Camille Kiefel sued the two Oregon mental-health professionals who each, she alleged, effectively rubber-stamped for her a referral letter for a mastectomy after a single telehealth appointment.
Thanks Ben for staying on top of these lawsuits and for helping to amplify these stories of iatrogenic harms that represent entirely predictable outcomes of activist-led movement to effectively eliminate appropriate assessment, mental health care and evolving body of scientific evidence from the practice of medicine
Glad to hear there is also now recognition that adults too require the same careful consideration as youth who may seek these treatments in a misguided way, and that many do not have capacity to consent, which is such an important part of ethically grounded consent procedures in medicine as well as being given information about less invasive alternatives and all of the potential harms as your coverage of this case highlights
My question to you is do you know why statute of limitations prevented her from pursuing her case against the surgeon but not the therapists who write her letters of referral? Assuming they both occurred in similar timeframe I didn’t understand that part
In the case of Camille Kiefel, the statute of limitations led to the dismissal of her claims against the surgeon, Dr. Tina Jenq, because Kiefel did not file that specific lawsuit until more than two years after the surgery took place. Oregon's medical malpractice statute of limitations generally requires a patient to file suit within two years of the date the injury occurred or was reasonably discovered.
The lawsuit against the therapists and their clinics, Kiefel v. Ruff et al., was able to proceed because it was filed earlier (December 2022) than the separate action against the surgeon.
'In an August 2025 deposition, Ms. Kiefel stated that she thought the purpose of the assessment with the mental-health providers was to determine “whether or not I was truly nonbinary.”'
Was their Nonbinary Detector broken? I bet they let the warranty expire.
Please also note that Camille runs the organization Detrans Help: https://detranshelp.org/, which connects detransitioners to resources whenever possible.
Seems like a very significant development in an area of research that is still so unknown and has permanent long-term physical and psychological effects, especially with young undeveloped brains. Can't for the life of me figure out why I haven't seen a news story on it anywhere on the Big 3 networks...
Thank you so much for covering Camille's story and those of other detransitioners. Now that she has been treated for chronic health conditions, Camille is a talented, capable and hard-working young woman, with a bright future ahead of her. It's unfortunate that her doctors did not attempt legitimate treatment before taking away her body parts. Whatever her settlement was, it is not enough to replace her healthy body, but she will use her experience to stop this predatory industry from doing the same to other youth.
As usual, excellent journalism. Unfortunate IMO it was settled out of court as a first case of this type. Praying some of the Detransitioners take their cases to full trial to deliver a jaw dropping settlement as that would, in my view, end the practice.
Thanks. It made things easier on me though, because it saved me from possibly trying to cover two trials running simultaneously on either ends of the country.
This actually isn’t the first detrans case to be settled out of court. Richard Ikechukwu Anumene, Christopher Miller and Ciara Summers also settled out of court. But their settlements are also confidential.
Under the original Dutch protocol, this woman would never have been permitted to get surgery. For anyone with mental problems other than gender dysphoria, it was assumed that it was impossible to determine which problems were caused by gender dysphoria, and which were caused by other factors.
Does any sane person need to be informed that removing your breasts would make it impossible to breast feed?
I used to think this was too strong a claim, but I have to credit your essays and the work of Kathleen Stock for causing me to reconsider the base claims about the very validity of gender identity as any kind stable property rooted in the self. If “gender” is not a stable or real biological trait then neither is “gender identity” and if there is no “gender identity” there exists nothing to be dysphoric about.
Yes, that's the only logical conclusion to come to once you realize this is just one big word game, and nobody can even define "gender" logically because it has no application to humans anyway.
Next they want to change it to "gender incongruence"--so where's the "dysphoria" (ie, unease) they've been harping about since 2013?
Everybody feels unease in our bodies in life, especially during puberty. That's called being human. It doesn't require hormones or surgeries.
And that's not to say mental illness doesn't exist.
Pretending that "gender dysphoria" is real prevents treatment of the real underlying issue because it's not only false but harmful. For most males, it's just crossdressing fetish. For most females, it's trauma.
