The Texas Supreme Court will decide whether it’s too late for a woman to sue a therapist who recommended a double mastectomy as part of her gender transition.
Soren Aldaco, a Fort Worth resident at the time, alleges various counselors and doctors recklessly pressured her into medical gender transition as a teen and were biased toward encouraging hormones and surgery as a remedy for gender dysphoria — psychological stress over one’s gender identity that is often the precursor to transitioning.
The case is a test of how the statute of limitations should be applied when an act of alleged medical negligence and the resulting harm occur at different times. But it could also determine if and when mental health professionals are to blame for recommending transgender treatment that their patients later regret.
“What was done to Ms. Aldaco and many people like her is a medical scandal,” Aldaco's attorney John Ramer told justices. “Kids and young adults suffering from severe psychological distress went looking for help and what they found is medical providers saying that what's going to liberate them from their distress is pumping them full of cross-sex hormones and cutting off their body parts.”
Aldaco started identifying as a boy in eighth and ninth grade. According to her lawsuit, Aldaco had a troubled family life, struggled with her body image and started exploring her gender after interacting with transgender friends online.
Aldaco was hospitalized for a manic episode in 2018, during which she alleges a Fort Worth doctor pressured her to identify as transgender. It was this and interactions with other people supportive of medical gender transition that led Aldaco to start taking testosterone, she said.
Aldaco began telehealth counseling with Barbara Wood of Three Oaks Counseling in 2020. She said the therapy primarily focused on relationship issues with her partner at the time, not assessing or resolving her “gender curiosity.”
Wood wrote a letter on Feb. 22, 2021, recommending Aldaco for a double mastectomy. Aldaco sought the procedure because she disliked the way her breasts looked on her body, according to court records.
Aldaco underwent surgery that June at the Crane Clinic in Austin when she was 19. She then suffered complications, including blood pooling around her chest wounds and severe pain, according to court records.
Aldaco ultimately “detransitioned,” the process of stopping or reversing gender transition. She attributed her issues with identity to her stressful adolescence and external influence and found peace instead through meditation, according to court records.
Aldaco sent a pre-suit notice in May 2023 and filed a medical negligence suit that July. Aldaco alleges 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. Much of the dispute centers on when exactly that was.
Wood and Three Oaks argue the limitations period began February 2021, so the suit should have been filed by February 2023.
“She was given a letter that she requested,” said William Newman, the attorney representing Wood and Three Oaks. “It's hard for me to understand exactly how that gets different from any routine medical negligence that's not discovered until later or not found out until later.”
The Fort Worth Second Court of Appeals sided with the defendants.
But Aldaco argues a tort hasn’t occurred until there are damages — in this case, her surgery in June 2021. She said if she’d sued the day after receiving the letter, the defendants could have moved to dismiss the case as no physical or financial injury had occurred yet.
Aldaco argued in court records that Wood’s and the Second Court of Appeals’ interpretation forces plaintiffs to sue before an injury exists, creating a "Hurricane Harvey for the medical field."
“Detrans Texans deserve better,” Aldaco said in a press release. “I am confident my case has merit, and I am confident God will deliver justice.”
KERA News has reached out to Wood for comment and will update this story with any response.
Justices appeared amenable to Aldaco’s claims and skeptical of the defense that the limitations period started before Aldaco could sue. In another major case dealing with transgender health care, the Texas Supreme Court in 2024 upheld the state law banning doctors from providing gender-affirming care to minors.
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 around 1% of people who undergo gender-affirmation surgeries later regret the procedures, but the exact number is unknown.
A coalition of 60 Texas House Republicans signed a statement Feb. 4 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 malpractice limitations period for “detransitioners harmed by negligent providers.”
“Quite simply: Do no gender-modification harm to Texans—or find no shelter from liability claims,” the lawmakers wrote.
Toluwani Osibamowo is KERA’s law and justice reporter. Got a tip? Email Toluwani at tosibamowo@kera.org.
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