advocates the use of “corrective therapy,” a treatment method that many parents and clinicians
now reject,62 which aims to help a child diagnosed with gender dysphoria feel more comfortable
in their biological sex by limiting the child’s play activities to conform closely to traditional gender
stereotypes.63 Parents fear that allowing their child to act in gender nonconforming ways
encourages the child to choose their gender preference.
Some parents still use conversion therapy to change their child’s gender identity,64 “a
treatment model paralleling the now-discredited ‘reparative therapy’ aimed at ‘curing’
homosexuals.65 This practice has been outwardly condemned by every major medical and mental
health organization in the United States as harmful and ineffective.66 Both the American
Psychological Association and the American Academy of Pediatrics reject the use of conversion
therapy, saying that not only is this method ineffective, but it frequently inflicts great psychological
distress.67 Courts properly applying the best interests principle when determining custody
arrangements ultimately reject the conversation therapy approach and promote placement of the
youth with the supportive parent,68 or, at the very least, require the State to take control under
parens patriae69 to determine the child’s best interests.
1. Physical interventions
Some courts have recently recognized that transgender-related healthcare, such as hormone
therapy, is well-established and medically necessary for individuals with gender dysphoria.70
Officially establishing gender dysphoria treatment as medically necessary would vest the state with
a duty to consent in place of the minor to receive such treatment in appropriate cases.71 Researchers
have observed that early intervention seems to lead to better psychological outcomes and a better
physical appearance, making acceptance as a member of the new gender easier compared to
individuals beginning treatment during adulthood.72
62 Padawer, supra note 55.
63 Skougard, supra note 8, at 1177.
64 Padawer, supra note 55.
65 Rubin Erdely, supra note 1.
66 Eliana T. Baer, Navigating the Murky Waters of Best Interests with a Transgender Child, N.J. L. J. (2014),
see also Perkiss, supra note 13, at 66 (“Generally, proponents of conversion therapy believe that gender nonconformity
is morally wrong and that gender-nonconforming individuals can adjust their behavior and identity accordingly, based
on tenets of conservative Judeo-Christian religions.”); Fedders, supra note 12, at 788 (“Some parents actively seek to
change their children’s gender identity . . . by sending them to gender clinics or “reparative” therapy . . . . Despite the
fact that every major mental health organization has condemned this therapy, its practice survives . . . .”).
67 Rubin Erdely, supra note 1.
68 Matthew J. Hulstein, Recognizing and Respecting the Rights of LGBT Youth in Child Custody Proceedings, 27
BERKLEY J. GENDER L. & JUST.
69 Id. at 178. Parens patriae is the government’s traditional power as the ultimate protector of a child’s welfare.
70 Turner, supra note 12, at 557 (quoting White v. Farrier, 849 F.2d 322, 325 (8th Cir. 1998). Transsexualism
constitutes serious medical need) (White v. Ferrier recognizes this conclusion in the context of the Eighth Amendment
and prisoners); see Wolfe v. Horn, 130 F.Supp.2d 648, 652 (E. D. Pa 2001) (considering transsexualism a “serious
medical need” in the Eighth Amendment context); Cuoco v. Moritsugu, 222 F.3d 99, 106 (9th Cir. 2000) (Conceding
for appeal purposes that transsexualism is a serious medical need); see also Scutti, supra note 19 (“Stopping puberty,
advocates argue, provides psychological relief to a transgender child . . . .”) (“. . . treatment with GnRH analogues
makes certain forms of transsexual surgery either redundant or less invasive because many irreversible features (such
as height) or surgically reversible features (such as breast and genital development) would not have formed.”) .
71 Turner, supra note 12, at 561.