When Medicine Won't Police Itself, Courts Will
At The Bigger Picture: Legal experts reveal how courts became medicine's conscience
This September, Dr. Johanna Olson-Kennedy faces an extraordinary challenge. She's preparing her president-elect address for the USPATH conference while simultaneously preparing her testimony for court. The nation's most prominent youth gender clinician must craft two entirely different narratives: one for the believers, one for the judge.
Her former patient, 20-year-old detransitioner Clementine Breen, filed a landmark lawsuit alleging that Olson-Kennedy diagnosed her within minutes and threatened her parents with their daughter's suicide. According to the lawsuit, this threat was false. Breen had never expressed suicidal thoughts until after she began treatment between ages 12 and 14.
You couldn't ask for a more perfect symbol of a field in crisis: the incoming president of America's supposedly premier medical professional association, ascending to her podium while defending in court the very practices her conference celebrates. When medical authority collides with judicial scrutiny like this, it's rarely coincidental. These moments become inevitable when professional oversight fails.
Just across New Mexico this September 27-28, two starkly different conferences will convene. USPATH will gather to promote the "affirmative" model that created this crisis. Meanwhile, Genspect's The Bigger Picture conference will showcase what's filling the void medicine abandoned: safeguards, accountability, and legal precedents.
A Legal Reckoning Years in the Making
This shift didn't happen overnight. For years, detransitioners spoke out about their experiences. Parents pleaded for caution. Whistleblowers risked their careers to raise alarms. Medical associations dismissed every concern as bigotry, doubling down on their approach even as troubling patterns emerged. Then something changed. The courts stepped in.
The legal challenges began bubbling up at the state level, where over twenty-five states enacted protections for minors seeking these interventions. Early lawmakers took real political risks, facing fierce opposition from medical organizations and activist groups who argued that any restriction amounted to discrimination.
Then came June 2025 and the game changer. The Supreme Court's decision in United States v. Skrmetti upheld Tennessee's ban on youth medical transitions, declaring that states possess legitimate constitutional interest in protecting minors from unproven, irreversible interventions. More importantly, the ruling demolished the medical establishment's favorite legal argument once and for all.
Now those early-adopting states have rock-solid constitutional backing, and you can feel the momentum shifting. Legislatures that once hesitated are moving forward with confidence. The Supreme Court essentially gave states a constitutional green light, and more are certain to act.
That confidence shows in the creative approaches states are taking. Texas championed a particularly clever piece of legislation that weaponizes liability law: insurance companies must cover all complications from these procedures permanently. Think about what happens when actuaries start calculating those lifetime costs across thousands of patients. "Gender-affirming care" will quickly become uninsurable. It's the kind of market-based solution that could accomplish what medical ethics couldn't, and it could serve as a model for legislatures nationwide.
The New Texas Law That Could Change Everything.
In May 2025, Texas passed Senate Bill 1257 (SB 1257) with an 87-58 vote in the House. This law requires insurance providers covering sex-trait modification treatments, such as hormone therapy or surgeries, must also fund complications, reconstructions, and recovery care.
Meanwhile, detransitioner lawsuits continue delivering accountability while driving systemic change. Through discovery and testimony, these cases expose disturbing patterns that medical organizations prefer to keep quiet: mental health evaluations skipped entirely, sexual abuse histories overlooked, vulnerable teenagers rushed toward permanent interventions. Each verdict establishes new legal standards. Each deposition forces transparency. As more cases succeed, they create roadmaps for future litigation while pressuring clinics toward meaningful reform.
The Architects of Accountability
The Bigger Picture brings together the legal minds driving this transformation. These aren't just conference speakers. They're the attorneys actually fighting in courtrooms and state capitols for change.
Josh Payne of Campbell Miller Payne represents detransitioners nationwide, and his track record speaks volumes. His upcoming session "Detransition Lawsuits as a Force for Change" will explore how civil litigation is rewriting standards of care in real time. Picture this: doctors forced to explain under oath why they prescribed testosterone to a sexually abused twelve-year-old without any psychological assessment. The facade crumbles pretty quickly under that kind of scrutiny. Payne's firm recently secured a landmark ruling allowing fraud claims to proceed, setting precedent that will reverberate through countless future cases.
Glenna Goldis has emerged as one of the most influential voices in gender law today, working at the highest levels of policy development. As a consumer fraud attorney, she's traced how gender ideology infiltrated our legal system and understands better than most how seemingly technical legal frameworks can either protect or endanger children. Her presentation "Gender in US Law: What's Next?" will examine the broader legal landscape, from federal regulations to constitutional questions, revealing how the law is being reshaped around us.
For Erin Friday, this work bridges the deeply personal with the political. After her daughter briefly identified as transgender, this California attorney transformed from concerned parent to fierce advocate. She now co-leads Our Duty USA while working the halls of power in Sacramento, where she's mastered the art of coordinated legal strategy. Her session "The Role of Lawfare in Dismantling Trans Ideology" will demonstrate how parents and lawyers can effectively combine litigation, legislation, and grassroots pressure to protect children.
Why Legal Action Actually Works
The pattern has become unmistakable. Where medicine chose ideology over evidence, law demands proof. Where clinics rushed children through irreversible procedures, courts require careful documentation. Where medical journals published activism disguised as research, judges insist on actual data.
This isn't about politics. It's about standards that actually matter. Insurance companies don't care about social movements; they care about liability and actuarial tables. Juries focus on evidence and witness credibility. State legislatures answer to voters who are parents, not to medical associations that activists have captured.
The legal system's unique power lies in enforceability. Medical guidelines can be ignored when convenient. Professional criticism gets dismissed. But court orders must be followed. When judges rule, clinics must change. When legislatures act, hospitals must comply. When insurance companies refuse coverage, the entire financial model collapses.
When Courts Become Medicine's Conscience
Every thread of this complex story will weave through our conference this September. We'll explore groundbreaking research, clinical alternatives, international perspectives, and survivor voices. The legal response represents one crucial strand in this larger tapestry.
When medical authorities abandon their fundamental principle of "first, do no harm," someone else has to step in. Judges, legislators, and lawyers are increasingly enforcing what medicine forgot. This September, join Genspect at The Bigger Picture conference as we examine how American law became medicine's conscience.
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When people stop living according to ethics, morals, and good will, then rules have to be made, laws have to be passed, and authorities have to apply discipline. When young people are enabled to be lifelong toddlers, and no authorities apply discipline, someone has to step in and set limits, then enforce them. When professionals fail to discipline themselves and each other, as we have pledged to do, then we are no longer professionals.
It is a great relief just to see legitimate authorities trying to impose some law and order on the chaos that woke radicalism has visited upon us. For so many years, few people in positions of power over institutions have shown the integrity and courage to say "no" to children, to the mentally ill, to addicts, to criminals, and it is so reassuring to hear from leaders who are willing and able to start doing that more often.
... and then there's Dr Michelle Telfer, Melbourne's RCH Gender clinic director. On the strength of the outcome of an individual case, the judge's strong comments regarding her testimony, and a good member of the public's concern regarding gender ideology's overreach, this concerned man has put in a complaint to AHPRA (Australian health registration body), questioning her right to competently practice.
It's good to read that 'small' people, like us, can have a say or even hold clout through legal channels.