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A 17-year-old transgender teenager identified only as S.B. in court documents has been denied access to a gender-affirming mastectomy and other transition-related care after a court ruled in favor of their mother, A.M.

The surgery was just days away when British Columbia Supreme Court Justice Shelley C. Fitzpatrick granted a temporary injunction against S.B.’s medical doctor and the prospective surgeon, Dr. Daniel McKee. They’re not only barred from performing the surgery; A.M. doesn’t want them even discussing it with S.B., lest they unduly advocate for the procedure.

You know, like doctors are supposed to do when a procedure is in the best interests of the patient.

While the surgery is the most obvious and imminent form of trans health care A.M. wishes to withhold from S.B., she also wants to prevent her child from accessing hormone therapy and LGBTQ-informed counseling. She wants to see S.B. referred to “a non-biased psychiatrist” — which, in parental-rights cases, usually translates as “a therapist who agrees with me.”

Mommie Dearest also wants to see records related to the counseling S.B. received leading up to the decision to schedule surgery, including medical reports, meeting notes, and copies of all e-mail and text communications.

According to A.M.’s lawyer, Carey Linde:

The mother needs to see all of the protocols that led to the two doctors coming to the conclusion that what they intended to do is in the best interest of the child. She says removing the breasts of her daughter are not in the best interest of her. Where does the parent get the opportunity to be involved in a life-changing decision for her child?

Left to describe the situation in her own words, A.M. demonstrates that S.B. has good, clear reasons for not involving their mother in their decision-making process:

I had no choice… I’m in total darkness and I don’t have any rights. I need some time for her to grow up and mature.

Never mind the use of “she/her” pronouns to refer to S.B.; this quote demonstrates that A.M.’s favorite pronoun is clearly “I.” It’s no stretch to imagine that S.B. is wary of involving a parent who would make herself the central focus of her child’s medical situation.

In a lot of cases, it would be easy to see that a parent shouldn’t have the right to interfere with their 17-year-old’s access to doctor-approved medical procedures because of their narcissism or lack of medical knowledge. But in this case, A.M. benefits from the fact that most people (within and outside of the court system) remain poorly educated on trans health care. Gender-affirming surgery is seen as elective and aesthetic, more akin to a nose job than a life-saving medical procedure.

But LGBTQ health experts have long noted that such surgeries can be a lot more critical to patients’ health than the phrasing suggests. According to Laura A. Jones, board chair at New York’s Callen-Lorde Community Health Center and practicing psychotherapist:

For many trans folks, existing daily in a body that doesn’t match your sense of self isn’t just uncomfortable, it’s traumatic. There’s a lot of research that shows that delaying treatment for trans people increases levels of depression, anxiety, and suicidal ideation.

Medical science indicates that trans people’s mental illness symptoms improve dramatically when they are able to access transition care such as hormone therapy and gender-affirming surgery.

In A.M.’s mind, though, the depression and anxiety S.B. already lives with every day serves as evidence that they aren’t capable of making this life-changing health care decision on their own.

It’s an extremely paternalistic view of mental illness. Contrary to A.M.’s insinuation, people living with mood disorders are able to understand simple concepts like the irreversible nature of a mastectomy.

To A.M., though, the problem is clearly the schools, where she suggests the SOGI 123 (Sexual Orientation and Gender Identity) curriculum is brainwashing children into believing they’re transgender. She says her child is “caught up in a fad” that they will one day regret, like a more permanent version of black nail polish or sneakers with wheels in the heel.

A.M. has until November 27 to seek access to her child’s private medical records before she’ll need to appeal to the courts again. There’s reason to hope she won’t have such an easy time extending the injunction based on prior BC case law. Earlier this year, a BC Court of Appeal upheld a ruling that a 15-year-old trans boy had the right to hormone treatment despite his father’s objections.

An even older case, from 2016, acknowledged that parental-rights cases about trans health care should focus on the child’s self-determination by assigning an 11-year-old trans child a legal representative to help him make his needs known despite parental power struggles.

We can hope that the injunction was a well-meaning misstep by a judge who, with limited awareness of LGBTQ issues, chose to buy more time to reach a reasonable answer.

Meanwhile, though, S.B. is left going without a surgery that can take as many as two years or more to access due to long waiting lists. To get so close only to have this injunction slapped in place out of public ignorance on trans issues must be torturous.

(Image via Shutterstock. Thanks to Richard for the link)