And that's why "gender dysphoria" does not exist...and neither does "trans."
Most people will take much longer to reach this conclusion because we've been so thoroughly conditioned by media and education, but there is no other conclusion to reach.
She was someone with a history of many mental health problems and diagnoses.
Every professional involved had the duty to make sure that they had information about her past psychiatric and medical care, and that she had thought through all the consequences of having her breasts removed, including effects on her sexual sensations and sexual relationships with others going forward, and on her gestating a fetus and breast feeding a baby.
The surgeon got off because the statute of limitations had passed by the time a lawsuit was filed against the surgeon.
When I read this, Ben, I had this crazy wondering if my beloved son (transed at 34 online, in Portland, by a 27 year old new therapist) would let it go for money. I know that he continues to struggle and surely has mental health issues. It is heart breaking for me every day and I haven’t heard from him in 4 years. I have a wee bit of info that he doesn’t know I can see. It continues to seem like a terrible choice for any human being and I am confident is a sign of mental and emotional struggle that could be addressed in ways that don’t destroy bodies and families. Nice work, thank you.
Hey Gretchen, thanks very much for sharing your story. I have heard many similar such stories of schisms in families. I’m sure you know you’re not alone in that regard.
Another example of gender care exceptionalism: these providers took less care with this patient than they would have for other conditions.
We need to figure out why such providers felt under pressure to abdicate any effort to understand a patient. Were they told they would be transphobic if they even explored what this patient was going through?
“Were they told they would be transphobic if they even explored what this patient was going through?”
… Yes.
100% this is the messaging these care providers are getting (and giving.)
Which is why these lawsuits can’t come fast enough. Too late for my eldest - who was provided SRS as a young adult with no gatekeeping, and a long history of diminished decision making capacity and foresight related to severe ADHD - but hopefully not too late for my youngest who is still only 15.
I’m so sorry about your child. Yes, my question was rhetorical in that I assume the same answer! But I am curious about documentation of these policies: were they written? Implied? Word of mouth? Just unwritten consensus?
Will anyone be able to find documentation—and use as a defense? Or as evidence of poor care?
My very strong sense is that in Canada as in the United States, any of these cases that go before a jury would result in a settlement for failure to comply with the standard of care. Because only an insane person who has been steeping in this cult for the last decade, sees it as reasonable to just provide body modification on demand to even the most troubled young people. None of these clinicians appear to be taking any kind of reasonable precautions, in terms of evaluating their capacity to consent. The difficulty here, of course, is that medical malpractice suits are very difficult, and limitation periods are not favorable. The timeline to detransition and regret is often much longer than 2 to 5 years. But I’m not sure. I’m far from an expert, but my vague recollection from first year torts is that limitation sometimes run from the date that you “discover“ the harm and maybe you can build a case on that.
Of course, statutes of limitation will bar the majority of detransitioners suing. This will be an added layer of suffering for those harmed and unable to claim justice.
I gotta say, it’s an easy call for me when it comes to gender activists and kids: keep your hands off of them.
But for a person well into adulthood, to have consented to a procedure, then to presumably have some regret afterwards, and to sue on that basis….boy…
Yes, she had psychiatric issues. But if we are saying that an adult in her condition (not acutely psychotic or delusional) is still not competent to give informed consent on a procedure that a competent adult should be able to request and receive if they so choose….where does that actually leave us?
The trial likely would’ve come down to whether the defendants followed their employers’ own training and whether that training followed standard practices in the field. The argument by the plaintiff’s attorney would have been that had the defendants followed their employers standard of care, Kiefel would not have had the surgery. Whether that is a convincing argument is another question. But why have the letter requirement at all if filling it out is a purely perfunctory exercise? The surgeon likely would say she relied on the mental health professionals to vet the patient to ensure the surgery was right for them.
It leaves us with not signing off so quickly to life altering surgery on those who clearly have a multitude of mental health issues. Which is a very good thing.
But then is that to suggest that people with “a multitude of mental health issues” are not competent to make medical decisions? Or are not competent to make “life altering” medical decisions?
As I said, yes she was dealing with mental health issues but she was not psychotic or delusional.
