A 23-year-old woman who had her uterus and breasts removed at UW Hospital after a self-diagnosis of gender dysphoria that she said was not confirmed by a doctor is suing the hospital and two UW surgeons, alleging they operated on her without proper informed consent.
Dr. Jay Lick performed a hysterectomy when the patient was 19, and Dr. Katherine Gast did a double mastectomy when she was 21, as gender-affirming procedures at the hospital, according to the lawsuit filed Wednesday in Dane County Circuit Court.
The patient, who lives in Chicago, identified as lesbian, explored if she was transgender and took on a nonbinary identity to “cleanse her of the severe psychological distress and trauma that she endured as a child,” the suit says.
Within the past year, as post-surgery therapy helped her realize that the childhood trauma, not physical features, had caused her mental distress, she stopped taking testosterone and began to “detransition,” the suit says. Now, as a Jewish woman, she “mourns that she will never be able to naturally conceive a large family, as expected in her culture.”
People are also reading…
A Sun Prairie mother and child wrestle with whether to pursue puberty blockers, hormones and surgery.
The Wisconsin State Journal is not naming the patient because her attorneys said they intended to file the lawsuit confidentially and are seeking an order for confidentiality at a court hearing scheduled for Wednesday.
“UW Health and its providers care deeply for the health and well-being of patients and work hard every day to ensure patients receive the best possible care,” spokesperson Sara Benzel said. She declined to address details of the case or explain how informed consent for gender-altering surgeries or other major procedures is obtained.
Gender care laws
The lawsuit comes as several states have adopted laws banning gender-altering hormone treatments and surgeries for minors, amid a national debate over whether such procedures help or harm youth who identify as transgender.
Last month, both houses of the Republican-controlled Wisconsin Legislature passed a bill to bar procedures for anyone under 18 “if done for the purpose of changing the minor’s body to correspond to a sex that is discordant with the minor’s biological sex,” according to a Legislative Reference Bureau analysis. Democratic Gov. Tony Evers has said he’ll veto the measure.
The lawsuit involving the young adult patient at UW Hospital was filed by attorneys at Eckland & Blando, a law firm in Minneapolis. Daniel Cragg, the lead attorney on the case, said it’s the first case filed of several the firm is evaluating involving gender-altering procedures.
“We’re not doing this as a (public relations) maneuver like a lot of the destransitioner cases are,” Cragg said. “This is a straight personal injury (medical-malpractice) case.”
According to the lawsuit:
The patient had a “series of traumatizing events within her childhood home, including being sexually abused.” Her family had “strong religious beliefs,” and she eventually “fled her abusive family.” She was diagnosed with anxiety, depression and post-traumatic stress disorder.
At or around the age of 17, she diagnosed herself with gender dysphoria, or psychological distress from having a gender identity that doesn’t match the sex assigned at birth. In Chicago, she was prescribed testosterone, even though no doctor diagnosed her with gender dysphoria.
Surgeries in Madison
In Madison, at 19, she saw Lick for uterine bleeding and other side effects from the testosterone. Without verifying her gender dysphoria or discussing the risks and benefits of a hysterectomy for a young woman with mental health diagnoses, Lick suggested the procedure and the patient agreed to it. Five months later, in August 2019, he removed her uterus and fallopian tubes, “coding the procedure as gender-affirming.”
Lick required two letters of referral. The patient provided one from her therapist and another from a doctor “she had never met or spoken to in her life.” The lawsuit doesn’t explain how or why that doctor became involved in her care.
In February 2021, after enrolling in Wisconsin’s Medicaid program, which covers gender-altering procedures, the patient met with Gast, medical director of UW Health’s Gender Services Program, to discuss a double mastectomy. Without evaluating the patient’s self-reported gender dysphoria or considering if she was able to consent for surgery “despite her young age, continued anxiety, and PTSD,” Gast did the surgery that August.
This year, the patient “began questioning why (the doctors) so strongly and quickly ushered her down the path of irreversible surgical interventions, without ever even considering a psychological intervention,” the suit says.
The UW doctors “recklessly, if not intentionally, overlooked or ignored her psychological history to justify their approach to treating her, a young woman confused about her gender identity and experiencing current and known mental distress,” the suit says.
It alleges malpractice and failure to obtain informed consent by both doctors, negligence by the hospital and discrimination under the Affordable Care Act against the doctors and the hospital. The patient was denied benefits and care that would have been provided to a “non-transgender woman,” the suit says.
Detransitioning rare
Little research is available about detransitioning, or reversing a gender transition. A study of 28 adults who detransitioned, published last year in the journal JAMA Network Open, found some felt regrets about their gender treatments but most didn’t. Reasons for detransitioning included health concerns, fertility preservation, change in political beliefs, shifting gender identity, social challenges and employment discrimination.
Another study, in the journal Pediatrics, found 94% of transgender youth continued to identify as transgender five years after they socially transitioned.
The World Professional Association for Transgender Health, or WPATH, recommends comprehensive assessments of adolescents before starting gender treatments, which typically involve ruling out causes of distress other than gender dysphoria, a thorough discussion of risks and benefits, and getting at least one letter of approval from a mental health therapist before beginning hormones or doing breast removal or augmentation surgery.
Five years ago, UW-Madison’s obstetrics and gynecology department said it changed its surgical consent process to ask patients to sign consent forms on the day of surgery, not before, after a case involving Lick in which a patient’s ovaries were not removed as desired during a hysterectomy in 2015.
After the patient discovered her ovaries had not been removed, Lick took them out during a second surgery the same day with no complications, according to the Wisconsin Medical Examining Board. The board did not take action against Lick’s license, accepting continuing education he completed as what the board would have ordered.
Lick was involved in another case in which a Dane County jury in 2019 awarded an Oregon woman and her husband $435,000 — reduced to $300,000 because of a state cap — after finding Lick failed to disclose information about a procedure after the birth of the couple’s son, causing injuries that led to a hysterectomy and loss of fertility.
Editor’s note: This story has been updated to correct the spelling of Daniel Cragg’s last name.
Orthopedic surgeons who left SSM Health plan to open surgery center
