In a groundbreaking legal case in Boston, Mass., the transgender trailblazing clinic Fenway Community Health Center is at center of a controversial lawsuit that has implications for Anchorage.
The case, Shape Shifter v. Fenway Community Health Center, could reach the Supreme Court and ultimately inform what it means to conduct “conversion therapy.”
In 2020, Anchorage Assembly banned conversion therapy for youth, which the extremists on the Assembly view as any attempt to dissuade youth from expressing themselves as gay or transgender. However, the practice of coercion continues in the opposite direction in Anchorage, with the group Identity Inc. as a lead promoter of transgender puberty-blocking hormones and therapies to lock-in youth and adults with non-biological gender expressions. The ordinance in Anchorage is vague and does not define what conversion therapy actually is, but it acts as a warning to therapists to not engage in counseling youth about their sexuality.
The Boston case is based on civil rights. The plaintiff, a gay man, accuses Fenway Health of engaging in what he describes as “gay conversion” practices by approving him for transgender hormones and surgeries. This lawsuit is unprecedented in the United States, marking the first time “gender-affirming care” is being legally challenged as a potential form of anti-gay discrimination.
At the heart of the Boston case is a complex clinical reality surrounding gender dysphoria, which the lawsuit argues has multiple developmental pathways.
The man’s legal team is using Section 1557 of the Affordable Care Act (ACA), which prohibits discrimination “on the basis of sex” in healthcare settings. They are drawing upon the 2020 Supreme Court ruling in Bostock v. Clayton County, which expanded the definition of “discrimination because of… sex” to include discrimination based on homosexuality.
The lawsuit asserts that federal law offers specific protections to gay men and lesbians, which are allegedly being undermined by clinics that are operating with a bias towards transgender care, an argument that opens a new frontier in the debate over gender identity, sexual orientation, and medical ethics.
The case, Shape Shifter v. Fenway Health is explained by the plaintiff himself at his legal team’s website:
Ever since I was a young kid, I exhibited gender nonconforming behavior. Even before I hit puberty, I knew I was romantically attracted to males. However, as I grew older I realized that my femininity and homosexuality were not accepted by society and by my parents. I was constantly bullied in school. My parents were ashamed of my femininity. My dad told me that I will never be a real man because I am too emotional and soft. My mum told me that she wished I were taller and more masculine like other boys my age. All of that made me hate everything about myself including my body, my height, and my feminine manners. I just was “not masculine enough.” No matter what I did, I could not hide my feminine mannerism or grow any taller. So, when I came across transgender ideology in grad school I quickly became convinced that I was a ‘straight’ woman trapped in the wrong body. Suddenly, everything made sense. Transgender ideology seemed to explain why I never fit in and felt uncomfortable with my own body. It was finally my chance to escape all the bullying and torment I faced my whole life for being an effeminate gay man. But, after fully transitioning, I realized that my issues had not resolved, and after deep self-reflection, I came to understand that I suffered from internalized homophobia,” he wrote.
“Fenway sold me a hardware fix for a software issue,” the man said.
The complaint summary notes that Fenway knowingly and willfully removed safety procedures known as “gatekeeping” from its transgender healthcare practice. This shows that Fenway was pursuing the goal of acquiring more transgender patients.
Under the “gate-keeping” model of care internalized homophobia is a contra-indicator to transition, because studies have identified it as the leading cause of transition regret, the lawsuit says.
The lawsuit states that Shape Shifter was rapidly medicalized, and his sexual orientation and symptoms of internalized homophobia were treated with deliberate indifference.
Under Fenway’s “undifferentiated care and undue influence Shape Shifter underwent a number of surgical procedures and fully transitioned. Shape Shifter should have been treated for internalized homophobia, instead he was converted to transgender. The lawsuit alleges that Fenway’s apathetic attitude toward Shape Shifter’s sexual orientation and its associated distress violated his civil rights, and caused him irreversible, irreparable physical and mental injury. As a result of transitioning, Shape Shifter cannot express himself as a gay man, and must live with dissonance between who he is and how he appears.”