To me, if you’re legally competent, do whatever you want to yourself, but you shouldn’t get to sue for “regret”. Choices have consequences and that’s what adulting is about.
If the decision was that she was fat and wanted to get signed off to get medications to help her lose weight, even though she was a healthy weight, in a healthy body, then any therapist would have delved into the source of those feelings. The fact is that delving into feelings around gender is not done. “You feel like you’re really a man and you want gender affirming care? Of course, here you go.” Exploring those feelings is called conversion therapy by the activists and is generally illegal. There’s nothing illegal about counseling an anorexic person.
I’m generally of the opinion that adults can do what they want, but in the case of “gender affirming” surgery, I believe there should be waiting periods and serious counseling for adults. Because such surgery has life long consequences and it should not be ok’d after a zoom calll and one consultation.
There are many psychological difficulties that don't go so far as psychosis, even so how does a medical person know about this. They only know who is sitting in front of them and in most of these cases don't get a thorough history because of the political climate. If these surgeries and medications weren't available what would these folks look like? Would they be sent for psychological support and for someone to do a deep dive into what is happening with them? Medical providers get VERY little psychological training. If you are thinking that body modification should be ok for any adult who wants it then it shouldn't be under the umbrella of 'medically necessary'. Medical doctors are not trained to decide who 'needs' these surgeries and psychology has not caught up with understanding what is really going on.
I agree. From the surgeon’s standpoint, I imagine it’s “competent person here wants a procedure; I can do that procedure safely and effectively…let’s go”.
Procedures that "do harm" to a healthy body part should not be ethical or allowed by a competent doctor who should "Do No Harm". Breast reduction surgery and fixing a known defect is not the same as removing a healthy body part just because a person desires it or thinks it will make them feel better. Illegal drugs make addicts feel better too. Why don't we allow them?
Do no Harm as determined by ethical medicine, not me. Yes, a competent adult can do what they want to their body. A competent doctor does not do to another whatever that person wants them to do.
Actually, if a patient wants something done, why would a doctor impose their own judgment on whether the patient should or should not have it done? Paternalism much?
Because a doctor uses his own judgement and follows medical laws. A doctor should say no if a patient desires him to do something that results in worse health for the patient. If an anorexic patient desires weight loss drugs should the doctor give them what they want?
What medical judgment or medical laws were contravened here? Competent patient wanted something that the surgeon could safely and effectively provide. So the surgeon provided it.
If the patient wants a mastectomy, how does a doctor following those wishes result in “worse health”?
I agree with your example, because clearly an “anorexic patient” doesn’t need to lose more weight. What does that have to do with the case at hand? The patient in this case wasn’t an anorexic seeking liposuction.
They probably wouldn’t share the amount of a settlement. But insurance companies follow lawsuits and new theories of liability in order to assess their risk and rates.
Since the settlement agreement included a provision that the details of that agreement were not to be made public by the parties to the lawsuit or their attorneys or insurers, it is likely that we will never know the amount. We do not really have to.
That’s impossible to know since settlements like this are always private. But statistics from law firms show that most settlements are between $50k-500k though so it was probably somewhere in that range.
Thanks Ben for staying on top of these lawsuits and for helping to amplify these stories of iatrogenic harms that represent entirely predictable outcomes of activist-led movement to effectively eliminate appropriate assessment, mental health care and evolving body of scientific evidence from the practice of medicine
Glad to hear there is also now recognition that adults too require the same careful consideration as youth who may seek these treatments in a misguided way, and that many do not have capacity to consent, which is such an important part of ethically grounded consent procedures in medicine as well as being given information about less invasive alternatives and all of the potential harms as your coverage of this case highlights
My question to you is do you know why statute of limitations prevented her from pursuing her case against the surgeon but not the therapists who write her letters of referral? Assuming they both occurred in similar timeframe I didn’t understand that part
I didn’t figure that out about the SoL disparity, no.
