New legal developments could affect ACPeds members in California, Colorado, Michigan, and New York. In all four states, either the state attorney general or a state trial court has taken the position that declining to offer interventions like puberty blockers, feminizing medications (e.g. spironolactone), cross-sex hormones, mastectomies, or other surgical procedures to patients who identify as transgender could subject the physician or health professional to liability for gender-identity discrimination if the provider offers those same interventions for other purposes.

This mandate to provide sex-rejecting interventions could be relevant to pediatric practices that offer these interventions for legitimate medical reasons. For example, pediatric endocrine practices that offer puberty blockers to treat precocious puberty, or pediatric specialist practices that prescribe spironolactone to manage high blood pressure, or acne in female patients could possibly be threatened with a lawsuit by transgender-identifying patients who are denied those medications for sex-rejecting purposes. However, this mandate and/or patient expectation violates your right of conscience.

If you believe your practice may be affected, Alliance Defending Freedom is available to speak with you and can help connect you with attorneys who can advise on your legal obligations and available options.

Please reach out directly to Hal Frampton, Senior Counsel and Director of the Center for Conscience Initiatives, at hframpton@adflegal.org.

Michelle Cretella, MD
Chair of Sexual Adolescence Committee, ACPeds