike Stuart said, praising ASPS for "bravely standing" with Secretary Robert F. Kennedy Jr.

"I think malpractice companies are going to drop doctors and hospitals that do transgender surgery" in light of the verdict for a "girl who was seduced into changing her gender," Dr. Peter McCullough, former vice chief of internal medicine at Baylor University Medical Center, told Just the News, No Noise. 

ASPS's immediate pivot shows "it wasn't morals, ethics" or "rational, scientific conversation" that changed guidance to doctors, but litigation that will "turn the tide on this transgender madness," he said.

One big unknown is how the verdict might affect the position of the American Academy of Pediatrics, which persuaded a judge last month to restore $12 million in federal funding that was allegedly stripped in part because of its support for the full range of medical interventions for gender-confused children. It didn't answer queries.

'Browbeating' her mother into signing off by invoking suicide

"Varian’s case is the first malpractice suit from a detransitioner to go before a jury, and I was the only reporter to attend the entire three-week trial," independent journalist Benjamin Ryan wrote on X in previewing his coverage for The Free Press.

Now 22, the teenager's providers mistook her fear of becoming a woman, especially menstruation, as telltale signs she was "born in the wrong body," as Ryan wrote in a free companion to his paywalled Free Press article. He also published some of the case files he obtained before the court sealed them.

Ryan said he's tracking 27 similar suits, "quite a few" that have stumbled on the statute of limitations. California's three-year limit ended a lawsuit against Children's Hospital Los Angeles pediatrician Johanna Olson-Kennedy, known for hiding the results of her federally funded study that failed to find mental health improvements from gender affirming care.

Olson-Kennedy dismissed concerns about pediatric informed consent and the permanence of surgical interventions in leaked video obtained by Ryan, who said he's publishing 12 hours of her gender affirming care training. Adolescents can "make a reasonable, logical decision" about breast removal and "go and get" new breasts later if they want, she told trainees.

Varian accused psychologist Kenneth Einhorn of rushing her into breast removal with surgeon Simon Chin while ignoring what role several mental illnesses might have played in her gender confusion. Her mother accused Einhorn of "browbeating her into consenting," in Ryan's words, by saying Varian would kill herself otherwise, and the girl believed him. 

Though Einhorn denied saying it, the heightened risk of child suicide without gender-affirming care is anecdotally a common assertion from doctors. It's not borne out by research, as an ACLU lawyer admitted to the Supreme Court when it considered state bans on medicalized gender transitions for minors.

Another gender-affirming surgeon, the incoming president of the World Professional Association for Transgender Health, admitted on the stand the procedure isn't intended to prevent suicide, Ryan reported. 

The New York Times, which didn't cover the trial but cited pretrial filings, portrayed Einhorn and Chin as outliers in the field who were in over their heads, rather than symptomatic of pediatric gender medicine's standards of care.

Former WPATH President Marci Bowers, who is also transgender, told the Times the verdict could unexpectedly help the field by reinforcing that standards of care must be followed. WPATH intentionally weakened its latest standards of care for youth under pressure from the Biden administration, however.