WHITE PLAINS, N.Y.—The first day of proceedings concluded on Jan. 12 for a civil trial in New York, where a young woman who previously identified as male is suing her psychologist and doctor after receiving breast removal surgery at age 16.

Fox Varian was given a mastectomy, also known as “top surgery,” as treatment for gender dysphoria in 2019. She has since begun to re-identify as female. In 2023, she filed suit against her psychologist, Dr. Kenneth Einhorn, and surgeon, Dr. Simon Chin, for medical malpractice.

During opening arguments, her attorney, Adam Deutsch, did not say that such procedures were inappropriate because Varian was a minor; he said it was because she did not really have gender dysphoria.

“This case is not about regret,” Deutsch said in his opening statement.

Instead, Deutsch told the jurors, Varian is suing because the healthcare professionals allegedly departed from the standards of medical care when they chose to “empower her” by going along with her attempt to change her gender.

He said that Varian’s statements in the months leading up to the surgery showed that she still felt unclear about what gender and pronouns were appropriate for her. Working through gender issues is a “journey,” he said, and surgery is for the end of that journey, not while it’s still in progress.

Deutsch argued that his client’s desire to change her gender had been a recent development when she approached Einhorn about the procedure. But attorneys for the defense told a different story.

“What the plaintiffs want you to believe is that Dr. Einhorn somehow brainwashed her,” Einhorn’s attorney Neil Kornfeld told jurors.

Varian had gender dysphoria before she met Einhorn, he alleged. He told jurors that evidence would show that Varian had tried to “come out” at age 13, and that she and her mother had researched the topic.

Varian had “socially transitioned” by cutting her hair short, using he/him pronouns, and changing her name from Isabel to Gabriel, then Rowan, and then to Fox.

He also challenged claims that the doctors had not made Varian aware of the risks associated with the surgery, or alternative treatments. Kornfeld said Einhorn had offered to refer Varian to a psychiatrist, but she refused.

He added that Chin had warned her about risks associated with the surgery, including possible regret, physical complications, and permanent “body and psychological alteration.”

Chin’s attorney, John Bugliosi, described the consent of the plaintiff’s mother as the “critical fact” of the case.

“Dr. Einhorn taught Fox how to convince her mother,” Varian’s attorney argued. But Bugliosi said her mother consented because Varian had repeatedly warned she might commit suicide without it. Similar statements were made by Varian to friends and in support groups, Bugliosi alleged.

He asked jurors to consider what would have happened if Chin had refused to do the surgery and Varian had followed through with the threat to harm herself, implying that would also have resulted in a lawsuit.

Varian, who was present in the courtroom, appeared visibly upset by Bugliosi’s statements, shaking her head when he suggested her parents’ relationship problems were the origin of her mental health issues.

Both sides noted that Varian suffered from other psychological disorders, including anorexia, depression, ADHD, and autism. She also experienced body dysmorphia, a condition that causes a person to unreasonably fixate on a physical flaw, real or imagined.

Her attorney said Einhorn and Chin should not have approved the surgery until those disorders were “well-controlled.” The defendants’ attorneys suggested these longstanding problems undercut Varian’s claim that her depression was caused by the surgery.