I found the answer on AI assisted google search:
In the case of Camille Kiefel, the statute of limitations led to the dismissal of her claims against the surgeon, Dr. Tina Jenq, because Kiefel did not file that specific lawsuit until more than two years after the surgery took place. Oregon's medical malpractice statute of limitations generally requires a patient to file suit within two years of the date the injury occurred or was reasonably discovered.
The lawsuit against the therapists and their clinics, Kiefel v. Ruff et al., was able to proceed because it was filed earlier (December 2022) than the separate action against the surgeon.
'In an August 2025 deposition, Ms. Kiefel stated that she thought the purpose of the assessment with the mental-health providers was to determine “whether or not I was truly nonbinary.”'
Was their Nonbinary Detector broken? I bet they let the warranty expire.
Yep, gotta keep up those service and extended warranty contracts on sophisticated machines like that.
Please also note that Camille runs the organization Detrans Help: https://detranshelp.org/, which connects detransitioners to resources whenever possible.
Very detailed information that isn’t being reported to the masses. Thank You
Seems like a very significant development in an area of research that is still so unknown and has permanent long-term physical and psychological effects, especially with young undeveloped brains. Can't for the life of me figure out why I haven't seen a news story on it anywhere on the Big 3 networks...
Thank you so much for covering Camille's story and those of other detransitioners. Now that she has been treated for chronic health conditions, Camille is a talented, capable and hard-working young woman, with a bright future ahead of her. It's unfortunate that her doctors did not attempt legitimate treatment before taking away her body parts. Whatever her settlement was, it is not enough to replace her healthy body, but she will use her experience to stop this predatory industry from doing the same to other youth.
As usual, excellent journalism. Unfortunate IMO it was settled out of court as a first case of this type. Praying some of the Detransitioners take their cases to full trial to deliver a jaw dropping settlement as that would, in my view, end the practice.
Thanks. It made things easier on me though, because it saved me from possibly trying to cover two trials running simultaneously on either ends of the country.
Curious, what’s the other trial?
https://www.thefp.com/p/a-legal-first-that-could-change-gender
He said that Fox Varian’s trial started just days apart from when this one was due to start.
That is one of the problems with civil litigation. The most compelling cases often settle.
This actually isn’t the first detrans case to be settled out of court. Richard Ikechukwu Anumene, Christopher Miller and Ciara Summers also settled out of court. But their settlements are also confidential.
Under the original Dutch protocol, this woman would never have been permitted to get surgery. For anyone with mental problems other than gender dysphoria, it was assumed that it was impossible to determine which problems were caused by gender dysphoria, and which were caused by other factors.
Does any sane person need to be informed that removing your breasts would make it impossible to breast feed?
The Dutch protocol was for minors. She was 30 at the time of her surgery.
I didn’t realize that. Thanks for letting me know. Isn’t there still a duty of care to inform adults about all the possible risk?
By definition, if somebody wants to pretend to be the opposite sex, they are not "sane," and that applies to any age.
Even amateurs know that the Dutch protocol applies to minors.
There is no such thing as "gender dysphoria."
“There is no such thing as “gender dysphoria.”
I used to think this was too strong a claim, but I have to credit your essays and the work of Kathleen Stock for causing me to reconsider the base claims about the very validity of gender identity as any kind stable property rooted in the self. If “gender” is not a stable or real biological trait then neither is “gender identity” and if there is no “gender identity” there exists nothing to be dysphoric about.
Yes, that's the only logical conclusion to come to once you realize this is just one big word game, and nobody can even define "gender" logically because it has no application to humans anyway.
Next they want to change it to "gender incongruence"--so where's the "dysphoria" (ie, unease) they've been harping about since 2013?
Everybody feels unease in our bodies in life, especially during puberty. That's called being human. It doesn't require hormones or surgeries.
And that's not to say mental illness doesn't exist.
Pretending that "gender dysphoria" is real prevents treatment of the real underlying issue because it's not only false but harmful. For most males, it's just crossdressing fetish. For most females, it's trauma.
And that's why "gender dysphoria" does not exist...and neither does "trans."
Most people will take much longer to reach this conclusion because we've been so thoroughly conditioned by media and education, but there is no other conclusion to reach.
Does any "sane" person need to be informed?
