A civil trial is starting in New York state on Jan. 12 to determine liability for health care practitioners who recommended and performed a mastectomy on a 16-year-old transgender-identifying girl.
The case was brought by Fox Varian, who underwent the mastectomy, also known as “top surgery,” as treatment for gender dysphoria in 2019. Regretting the surgery, Varian has alleged that her therapist, Dr. Kenneth Einhorn, and her surgeon, Dr. Simon Chin, were “negligent” because they did not fully inform her of the risks or alternatives to such an intervention.
Now, Varian is seeking damages in state court from both those doctors and their employers over alleged malpractice. Among other things, Varian said, she experiences ongoing pain, has post-traumatic stress disorder, and requires corrective surgery.
“[Varian] currently has days in bed due to depression and anxiety that are ongoing,” states her lawsuit, which was filed in 2023.
The trial is expected to last two to three weeks and will determine whether Varian’s providers are liable for the issues she alleges.
The defendants denied responsibility in a court filing, saying that any damages “were caused by the culpable conduct, wrongdoing, negligence, lack of care, breaches, omissions, and failure to act of third parties ... over whom defendant has no control and for whom defendant bears no legal responsibility.”
Varian’s attorneys argued that Einhorn was negligent because he did not adequately address her “pre-existing psychological and cognitive conditions” and misdiagnosed her with gender dysphoria.
They also dispute the facts of the case.
Varian said Einhorn did not discuss hormone therapy as an alternative, but according to a court filing, Einhorn said that he recommended the therapy and that Varian refused it. He also said she insisted on the surgery, threatening to harm herself if she did not receive it.
Chin also told the court that he had warned her about risks, saying that “there was a risk that the nipple could die, be necrotic and fall off, temporary drains would be inserted, and tight bandages would be applied,” the filing reads. Allegedly, Varian was happy with the surgery at first, despite the need for some corrective procedures.
Both sides have produced affidavits by medical experts in support of their legal positions, and expert witnesses are expected to testify.
The trial for Varian’s civil suit comes nearly a year after President Donald Trump signed an executive order directing the defunding of medical and research institutions that carry out surgical or medical interventions on minors.
It also follows a push by the Federal Trade Commission to examine whether these surgeries are being offered under fraudulent claims.
“I’m not charged with passing moral judgment on anyone’s ideology, lifestyle, or medical choices,” Federal Trade Commission Chairman Andrew Ferguson said at a July 9, 2025, conference examining the issue.
“I am charged, however, with protecting my fellow citizens from unfair or deceptive trade practices.”
Ferguson said surgical and hormonal treatments are often recommended to parents to relieve their children’s gender dysphoria. Proponents may say puberty blockers, hormone therapy, and surgeries are necessary to prevent further distress or suicide.
“Parents are thus confronted with a terrifying choice: Either consent to gender-affirming care, or their child may die,” Ferguson said.
A 2023 evaluation by the National Institutes of Health references several studies showing “no statistically significant difference” between individuals who had undergone the procedures and those who had not.
On Dec. 18, 2025, Health Secretary Robert F. Kennedy Jr. also said the Trump administration would cut funding for “sex-rejecting” procedures in youth because they “are neither safe nor effective as a treatment modality for gender dysphoria, gender incongruence, or other related disorders in minors, and therefore, fail to meet professional recognized standards of health care.”
