JOHANNA OLSON-KENNEDY is among the most celebrated youth gender medicine clinicians in the world. She has been the Medical Director of the Center for Transyouth Health and Development at Children’s Hospital Los Angeles (CHLA), one of the first high-profile American youth gender clinics and presently the largest, since 2012. A frequent expert witness in court cases who is often quoted in the media, Dr Olson-Kennedy also leads a $10m initiative funded by the National Institutes of Health to study youth gender medicine—by far the largest such project in America. In addition, she is the president-elect of the United States Professional Association for Transgender Health.

 

As state-level bans on youth gender medicine have accumulated, and are being tested at the Supreme Court, this controversial field has been seized by a fierce debate over the proper role of mental-health assessments. The Dutch clinicians who published the seminal youth gender medicine protocol in 2012 emphasised the importance of conducting a careful, in-depth assessment prior to starting a young person on puberty blockers or cross-sex hormones. But Dr Olson-Kennedy has emerged as a critic of what she views as undue and unnecessary “gatekeeping”. “I don’t send someone to a therapist when I’m going to start them on insulin,” she told the Atlantic in 2018. In her published research, Dr Olson-Kennedy has reported prescribing cross-sex hormones to patients as young as 12, and referring patients as young as 13 for double mastectomies.

 

Now, however, Dr Olson-Kennedy is being sued by a former patient, Clementine Breen, who believes that she was harmed precisely by a lack of gatekeeping. And many of Ms Breen’s claims appear to be backed up by Dr Olson-Kennedy’s own patient notes, which Ms Breen and her legal team have shared with The Economist. The medical-negligence lawsuit was filed on December 5th in California.