The Texas Supreme Court ruled Friday it’s not too late for a woman to sue a therapist who recommended she get a double mastectomy as part of her gender transition.
Former Fort Worth resident Soren Aldaco alleged various counselors and doctors, including therapist Barbara Wood, recklessly pressured her into medical gender transition, which resulted in complications from a surgery to remove both her breasts.
Lower courts ruled Aldaco’s lawsuit was filed five months too late under the Texas Medical Liability Act, but high court justices ruled the pre-suit notice Aldaco sent to Wood and other providers was a timely initiation of legal proceedings.
KERA News has reached out to Aldaco and Wood for comment and will update this story with any response.
The case comes as a victory for conservatives who have backed Aldaco in opposition to minors receiving gender-affirming care. State lawmakers have indicated they’ll file legislation that further defines if and when mental health professionals can be sued for recommending transgender treatment that their patients later regret.
Aldaco had been struggling with her gender identity as a teen and began taking testosterone before beginning telehealth counseling with Wood of Three Oaks Counseling in 2020, according to court records. However, the therapy primarily focused on relationship issues with her partner at the time, not assessing or resolving her “gender curiosity,” Aldaco said in court documents.
Aldaco sought a double mastectomy because she disliked the way her breasts looked on her body, according to court records. Wood wrote a letter on Feb. 22, 2021, recommending Aldaco receive the surgery.
Wood later terminated Aldaco’s counseling on May 14, 2021, after Aldaco missed a subsequent session, failed to pay a no-show fee and discontinued contact.
Aldaco underwent surgery in June 2021 at the Crane Clinic in Austin when she was 19. According to court records, she suffered complications, including blood pooling around her chest wounds and severe pain.
Aldaco ultimately “detransitioned,” the process of stopping or reversing gender transition. In court records, she attributed her issues with identity to her stressful adolescence and external influence and found peace instead through meditation.
After sending a pre-suit notice May 9, 2023, Aldaco filed a medical negligence suit that July. Aldaco alleged Wood didn’t adequately examine her mental state and falsely claimed in the recommendation letter that she was treated for gender dysphoria and had lived as a transgender man for a year.
Health care liability claims in Texas must be filed within two years from the date the tort, or civil wrong, occurred. Wood and Three Oaks argued the suit should have been filed by February 2023, two years after Wood wrote the letter of recommendation.
Aldaco argued a tort hasn’t occurred until there are damages — in this case, her surgery in June 2021. That means Aldaco was allowed to file her lawsuit by June 2023 or even May 2023, which was two years after Wood terminated her psychotherapy, she argued in court filings.
The Texas Supreme Court ruled multiple events can trigger the start of the statute of limitations under the Texas Medical Liability Act, including the completion of health care treatment.
Therefore, Aldaco sent her May 9, 2023 pre-suit notice within two years from the time she “completed” telehealth counseling with Wood on May 14, 2021, so Aldaco’s legal claims are timely.
And because Aldaco sent the pre-suit notice within two years of her surgery date on June 11, 2021, that also meant her claims were timely, justices ruled.
The court agreed with Aldaco’s argument that if she’d sued after receiving the letter but before the surgery, the case could have failed as no physical or financial injury had occurred yet.
“There was no bodily injury Aldaco could’ve discovered until her double mastectomy was performed on June 11, 2021,” Justice James Sullivan wrote for the court.
Transgender care is supported by major medical associations across the United States as the best standard of care for transgender youth experiencing gender dysphoria. Studies show about 1% of people who undergo gender-affirming surgeries later regret the procedures, but the exact number is unknown.
In an opinion partially concurring with the majority, Justice Evan Young said the ruling in Aldaco’s case should be “minimally disruptive” to the law governing medical liability, and any significant change “should come from the policymaking branches, not the courts.”
Lawmakers are signaling that change could come soon.
Conservatives have rallied behind Aldaco’s case, including a coalition of 60 Texas House Republicans who signed a statement in February urging the court to allow Aldaco’s claims to proceed. The letter states the lawmakers plan to advance legislation in next year’s legislative session to extend the malpractice limitations period for “detransitioners harmed by negligent providers.”
One of those lawmakers, Rep. Shelby Slawson, R-Granbury, said in a post on X Friday she’d be refiling bills she filed in the 2023 legislative session to extend the statute of limitations on health care liability claims involving gender transition care.
Another, Republican Texas Rep. Jeff Leach of Plano, lauded the ruling in his own post on X Friday, calling it a win for those who have been injured by “harmful and dangerous gender medication procedures.”
“This Supreme Court Opinion, expertly written by the esteemed Justice James Sullivan, is just the next step in this important battle — with much more left to do in the next #txlege session,” Leach wrote.
Toluwani Osibamowo is KERA’s law and justice reporter. Got a tip? Email Toluwani at tosibamowo@kera.org.
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