J. D. v. Lackner
Decision Date | 20 April 1978 |
Parties | Jane DOE, Plaintiff and Appellant, v. Jerome A. LACKNER, as Director of the State Department of Health, State of California, Defendant and Respondent. Civ. 42125. |
Court | California Court of Appeals Court of Appeals |
Carl L. McConnell, Peter H. Reid, San Mateo County Legal Aid Society, Redwood City, for plaintiff and appellant.
Evelle J. Younger, Atty. Gen., Asher Rubin, John Davidson, Deputy Attys. Gen., San Francisco, for defendant and respondent.
The essential facts in this case are not in dispute.
Appellant, who has been and shall be allowed to proceed herein under the fictitious name "Jane Doe" was born physically a male on January 1, 1948. At a very early age, she developed many female characteristics which became more obvious as she grew older. The evidence presented at the hearing was that appellant has never experienced an erection or had sexual relations and has failed to develop secondary male sex characteristics, such as facial hair and a deepening of the voice. Her mother and father were unable to accept this. Appellant's childhood was unstable and she developed a drinking problem in late adolescence. As a result of family problems, appellant moved to San Francisco at age 20, adopted a female name and started living completely as a woman. She obtained employment at various places but was unable to continue in these jobs more than a month or so and then she would be fired or would quit due to her failure to undergo physical examinations because of her fear of having her genital identity discovered. She has suffered severe depression and has attempted suicide on several occasions.
In 1969, appellant sought assistance from Dr. J. Leibman at the Center for Special Problems. He began hormone therapy and eventually referred her to the Stanford University Gender Dysphoria Program, where she has been receiving treatment for the past three or four years.
Dr. Donald Laub, Codirector of the Stanford Program in a letter dated September 14, 1976, states that:
Dr. Norman Fisk, a psychiatrist at the Stanford Medical Center, has also been treating the appellant for the past three years for severe depression caused by her frustration over her gender identity. During the course of the hearing, Dr. Fisk testified that he has treated the appellant on an in-patient basis on at least five occasions, some of which involved suicide attempts. Dr. Fisk further testified that there are no other known cures for the appellant's condition through psychotherapy and that the surgery is needed not only from a diagnostic standpoint but may even be life saving from the standpoint of the appellant's suicide attempts.
On May 6, 1976, Dr. Laub filed a treatment authorization request with Medi-Cal for a surgical procedure described as: neocolporrhaphy with split thickness skin graft or surgical removal of the male genitalia and construction of female genitalia. The request was denied by Dr. Wayne Erdbrink, a Medi-Cal consultant whose specialty is ophthalmology.
No examination of any kind has ever been performed on Jane Doe by anyone in the Department of Health.
Jane Doe requested a hearing pursuant to Welfare and Institutions Code section 10950. The hearing was held on September 15, 1976, before Thomas Wilcock, a referee for the California Department of Health, who ordered the treatment authorization request be granted.
The order of the referee was reversed by the Director of the Department of Health (hereinafter referred to as the Director), who ruled that the request for the operation would be denied since
At the hearing...
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O'Donnabhain v. Comm'r of Internal Revenue, 6402–06.
...F.Supp. 383, 390–391 (N.D.Ga.1977) (to same effect), revd. on other grounds 625 F.2d 1150 (5th Cir.1980); J.D. v. Lackner, 80 Cal.App.3d 90, 145 Cal.Rptr. 570, 572 (Ct.App .1978) (sex reassignment surgery is not “cosmetic surgery” as defined in State Medicaid statute; “We do not believe, by......
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