Westchester County jury finds psychologist and surgeon liable for rushing minor into irreversible surgery.
A Westchester County Supreme Court jury has awarded $2 million to Fox Varian, a 22-year-old woman who underwent a double mastectomy at age 16 while identifying as male. This verdict marks the first time a U.S. jury has held medical providers liable for malpractice related to gender-related surgery on a minor. The jury found psychologist Kenneth Einhorn and surgeon Simon Chin failed to meet the standard of care by rushing the procedure without adequate psychological screening or communication. Varian, who has since detransitioned, alleged the providers ignored her underlying mental health conditions, including autism and depression. The award includes $1.6 million for pain and suffering and $400,000 for future medical expenses. This decision establishes a legal precedent for detransitioner lawsuits and medical liability in adolescent care. Defendants do have the opportunity for appeal.
Case Info
Case Caption: Fox Varian v. Kenneth Einhorn, PhD and Simon Chin, MD
Date: January 30, 2026
Court: Westchester County Supreme Court, New York (in New York, trial courts are called “Supreme Courts”)
A New York jury has ruled that medical providers committed malpractice by performing a double mastectomy on a 16-year-old minor without sufficient psychological evaluation. The verdict confirms that healthcare professionals can be held financially liable for failing to follow diagnostic protocols before proceeding with irreversible procedures.
This case serves as a critical turning point for medical liability. It highlights the legal risks for providers who bypass comprehensive mental health assessments. The ruling provides a framework for how the “standard of care” will be scrutinized in future detransition litigation involving both surgical and hormonal interventions.
What are the facts of the Varian v. Einhorn case?
Fox Varian began identifying as transgender at age 15 while under the care of psychologist Kenneth Einhorn. Within five months of expressing a desire to transition, she was referred to and underwent a double mastectomy performed by Dr. Simon Chin. At the time, Varian was 16 years old and struggled with multiple co-occurring conditions, including:
* Autism
* Anorexia
* Depression and anxiety
* Social phobia
The plaintiff argued that the providers failed to address these underlying issues or ensure her gender identity was stable. During the trial, evidence emerged that Varian had expressed uncertainty about her identity to other counselors, but Einhorn failed to follow up on those reports. The jury determined that these omissions constituted a departure from accepted medical standards.
How does this ruling affect the provision of hormones?
Legal analysts expect this verdict to substantially alter how doctors prescribe testosterone and estrogen to minors. While the Varian case focused on surgery, the jury’s focus on “inadequate psychological screening” applies directly to chemical interventions. The potential impacts include:
* Lengthening Evaluation Periods: Providers may require years of psychotherapy rather than months before starting a minor on hormones to avoid claims of “rushing” the process.
* Insurance Premium Hikes: Malpractice insurers may raise rates or stop covering clinics that provide hormones to minors, viewing them as high-risk for future lawsuits.
* Gatekeeping Re-emergence: Doctors are likely to return to stricter “gatekeeping,” requiring proof that co-occurring mental health issues like autism are fully managed before starting medication.
* Increased Documentation: Clinics will likely implement more rigorous informed consent forms that explicitly list long-term risks, such as infertility and bone density loss, to shield themselves from “failure to warn” claims.
What is the possibility of an appeal in this case?
Under New York law, the defendants have 30 days from the entry of the judgment to file a Notice of Appeal with the Appellate Division. Legal experts anticipate an appeal based on several procedural and legal grounds:
* Standard of Care Defense: The defense argued throughout the trial that they followed WPATH (World Professional Association for Transgender Health) guidelines. They may appeal on the basis that following these widely used guidelines should have precluded a finding of negligence.
* Parental Consent: The defense emphasized that Varian’s mother signed the consent forms. An appeal could argue that the court failed to give sufficient weight to the mother’s legal authorization for the surgery.
* Expert Testimony Disputes: The defense may challenge the admissibility of the plaintiff’s expert witnesses, who argued that “affirmation-only” care is inherently flawed.
If an appeal is filed, the case would move to the Appellate Division, Second Department. This process typically takes 12 to 18 months. During this time, the $2 million award would likely be stayed, pending the outcome of the higher court’s review.
What are the legal implications for other providers?
This $2 million award is the first of its kind to reach a trial verdict in the United States. Following the verdict, the American Society of Plastic Surgeons issued a statement recommending that surgeons delay gender-related surgeries until a patient is at least 19 years old.
The focus of future litigation will likely center on informed consent. Varian’s mother testified that she only consented to the surgery because she was told her daughter would otherwise be at high risk for suicide. The jury’s rejection of the defendants’ arguments suggests that such claims may no longer protect providers from negligence claims.
Commentary
This verdict is a wake-up call for the medical establishment. For years, the “affirmation-only” model has been treated as a shield against liability. This jury just shattered that shield. They looked at the facts and saw a 16-year-old girl with a history of autism and an eating disorder who was fast-tracked into a major, irreversible operation.
The law of malpractice is built on the “reasonable physician” standard. A reasonable psychologist does not ignore signs of uncertainty in a minor. A reasonable surgeon does not pick up a scalpel without ensuring the underlying psychological house is in order. By awarding $2 million, the jury sent a message that the standard of care must be applied equally to all patients, regardless of the diagnosis.
We are potentially seeing the beginning of a wave of litigation. There are hundreds, perhaps thousands, of young people, many with significant co-morbidities, who will claim they were rushed through these systems. As they reach adulthood and realize the permanent nature of these surgeries and hormonal changes, they will look for accountability. The informed consent defense is challenged because you cannot have informed consent when the risks are downplayed and the patient’s mental capacity is compromised.
This case was not a political debate; it was a garden-variety medical malpractice case. The defendants tried to hide behind guidelines, but the jury looked at the individual. In the eyes of the law, the individual patient always comes before the prevailing social trend.
Citations
* Varian v. Einhorn, Westchester County Supreme Court, Index No. 64834/2023 (N.Y. Sup. Ct. 2026).
* “NY jury finds malpractice in gender-affirming care case,” Advocate.com, Feb. 4, 2026. https://www.advocate.com/health/transgender-health/jury-rules-malpractice-transgender-treatment
* “New York Jury Awards Detransitioner $2 Million after Historic Malpractice Trial,” Washington Stand, Feb. 2, 2026. https://washingtonstand.com/article/new-york-jury-awards-detransitioner-2-million-after-historic-malpractice-trial
* “American Society of Plastic Surgeons position statement,” Becker’s Hospital Review, Feb. 3, 2026. https://www.beckershospitalreview.com/legal-regulatory-issues/new-york-jury-delivers-1st-malpractice-verdict-against-pediatric-gender-affirming-surgeries/
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Disclaimers
AI Disclaimer: This article was assisted by AI.
Legal Disclaimer: This does not constitute legal advice. Readers are encouraged to talk to licensed attorneys about their particular situations.
Tags: medical malpractice, Fox Varian, detransition lawsuit, hormone therapy liability, New York legal news