A prominent test case for a new medical malpractice law in North Carolina could provide a playbook for Republican states looking to eliminate gender transition medical treatments for minors.
Medical and legal experts on gender transition medicine have focused their attention on a case working its way through the courts in the Tar Heel State filed by 26-year-old Prisha Mosley. Mosley began gender transition procedures when she was 17, after doctors advised that she would likely endure heightened risks of suicidal ideation if she did not address her gender dysmorphia through hormonal therapies and surgical procedures.
Mosley’s attorney, Josh Payne, partner at Campbell Miller Payne in Texas, told the Washington Examiner that his client, as a teen, struggled with anorexia, suicidality, and trauma from sexual assault. Within months of seeking treatment, she was prescribed testosterone, and by 18, doctors had approved her double mastectomy, an irreversible procedure that will affect her for the rest of her life.
Last year, a North Carolina judge allowed Mosley’s medical fraud case to proceed through the initial phases of discovery, but dismissed her malpractice claim based upon the state’s original four-year statute of limitations. That hurdle could have ended her malpractice claims for good, but a new law passed by the Republican-led legislature has now extended the statute of limitations for such cases involving the gender transition of minors.
Under House Bill 805, which became law over Democratic Gov. Josh Stein’s veto, those who underwent transition procedures as minors now have up to 10 years from discovering the harm, rather than four years from the date of treatment, to file suit.
The change gives Mosley a second chance to add her malpractice claim back into her lawsuit. If she succeeds, it will mark the first medical malpractice case for gender transition of a minor to reach a civil jury trial. A hearing took place on Friday, during which a judge reexamined the case, and a ruling is expected in the coming weeks.
Payne said what the North Carolina General Assembly did could be seen as a “legislative road map” for other states to follow. Otherwise, the statute of limitations will likely continue to be a barrier to bringing these types of claims in court.
Medical malpractice, fraud, and negligence
Payne said that his Texas-based law firm represents roughly a dozen detransitioners, including both women and men, though the majority are young women, some of whom began medical transition in their teens.
Payne described his female clients as “young women wanting to escape sexual trauma, who have body image issues or issues with becoming a woman.” He also stressed that not every case applies to clients who may describe themselves as detransitioners, noting that harm can still be alleged by clients who say practitioners may have jumped to drastic measures to resolve their gender dysphoria, rather than offering alternatives like psychotherapy, or simply requiring more thorough consultation.
“Most, if not all of our clients have mental health comorbidities like major depression, anxiety, obsessive-compulsive disorder, borderline personality disorder, and dissociative identity disorder,” Payne told the Washington Examiner. “One of our clients had nine alternate personalities and was nevertheless guided into taking testosterone because at least one of her identities wanted to become a man.”
Mosley now suffers from permanent health problems as a result of her medical transition, including chronic pain in her neck and shoulders from testosterone-induced muscle changes, insulin resistance, polycystic ovary syndrome, and loss of breastfeeding ability after her mastectomy.
While her legal counsel is asking the judge in Mosley’s case to consider the extended statute of limitations to allow her medical malpractice claims to continue, the practitioners named in the lawsuit are asking the judge to reconsider his decision allowing her medical fraud claim to move forward.
Legal experts say that North Carolina’s Supreme Court has already cleared the way for this kind of retroactive statute-of-limitations reform.
In the case McKinney v. Goins, decided in January, the North Carolina court upheld a retroactive extension for child sexual abuse survivors under the SAFE Child Act, ruling that such changes do not disturb a “vested right” and therefore do not violate the state constitution’s Law of the Land Clause. The majority held that the General Assembly has wide latitude to enact retroactive legislation, so long as it does not fall into the two expressly prohibited categories in the state constitution’s Ex Post Facto Clause.
Statute of limitations stands in the way for others
Outside of North Carolina, however, most states still have strict malpractice deadlines that can shut cases down before evidence is heard. For example, many states give patients only one year from discovering an injury or three years from the date of injury to sue, with only narrow exceptions for minors. For a child injured at 14, that could mean the claim expires before they become an adult.
Martha Shoultz, an attorney and the head of the advocacy group Transition Justice, told the Washington Examiner that the statute of limitations is the primary problem in not being able to file medical malpractice cases for detransitioners who contact her group.
She said that her non-profit organization does not offer legal advice or representation but puts detransitioners in touch with legal professionals in their states.
Shoultz highlighted New York as one of the states from which her group receives a significant number of calls, but only a handful of cases are actually viable due to the short statute of limitations.
“That’s really the travesty of this all, is that we have so many kids or young people who come to us from New York, and their statute of limitations is so short and so restrictive that we just can’t bring a case,” she said.
That’s the same challenge facing 20-year-old UCLA student Kaya Clementine Breen, who filed a lawsuit in Los Angeles County Superior Court in December 2024. She alleges she was misdiagnosed with gender dysphoria and “fast-tracked” into puberty blockers at 12, testosterone at 13, and a double mastectomy at 14 — despite a documented history of PTSD from childhood sexual abuse, anxiety, and depression.
Her case names prominent figures in gender medicine, including Dr. Johanna Olson-Kennedy of Children’s Hospital Los Angeles and Dr. Scott Mosser of the Gender Confirmation Center in San Francisco. Breen’s attorneys say her mental health conditions were ignored, but under California law, the statute-of-limitations clock started ticking years ago.
Olson-Kennedy’s clinic is one of the several nationwide that have shut down operations during the first six months of the Trump administration.
If the court strictly applies the existing deadlines, Breen’s malpractice claims could be thrown out before evidence is heard, underscoring why Mosley’s situation in North Carolina is the exception, not the rule.
Dr. Jared Ross, a senior fellow at the Do No Harm medical advocacy group, told the Washington Examiner that rushing adolescents into irreversible interventions without a comprehensive mental health evaluation violates basic medical ethics.
“If you ignore trauma, depression, or other psychiatric conditions and move straight to hormones or surgery, you are not practicing evidence-based medicine,” Ross said. “These lawsuits are a predictable result.”
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But Shoultz said that in states without statute of limitations reform for these types of cases, they won’t advance in court.
“Until we can extend that statute of limitations for everybody, nothing is going to happen. Most of these kids will be stuck with no remedy,” Shoultz said.