She was someone with a history of many mental health problems and diagnoses.
Every professional involved had the duty to make sure that they had information about her past psychiatric and medical care, and that she had thought through all the consequences of having her breasts removed, including effects on her sexual sensations and sexual relationships with others going forward, and on her gestating a fetus and breast feeding a baby.
The surgeon got off because the statute of limitations had passed by the time a lawsuit was filed against the surgeon.
When I read this, Ben, I had this crazy wondering if my beloved son (transed at 34 online, in Portland, by a 27 year old new therapist) would let it go for money. I know that he continues to struggle and surely has mental health issues. It is heart breaking for me every day and I haven’t heard from him in 4 years. I have a wee bit of info that he doesn’t know I can see. It continues to seem like a terrible choice for any human being and I am confident is a sign of mental and emotional struggle that could be addressed in ways that don’t destroy bodies and families. Nice work, thank you.
Hey Gretchen, thanks very much for sharing your story. I have heard many similar such stories of schisms in families. I’m sure you know you’re not alone in that regard.
None of this should be happening to anyone at any age because there is no such thing as gender dysphoria.
Another example of gender care exceptionalism: these providers took less care with this patient than they would have for other conditions.
We need to figure out why such providers felt under pressure to abdicate any effort to understand a patient. Were they told they would be transphobic if they even explored what this patient was going through?
“Were they told they would be transphobic if they even explored what this patient was going through?”
… Yes.
100% this is the messaging these care providers are getting (and giving.)
Which is why these lawsuits can’t come fast enough. Too late for my eldest - who was provided SRS as a young adult with no gatekeeping, and a long history of diminished decision making capacity and foresight related to severe ADHD - but hopefully not too late for my youngest who is still only 15.
I’m so sorry about your child. Yes, my question was rhetorical in that I assume the same answer! But I am curious about documentation of these policies: were they written? Implied? Word of mouth? Just unwritten consensus?
Will anyone be able to find documentation—and use as a defense? Or as evidence of poor care?
My very strong sense is that in Canada as in the United States, any of these cases that go before a jury would result in a settlement for failure to comply with the standard of care. Because only an insane person who has been steeping in this cult for the last decade, sees it as reasonable to just provide body modification on demand to even the most troubled young people. None of these clinicians appear to be taking any kind of reasonable precautions, in terms of evaluating their capacity to consent. The difficulty here, of course, is that medical malpractice suits are very difficult, and limitation periods are not favorable. The timeline to detransition and regret is often much longer than 2 to 5 years. But I’m not sure. I’m far from an expert, but my vague recollection from first year torts is that limitation sometimes run from the date that you “discover“ the harm and maybe you can build a case on that.
Of course, statutes of limitation will bar the majority of detransitioners suing. This will be an added layer of suffering for those harmed and unable to claim justice.
Great reporting.
I gotta say, it’s an easy call for me when it comes to gender activists and kids: keep your hands off of them.
But for a person well into adulthood, to have consented to a procedure, then to presumably have some regret afterwards, and to sue on that basis….boy…
Yes, she had psychiatric issues. But if we are saying that an adult in her condition (not acutely psychotic or delusional) is still not competent to give informed consent on a procedure that a competent adult should be able to request and receive if they so choose….where does that actually leave us?
The trial likely would’ve come down to whether the defendants followed their employers’ own training and whether that training followed standard practices in the field. The argument by the plaintiff’s attorney would have been that had the defendants followed their employers standard of care, Kiefel would not have had the surgery. Whether that is a convincing argument is another question. But why have the letter requirement at all if filling it out is a purely perfunctory exercise? The surgeon likely would say she relied on the mental health professionals to vet the patient to ensure the surgery was right for them.
It leaves us with not signing off so quickly to life altering surgery on those who clearly have a multitude of mental health issues. Which is a very good thing.
But then is that to suggest that people with “a multitude of mental health issues” are not competent to make medical decisions? Or are not competent to make “life altering” medical decisions?
As I said, yes she was dealing with mental health issues but she was not psychotic or delusional.
