On January 30, 2026, a New York jury issued the first malpractice verdict of its kind, awarding Fox Varian $2 million ($1.6 million for past and future pain and suffering, $400,000 for future medical expenses). At age 16 in 2019, Varian underwent a double mastectomy — the surgical removal of both healthy breasts, commonly referred to as “top surgery” in gender-related care — after identifying as male during adolescence. She has since detransitioned and identifies as a woman.
The jury found her psychologist, Kenneth Einhorn, and plastic surgeon, Simon Chin, liable for breaching the standard of care. Evidence at trial showed inadequate psychological evaluation(including failure to adequately follow up when Varian expressed uncertainty about her gender identity), poor communication between the providers (with a referral letter becoming central evidence), and insufficient informed consent about the procedure’s permanent risks and alternatives. Testimony highlighted how the psychologist was seen as strongly encouraging the surgery without fully exploring underlying issues. After reviewing this evidence over the course of the trial, the jury determined these departures from accepted medical practice directly caused Varian’s irreversible harm.
What Constitutes Medical Malpractice?
To succeed in a malpractice claim, four elements must be proven:
• A doctor-patient relationship establishes a duty of care.
• The provider breaches that duty by failing to act as a reasonably prudent practitioner would under similar circumstances.
• The breach proximately causes the patient’s injury.
• The patient suffers actual damages (physical, emotional, or economic harm).
These standards apply with special rigor to irreversible transition-related surgeries on minors, who have limited capacity to consent. Providers must conduct thorough psychological evaluations, screen for co-occurring mental health conditions, explore non-surgical options (such as therapy), and ensure clear disclosure of lifelong consequences — including permanent loss of breast tissue, scarring, loss of nipple sensation, inability to breastfeed, infertility (if combined with hormones), chronic pain, and potential regret.
In Varian’s case, the jury determined these safeguards were not met, resulting in compensable harm. This verdict applies longstanding malpractice principles to gender-related surgeries on minors: when evaluation, consent, or evidence-based practice falls short, the resulting irreversible injury can support liability.
The ruling arrives alongside updated professional guidance. On February 3, 2026, the American Society of Plastic Surgeons (ASPS) issued a position statement recommending that surgeons delay gender-related breast/chest, genital, and facial surgeries until a patient is at least 19 years old. ASPS cited insufficient evidence of a favorable risk-benefit ratio, low-certainty long-term data, and ethical concerns about operating on healthy tissue in adolescents.
Shortly after, the American Medical Association (AMA) stated: “In the absence of clear evidence, the A.M.A. agrees with A.S.P.S. that surgical interventions in minors should be generally deferred to adulthood.”
While not binding law, such specialty guidance helps define the standard of care courts consider.
More than two dozen similar malpractice claims are now advancing nationwide. Notable examples include:
• Chloe Cole (California), alleging inadequate screening before mastectomy and other interventions as a teenager.
• Luka Hein (Nebraska), claiming she underwent a double mastectomy at 16 after only two consultations, with insufficient exploration of underlying issues.
The alleged harms — permanent loss of healthy tissue, sterility, chronic pain, psychological trauma, and disfigurement — are precisely the types of damages malpractice law addresses, especially for minors.
As courts apply established principles to these procedures and professional bodies emphasize caution, providers who fail to meet rigorous standards of evaluation, consent, and evidence-based practice face growing accountability.
If you or a loved one have been injured by a transition surgery, please contact us here at the Michael Brady Lynch Firm at 888-585-5970 or email us at brandon@mblynchfirm.com.
Attorney and Editor-in-Chief: Brandon Salter
Footnotes
1. The New York Times, “Woman Wins Malpractice Suit Over Gender Surgery as a Minor” (Feb. 3, 2026).
2. The Free Press, “A Legal First That Could Change Gender Medicine.”
3. American Society of Plastic Surgeons, Position Statement on Gender Surgery for Children and Adolescents (Feb. 3, 2026).
4. American Medical Association statement, as reported in National Review and The New York Times (Feb. 2026).
5. Dhillon Law Group, Chloe Cole v. Kaiser Permanente.
6. Dhillon Law Group, Luka Hein v. UNMC Physicians