USCA11 Case: 18-13592 Document: 304-1 Date Filed: 12/30/2022 Page: 92 of 150
Upon realizing he was transgender, Adams learned why he hated the feminine parts of his own body. His psychologist diagnosed him with “gender dysphoria.” Id. at 11. Gender dysphoria “is characterized by debilitating distress and anxiety resulting from the incongruence between an individual’s gender identity and birth-assigned sex.” Id. at 7 (internal quotation marks omitted). The condition is recognized by the Diagnostic and Statistical Manual of Mental Disorders. The intensity of the negative emotion Adams felt, he would later testify, was life-threatening. Adams’s deep distress was unexceptional when compared to the mental well-being of other transgender school-age children. Tragically, “more than 50% of transgender students report attempting suicide.” Doc. 151-8 at 13. It therefore should come as no surprise that Adams and his parents sought to treat his gender dysphoria.
The World Professional Association for Transgender Health (“WPATH”) has established a standard of care for persons suffering from gender dysphoria. “Many of the major medical and mental health groups in the United States recognize the WPATH Standards of Care as representing the consensus of the medical and mental health community regarding the appropriate treatment for gender dysphoria.” Doc. 119-1 at 10. “The recommended treatment for transgender people with gender dysphoria includes assessment, counseling, and, as appropriate, social transition, puberty-blocking drug treatment, hormone therapy, and surgical interventions to bring the body into alignment with one’s gender identity.” Id. at 10–11. With the support of his parents and medical providers,
