The Texas Supreme Court ruled Friday it鈥檚 not too late for a woman to sue a therapist who recommended she get a double mastectomy as part of her gender transition.
Former Fort Worth resident Soren Aldaco alleged various counselors and doctors, including therapist Barbara Wood, recklessly pressured her into medical gender transition, which resulted in complications from a surgery to remove both her breasts.
Lower courts ruled Aldaco鈥檚 lawsuit was filed five months too late under the Texas Medical Liability Act, but high court justices ruled the pre-suit notice Aldaco sent to Wood and other providers was a timely initiation of legal proceedings.
"Today the Texas Supreme Court unanimously ruled that my case deserves to be heard, and that providers implicated in harming vulnerable patients can鈥檛 twist the statute of limitations to escape accountability," Aldaco said in a press release Friday. "This ruling is a watershed moment. The Court鈥檚 opinion is already sending shockwaves far beyond Texas. The direct impact will be felt here at home鈥攂ut providers across the country, and federally, will now think twice about their responsibility to patients."
四虎影院 has reached out Wood for comment and will update this story with any response.
The ruling comes as a victory for conservatives who have backed Aldaco in opposition to minors receiving gender-affirming care, although Aldaco was legally an adult at the time of her procedure. State lawmakers have indicated they鈥檒l file legislation that further defines if and when mental health professionals can be sued for recommending transgender treatment that their patients later regret.
Aldaco had been struggling with her gender identity as a teen and began taking testosterone before beginning telehealth counseling with Wood of Three Oaks Counseling in 2020, according to court records. However, the therapy primarily focused on relationship issues with her partner at the time, not assessing or resolving her 鈥済ender curiosity,鈥� Aldaco said in court documents.
Aldaco sought a double mastectomy because she disliked the way her breasts looked on her body, according to court records. Wood wrote a letter on Feb. 22, 2021, recommending Aldaco receive the surgery.
Wood later terminated Aldaco鈥檚 counseling on May 14, 2021, after Aldaco missed a subsequent session, failed to pay a no-show fee and discontinued contact.
Aldaco underwent surgery in June 2021 at the Crane Clinic in Austin when she was 19. According to court records, she suffered complications, including blood pooling around her chest wounds and severe pain.
Aldaco ultimately 鈥渄etransitioned,鈥� the process of stopping or reversing gender transition. In court records, she attributed her issues with identity to her stressful adolescence and external influence and found peace instead through meditation.
After sending a pre-suit notice May 9, 2023, Aldaco filed a medical negligence suit that July. Aldaco alleged Wood didn鈥檛 adequately examine her mental state and falsely claimed in the recommendation letter that she was treated for gender dysphoria and had lived as a transgender man for a year.
Health care liability claims in Texas must be filed within two years from the date the tort, or civil wrong, occurred. Wood and Three Oaks argued the suit should have been filed by February 2023, two years after Wood wrote the letter of recommendation.
Aldaco argued a tort hasn鈥檛 occurred until there are damages 鈥� in this case, her surgery in June 2021. That means Aldaco was allowed to file her lawsuit by June 2023 or even May 2023, which was two years after Wood terminated her psychotherapy, she argued in court filings.
The Texas Supreme Court ruled multiple events can trigger the start of the statute of limitations under the Texas Medical Liability Act, including the completion of health care treatment.
Therefore, Aldaco sent her May 9, 2023 pre-suit notice within two years from the time she 鈥渃ompleted鈥� telehealth counseling with Wood on May 14, 2021, so Aldaco鈥檚 legal claims are timely.
And because Aldaco sent the pre-suit notice within two years of her surgery date on June 11, 2021, that also meant her claims were timely, justices ruled.
The court agreed with Aldaco鈥檚 argument that if she鈥檇 sued after receiving the letter but before the surgery, the case could have failed as no physical or financial injury had occurred yet.
鈥淭here was no bodily injury Aldaco could鈥檝e discovered until her double mastectomy was performed on June 11, 2021,鈥� Justice James Sullivan wrote for the court.
Transgender care is supported by across the United States as the best standard of care for transgender youth experiencing gender dysphoria. Studies show about 1% of people who undergo gender-affirming surgeries later regret the procedures, but the exact number is .
In an opinion partially concurring with the majority, Justice Evan Young said the ruling in Aldaco鈥檚 case should be 鈥渕inimally disruptive鈥� to the law governing medical liability, and any significant change 鈥渟hould come from the policymaking branches, not the courts.鈥�
Lawmakers are signaling that change could come soon.
Conservatives have rallied behind Aldaco鈥檚 case, including a coalition of 60 Texas House Republicans who in February urging the court to allow Aldaco鈥檚 claims to proceed. The letter states the lawmakers plan to advance legislation in next year鈥檚 legislative session to extend the malpractice limitations period for 鈥渄etransitioners harmed by negligent providers.鈥�
One of those lawmakers, Rep. Shelby Slawson, R-Granbury, said in a on X Friday she鈥檇 be refiling bills she filed in the 2023 and 2025 legislative sessions to extend the statute of limitations on health care liability claims involving gender transition care for minors.
Another, Republican Texas Rep. Jeff Leach of Plano, lauded the ruling in his own on X Friday, calling it a win for those who have been injured by 鈥渉armful and dangerous gender medication procedures.鈥�
鈥淭his Supreme Court Opinion, expertly written by the esteemed Justice James Sullivan, is just the next step in this important battle 鈥� with much more left to do in the next #txlege session,鈥� Leach wrote.
Johnathan Gooch, deputy director of public affairs for the statewide LGBTQ+ nonprofit Equality Texas, said in an emailed statement the letter from Texas House Republicans shows the partisan nature of the ruling.
鈥淭exas politicians have banned treatment for trans young people, disincentivized insurance coverage for gender-affirming care, and even undermined access to mental health treatment,鈥� Gooch wrote. 鈥淭his case only further compounds the fear and chaos surrounding essential medical care for trans folks across the state.鈥�
Toluwani Osibamowo is 四虎影院鈥檚 law and justice reporter. Got a tip? Email Toluwani at tosibamowo@kera.org.
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