Last week, a Gaston County judge dismissed fraud and conspiracy claims brought by Prisha Mosley, a young North Carolina woman who says experimental gender-transition treatments caused her permanent harm. Mosley alleged her providers misled her about the consequences of puberty blockers, cross-sex hormones, and surgery.
The court granted summary judgment to the medical provider defendants, finding no “material issues of fact,” and declined to revive a malpractice claim despite the passage of HB 805, which extended the statute of limitations for detransitioners. Mosley’s supporters, including NC Values Coalition, vowed to appeal, arguing that she was not adequately informed about the long-term risks.
The case raises a larger question North Carolinians cannot ignore: How should our state approach deeply personal medical policies when the evidence is contested and the stakes are life-altering?
The NIH believes that “detransition” rates are low, but makes clear that studies offer a wide range on the rate of “regret,” anywhere from 1% to 13% of gender transition patients. Another study from the NIH did find however that individuals who underwent gender-affirming surgery had a 12.12-fold higher suicide attempt risk than those who did not.
Of patients who did decide to detransition, a 2021 study found that more than half of them felt that they did not receive an adequate evaluation from a doctor or mental health professional before starting the transition process. Two-thirds of those surveyed said they would not have had medical intervention had they known what they know now.
We’ve been here before. Starting in 1929, even before Nazi Germany started forced sterilization, the state of North Carolina ran one of the most aggressive eugenics programs in the country, forcibly sterilizing more than 7,600 people — many of them women, the disabled, people of color, or those living in poverty.
Back then, the rationale was to protect society, save money, and reduce suffering. However, in practice, it was cruel coercion and state overreach, leaving thousands of our fellow citizens scarred and stripped of their dignity.
The state ended the Eugenics Board of North Carolina in 1974. In 2013, the General Assembly finally enacted a compensation program for the victims. The Eugenics Asexualization and Sterilization Compensation Program authorizes the state to pay a total of $10 million to victims of the state’s eugenics program.
The connection is not that state-run eugenics and gender transition care are the same. They are not.
The parallel lies in how government and institutions approach medicine: Who decides, on what evidence, and with what safeguards? At the time, eugenics policies were justified by pseudoscience and driven by prejudice. Survivors were told it was for their own good.
Today, gender transition care has become a cultural flashpoint, and the subject of legislation and litigation. We must see the commonalities in history. We cannot let ideology replace evidence and deny the victims their right to compensation. Funders and providers of such gender-transition surgeries should not be afraid to put their money where their mouth is.
Effective in August of 2023, North Carolina state law bars medical gender transition intervention for minors. The bill was passed by the state legislature and vetoed by former Gov. Roy Cooper, now candidate for US Senate. But his veto was overridden by the General Assembly.
North Carolina more recently passed a bill barring adoption agencies from refusing to place children with adoptive parents based on race or for choosing not to pursue “gender-affirming” care for their children. The bill had bipartisan support in the state legislature and was signed by Gov. Josh Stein.
The bills were opposed by some who feared that young people will be denied access to treatments that could help them. For others, including Mosley, the concern is that patients are being rushed into life-changing interventions without adequate information and protections. Both perspectives highlight the same danger: the cost of making irreversible decisions without extended study and safeguards.
Mosley’s lawsuit may or may not succeed on appeal. But the warning it carries is unmistakable: We must ensure that policy is rooted in transparent science, that patients and families give informed consent free of coercion, and that those in power never repeat the errors of dictating personal medical choices without accountability.
