In the Matter of Brian (a.k.a. Mariah) L.

Summary

Mariah has been in the care of New York City’s Administration for Children’s Services (ACS) since she was 10 years old. When she was 18, ACS arranged for several health care providers experienced in treating transgender youth to evaluate Mariah, who identifies as transgender. All of those providers determined that necessary therapeutic treatment for Mariah includes sex reassignment surgery. However, ACS continued to send Mariah for repeated medical evaluations in an apparent attempt to delay the recommended treatment until Mariah turned 21 and aged out of the foster care system. The family court ordered ACS to provide the necessary treatment, and ACS filed an appeal. Lambda Legal collaborated on a friend-of-the-court brief filed in New York Supreme Court’s First Appellate Division, arguing that sex reassignment is neither experimental or unduly “risky” and that ACS is bound to provide the treatment. Unfortunately, the First Appellate Division ruled that the Family Court lacked authority to order ACS to provide treatment for Mariah, and New York's highest court upheld that decision.

Context

An increasing number of health care providers recognize the necessity of transition-related care for transgender people. As this medical knowledge flows into the courtroom, we are seeing an increasing number of judges — like the family court judge in this case — recognize that sex reassignment surgery and related treatments are therapeutically effective and are not “cosmetic” or “elective.”

Lambda Legal's Impact

Many transgender people have serious health needs that require therapeutic treatment. Too often, though, transgender people seeking competent health care instead find misunderstanding and bias. This case advances Lambda Legal’s work to eradicate health care discrimination against all LGBT people.

History

• April 2006 Lambda Legal files amicus brief is filed in New York Supreme Court’s First Appellate Division, arguing that sex reassignment is neither experimental or unduly “risky” and that ACS is bound to provide the treatment to Mariah.
• August 2006 The Appellate Division sends the case back to family court, demanding that ACS provide a clear reason for its denial of treatment to Mariah.
• February 2007 The family court orders ACS to pay for Mariah’s sex reassignment surgery, holding that she is “both mentally and physically ready” for surgery. The family court further held that ACS’s conclusion that surgery was not necessary for Mariah was “based on archaic law and out-of-date medical diagnosis and technologies.”
• May 2007 ACS appeals the Family Court decision and Lambda Legal files an amicus brief with the Appellate Court in support of Mariah.
• May 2008 The Appellate Division rules that, while ACS must provide necessary medical and surgical care to all children in its care, the Family Court does not have the power to rule that ACS provide particular care, including surgery for Mariah. Mariah's attorneys ask the New York Court of Appeals, the state's highest court, to review this decision.
• September 2008 The New York Court of Appeals, the state's highest court, declines to review the Appellate Division's ruling, ending the case.