Metro Weekly

Parents of trans children sue Arizona over surgical requirement for changing gender markers

Parents claim the state's policy for changing the gender marker on trans people's birth certificates is unconstitutional

arizona, trans, transgender, gender marker
Arizona State Capitol complex – Photo: Adavyd, via Wikimedia.

The parents of three transgender children in Arizona have filed a lawsuit challenging the Arizona Department of Health Services’ policy requiring trans people to undergo surgery before being able to change the gender marker on their birth certificates.

The children in question are D.T., 13-year-old transgender boy who lives in Pima County, “Jane Doe,” a 10-year-old girl who lives in Maricopa County, and “Helen Roe,” a six-year-old who lives in Pima County.

All wish to obtain a birth certificate reflecting their true gender identity, but have been prevented from doing so by an Arizona law requiring gender confirmation surgery in order to change their gender marker.

Enlisting the help of the National Center for Lesbian Rights, their parents — Lizette Trujillo, Susan Doe, and Megan Roe — filed suit in the U.S. District Court for the District of Arizona against Dr. Cara Christ, the State Registrar of Vital Records and director of the Arizona Department of Health Services, Thomas Salow, the branch chief of the Division of Public Health Licensing Services, and Krystal Colburn, the Assistant State Registrar and Bureau Chief of the Bureau of Vital Records, for enforcing the surgical requirement.

In their lawsuit, the parents argue that the surgical requirement violates their children’s right to equal protection and due process under the Fourteenth Amendment of the U.S. Constitution, and are asking for a permanent injunction to block the state from trying to enforce its current policy.

They are also asking that the state issue corrected birth certificates to their children, and to pay the legal costs they incurred in the course of bringing the lawsuit, as well as any other relief the court deems necessary.

Lawyers for the parents argue that the surgical requirement is particularly harmful to transgender minors, because it is not medically appropriate for the children to undergo surgery at such a young age, and because lacking an accurate birth certificate creates a number of obstacles for the children when it comes to being treated consistent with their gender identity.

For example, Trujillo told the Arizona Republic that her son, D.T., took medicine to stop the onset of puberty and doesn’t need surgery. Although she’s been able to change D.T.’s name to one that fits his gender, Trujillo is often subjected to questions about her child’s gender — and the incongruity between her child’s name and their gender marker — whenever she has to provide a birth certificate for things like registering for school or signing up for recreational sports teams.

“Something as simple as going to the CVS to get a flu shot is problematic,” Trujillo told the newspaper. “Because I had a child who was presenting as male and we didn’t have at the time the insurance changed over.”

“For transgender people, the sex listed on their initial birth certificate does not match who they are,” lawyers with the National Center for Lesbian Rights, who are representing the parents, write in their complaint. “For a young person who has undergone gender transition, having a birth certificate that fails to reflect who they are puts them at risk of exposure, discrimination, harassment, and even violence.”

See also: Court strikes down Idaho law barring transgender people from changing their birth certificates

The lawsuit also alleges that there is “no compelling, important, or even legitimate governmental justification” for keeping the surgical requirement in place. 

“Unlike other youth, transgender youth in Arizona must navigate the world with a birth certificate that does not match their sex,” the complaint continues. “By barring these youth from obtaining corrected certificates, Arizona law forces them to disclose their transgender status, which invades their privacy and exposes them to discrimination, harassment, and violence. Accordingly, the current law violates the United States Constitution’s guarantees of equal protection of the laws and the fundamental rights to privacy, liberty, and autonomy.”

Citing the American Psychiatric Association’s diagnostic manual, the lawsuit notes that gender dysphoria — which can occur as early among transgender people as early as age 2 — is a legitimate health condition that can be treated in other ways, such as through puberty blockers and hormones, and does not require all transgender people diagnosed with gender dysphoria to undergo surgery, thereby placing an unfair burden on those who don’t have to undergo the medical procedure.

The lawsuit comes on the heels of another lawsuit, filed in August, in which a group of transgender teens have sued the Arizona Health Care Cost Containment System for refusing to provide them with coverage under Medicaid for transition-related surgical expenses.

Asaf Orr, a senior staff attorney with the National Center for Lesbian Rights, told the Arizona Republic that the state’s birth certificate policy violates the children’s right to privacy and their right to refuse medical treatment, and that the policy could easily be remedied — as it has been in other states — by allowing transgender people to change their gender marker by simply presenting a letter from a doctor of health care provider attesting that the individual has undergone appropriate treatment for gender dysphoria.

“The U.S. Constitution protects the right of transgender people to be who they are without interference from the government,” Orr said in a statement. “Arizona’s surgery requirement runs afoul of that fundamental constitutional principle.”

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