The Ohio Department of Health hired a conversion therapy advocate to serve as its expert witness in a civil rights lawsuit filed against the state, despite the medical world’s rejection of the practice.
ODH lawyers retained Dr. Quentin Van Meter, a pediatric endocrinologist from Georgia, at rates reaching $450 per hour, to support the state’s refusal to change the listed sex on the birth certificate of four transgender people.
Ohio and Tennessee are the only two U.S. states that do not allow such changes, court filings state.
Van Meter is the president of the American College of Pediatricians, a group of physicians who splintered off from the American Academy of Pediatrics in 2002. Van Meter said the new group formed when the AAP established a position that same-sex couples can raise children with no adverse effects on their well-being.
ACP urges health care professionals, lawmakers and educators to “reject all policies that condition children to accept as normal a life of chemical and surgical impersonation of the opposite sex.”
Van Meter has treated 15 patients diagnosed with gender dysphoria, the perceived distress when one’s gender identity does not match their sex. Deviating from recommendations of most every medical association, Van Meter said he referred his patients to conversion therapy.
He also advocates for the practice, which the Substance Abuse and Mental Health Services Administration describes as the “coercive” and possibly harmful effort aimed at changing a patient’s sexual orientation or gender identity.
The process is considered emotionally traumatic and has been linked to higher rates of suicide and depression, according to the American Psychological Association.
When it comes to conversion therapy, most every major medical association stands unequivocally opposed.
“I think [Van Meter] came to conclusions that are very much in contradiction to what is accepted by the broader medical community as far as treating trans patients,” said Dr. Ryan Gorton, a physician who has treated about 500 transgender patients and is serving as a pro bono expert witness for the plaintiffs.
“His views on that are pretty fringe,” Gorton said.
A spokeswoman with the Department of Health declined comment on why the state selected Van Meter as its expert.
During a deposition, the plaintiffs’ lawyers asked Van Meter how the state came to identify him as an expert. He traced his reputation, in part, to a presentation at the “Teens for Truth Conference: Countering the LGBT Agenda,” hosted at the Southwestern Baptist Theological Seminary in Texas.
In an interview, he said he couldn’t say how or why the Department of Health picked him.
“I don’t know, I guess I’m known for my opinion,” he said.
Experts on conversion therapy
Dr. Jason Rafferty has practiced transgender medicine for eight years and said he’s treated more than 1,000 patients. He also is the co-author of the American Academy of Pediatrics position statement opposing conversion therapy.
He said while conversion therapy and similar practices may have once been accepted, experts now advise affirmative care. This, he said, is about letting people express who they are in a safe setting, and working with a team of endocrinologists, psychiatrists, and primary care specialists to consider the best course of action.
Beyond being outdated, Rafferty warned conversion therapy is dangerous.
“The real harm can come from an environment where kids are forced to suppress their identity, where they sometimes develop guilt and shame of who they are because it doesn’t foster growth, it doesn’t foster critical thinking, it doesn’t foster exploration necessary to allow self-discovery,” he said.
The American Medical Association, among the largest, oldest and most powerful of professional health organizations, has called for a legislative ban on conversion therapy.
“Conversion therapy has no foundation as scientifically valid medical care and lacks credible evidence to support its efficacy or safety,” said board member Dr. William Kobler, in a statement emailed through an AMA spokesman.
The Endocrine Society, which represents about 18,000 endocrinologists (hormone doctors), rejects Van Meter’s approach as well.
“Individuals may make choices due to other factors in their lives, but there do not seem to be external forces that genuinely cause individuals to change gender identity,” according to the association’s position statement.
Researchers at Cornell University in New York conducted a review of 13 primary research studies about whether conversion therapy can alter sexual orientation without causing harm. Of those, 12 concluded the practice is ineffective and can be linked to depression, suicide, anxiety, and social isolation.
They noted the outlier study has “several limitations,” including that it’s self-identified as religious and based on self-reporting.
This tracks with September 2019 research in the Journal of American Medicine analyzing more than 27,000 transgender people. That study found transgender adults who recalled conversion efforts before they were 10 years old were “significantly associated” with an increase in the lifetime odds of suicide attempts.
Van Meter said he’s well aware he stands in opposition to these medical groups. He said their focus on what he described as political correctness and financial agendas have led them to follow bad science based on whatever opinion “is noisiest in the world.”
He said the medical groups’ policies represent tiny fractions of their members. In his interview, he said hormonal and surgical approaches to change gender harm patients. He said gender dysphoria is a symptom of the underlying conditions like depression and anxiety.
Litigation and status
Four transgender people — Stacie Ray, Ashley Breda, Basil Argento and a Jane Doe — filed the lawsuit challenging Ohio’s refusal to change their birth certificates, represented by the ACLU of Ohio and Lambda Legal.
They say life’s ordinary errands that require a birth certificate have wound up outing them as transgender, causing them fear and humiliation.
Argento said when his birth certificate didn’t match his other identity documents, it led people to treat him “like a zoo specimen” when he tried explaining himself, court filings state. It took him three years to obtain an accurate passport because of the sex disparity on his identifying documents.
Ray said in court filings she was bullied and threatened at work when forced to present her birth certificate, which lists her sex as male, in front of several new colleagues. One of them allegedly threatened to “beat [her] ass” if she used a women’s restroom.
ACLU lawyers said in court filings that before 2016, ODH permitted transgender people to correct the sex marker on their birth certificates, and adopted internal guidance to reverse its position.
They say the policy violates the four’s constitutional rights of speech, privacy and equal protection under the law.
On the other side, lawyers for the state argued that Ohio law allows only a narrow scope of edits to birth certificates, generally related to correcting an error. They say these are necessary statistics in the government’s interest to collect when it comes to sex, which they say is an immutable characteristic.
Moreover, they argue the issue is political, not legal.
“In sum, plaintiffs’ complaint is with legislative policy choices in a controversial area, and that is a matter for state legislatures, not for federal courts to impose a one-size-fits-all policy mandate,” they wrote.
Jason Blake, a lawyer for the state, declined to comment.
In September, U.S. District Judge Michael Watson denied a request from the state to dismiss the case, handing an early victory to the plaintiffs.
In his ruling, he said all four plaintiffs had already changed the gender on their driver’s licenses and he’s “not convinced” that Ohio law prohibits changing the birth certificates.