To me, if you’re legally competent, do whatever you want to yourself, but you shouldn’t get to sue for “regret”. Choices have consequences and that’s what adulting is about.
If the decision was that she was fat and wanted to get signed off to get medications to help her lose weight, even though she was a healthy weight, in a healthy body, then any therapist would have delved into the source of those feelings. The fact is that delving into feelings around gender is not done. “You feel like you’re really a man and you want gender affirming care? Of course, here you go.” Exploring those feelings is called conversion therapy by the activists and is generally illegal. There’s nothing illegal about counseling an anorexic person.
I’m generally of the opinion that adults can do what they want, but in the case of “gender affirming” surgery, I believe there should be waiting periods and serious counseling for adults. Because such surgery has life long consequences and it should not be ok’d after a zoom calll and one consultation.
I can see the principle of “big decisions need a cooling off period”.
But then I’d say that should apply to more than just “gender affirming surgery”.
And how do you operationalize that principle? How long is/ how many opinions are enough?
I suppose it comes down, for own, to having mental health conditions “reasonably” under control.
There are many psychological difficulties that don't go so far as psychosis, even so how does a medical person know about this. They only know who is sitting in front of them and in most of these cases don't get a thorough history because of the political climate. If these surgeries and medications weren't available what would these folks look like? Would they be sent for psychological support and for someone to do a deep dive into what is happening with them? Medical providers get VERY little psychological training. If you are thinking that body modification should be ok for any adult who wants it then it shouldn't be under the umbrella of 'medically necessary'. Medical doctors are not trained to decide who 'needs' these surgeries and psychology has not caught up with understanding what is really going on.
I agree. From the surgeon’s standpoint, I imagine it’s “competent person here wants a procedure; I can do that procedure safely and effectively…let’s go”.
My question is, have you met any adult who identifies as transgender without psychiatric issues?
Procedures that "do harm" to a healthy body part should not be ethical or allowed by a competent doctor who should "Do No Harm". Breast reduction surgery and fixing a known defect is not the same as removing a healthy body part just because a person desires it or thinks it will make them feel better. Illegal drugs make addicts feel better too. Why don't we allow them?
“Do harm” according to whom? You? Why do you get to decide what is and isn’t “harmful” to another adult’s body?
Competent adults have autonomy over their own body. What they want to do to it is up to them.
Sure, don’t “allow” illegal drugs. How’s that working out?
Do no Harm as determined by ethical medicine, not me. Yes, a competent adult can do what they want to their body. A competent doctor does not do to another whatever that person wants them to do.
Actually, if a patient wants something done, why would a doctor impose their own judgment on whether the patient should or should not have it done? Paternalism much?
Because a doctor uses his own judgement and follows medical laws. A doctor should say no if a patient desires him to do something that results in worse health for the patient. If an anorexic patient desires weight loss drugs should the doctor give them what they want?
What medical judgment or medical laws were contravened here? Competent patient wanted something that the surgeon could safely and effectively provide. So the surgeon provided it.
If the patient wants a mastectomy, how does a doctor following those wishes result in “worse health”?
I agree with your example, because clearly an “anorexic patient” doesn’t need to lose more weight. What does that have to do with the case at hand? The patient in this case wasn’t an anorexic seeking liposuction.
Somebody please find out how much they paid up 👍🏼
They probably wouldn’t share the amount of a settlement. But insurance companies follow lawsuits and new theories of liability in order to assess their risk and rates.
The insurers were absolutely involved in the decision to settle
Without a doubt since they likely had to pay the bill.
Since the settlement agreement included a provision that the details of that agreement were not to be made public by the parties to the lawsuit or their attorneys or insurers, it is likely that we will never know the amount. We do not really have to.
The insurance companies know about the settlement and the amount and that will have consequences of its own
In all likelihood, the insurers made the decision to settle the case.
Well, consequences for that particular company's rates anyway.
I don't know how much insurance companies would share secret information with each other - they are competitors after all.
That’s impossible to know since settlements like this are always private. But statistics from law firms show that most settlements are between $50k-500k though so it was probably somewhere in that range.
How many of these people are there? How many will sue?