The Texas Supreme Court on Wednesday heard arguments in a case surrounding a statute that could impact how gender medical malpractice lawsuits are handled across the country.
Detransitioner Soren Aldaco’s medical malpractice lawsuit was dismissed in November 2024 when a judge ruled her claims were filed outside of Texas’ two-year statute of limitations, nullifying her ability to seek damages for the harms caused by her sex-rejecting surgery.
When Aldaco’s appeal reached the Texas Supreme Court this week, her counsel argued the statute of limitations couldn’t begin until she was physically harmed by the surgeon’s knife.
“What was done to Miss Aldaco and many people like her is a medical scandal,” attorney John Ramer argued. “Kids and young adults suffering from severe psychological distress went looking for help, and what they found is medical providers saying that what’s going to liberate them from their distress is pumping them full of cross sex hormones and cutting off their body parts.”
Some Texas lawmakers have proposed legislation that would extend the statute of limitations from two to ten years for those harmed by rejection interventions in their state. They say that Aldaco’s case highlights the need for reform.
“Cases like Soren’s are not the intent of these two-year statutes of limitations in the Texas Medical Liability Act,” Texas State Representative Shelby Slawson told The Daily Wire. “Those limitations are not meant to give safe harbor hideouts for medical professionals whose ideology causes egregious harm to Texas patients.”
The outcome of Aldaco’s case could reverberate across the country. The statute of limitations for medical malpractice varies from state to state, with many limiting the timeframe in which a patient can sue between one and three years after the injury occurred. If the Texas Supreme Court rules in Aldaco’s favor, it could inspire detransitioners in other states to bring similar suits.
Attorneys for Aldaco say the court “clearly expressed concern” at what was done to her, and are hopeful that its ruling “will encourage courts in other states to ensure justice for their vulnerable citizens.”
“Soren’s case reaching the Texas Supreme Court highlights the fact that the treatment she was subjected to is unprecedented,” Daniel Sepulveda, a partner
at Campbell Miller Payne told The Daily Wire. “During oral argument, the Court clearly expressed concern at the idea of vulnerable individuals like Soren not having a reasonable amount of time to sue after being subjected to such medical and mental health treatments. A ruling in her favor would benefit all Texans harmed in these ways, and could also encourage courts in other states to ensure justice for their vulnerable citizens.”
Prisha Mosely, who was given testosterone and underwent a sex rejecting double mastectomy as a teen, filed a lawsuit in July 2023 against her gender affirming healthcare providers that was initially dismissed because it was filed outside of North Carolina’s statute of limitations. In July 2025, the North Carolina General Assembly passed HB 805, which extended the statute of limitations for sex-rejecting interventions to 10 years, allowing Mosely to refile her lawsuit.
Texas State Representative Brent Money told The Daily Wire that in cases where there has been a “clear violation of the duty of care,” it is important that individuals, particularly children, can seek compensation through the court system.
“We also need to make sure that, in cases where there’s a clear violation of the duty of care, that the patient, who has been wronged, can be adequately compensated for that. Especially when the patient is a child,” Money told The Daily Wire.
Aldaco, a woman who struggled with gender confusion throughout her adolescence, underwent a double mastectomy at 19 that she later regretted, court documents show. She sued her mental health providers, Barbara Rose Wood and Three Oaks Counseling Group, LLC, alleging they negligently wrote a surgical recommendation letter in February 2021 that allowed her to undergo the mastectomy in June 2021, court documents show.
Many insurance companies and surgeons require a timely mental health assessment and surgery recommendation letter in order to move forward with sex-rejecting surgery.
In May 2023, Aldaco sent her former healthcare providers notice of her “health care liability claims,” weeks before the two-year anniversary of her surgery, believing she was within the statute of limitations. However, a judge agreed with the defendants, who argued the two-year period of liability began when the surgical recommendation letter was written in February 2021, and Aldaco missed her window to sue, court documents show.
Ramer told the court that while the mental healthcare was provided before surgery, Aldaco didn’t have cause of action — giving her grounds for her lawsuit — until she underwent surgery.
“The limitations period for a health care liability claim does not begin to run before the claimant is even injured,” Ramer told the court.
“There’s no such thing as a tort without an injury, and more specifically here, there’s no such thing as a negligence claim without an injury,” Ramer stated.
Opposing counsel argued the statute of limitations began in February 2021, when the surgery letter of recommendation was written, and acknowledged Aldaco’s mental health provider did not discuss her gender dysphoria before writing the surgery recommendation letter.
Ramer explained to the justices that the surgical recommendation letter was not equivalent to a simple medical referral but was critical to Aldaco accessing a double mastectomy.
“The letter was the gateway to the injury,” Ramer said. “The letter is what got her into–onto–the operating table for purposes of receiving this surgery because it was a required letter from the psychologist under the standards of gender affirming care that have to be followed.”
In 2021, guidance from the World Professional Association of Transgender Health, whose recommendations underpin insurance and health policies worldwide, required patients to undergo a mental health assessment to determine if sex-rejecting was “medically necessary.”
The guidance stated mental health professionals and surgeons had a “shared responsibility” when deciding to move forward with irreversible sex-rejection surgeries.
A recent policy statement published by the American Society of Plastics Surgeons recommending minors do not receive sex-rejection surgeries addressed the role of “shared responsibility” in the multidisciplinary care of gender confused children.
“Diagnostic assessment, psychosocial support, endocrine intervention, and surgery form a connected clinical pathway rather than a series of independent steps,” the policy reads.
The American Society of Plastics Surgeons warned surgeons they cannot “rely” on the assessments of other healthcare disciplines when deciding if an adolescent is an appropriate candidate for sex-rejecting surgery.
“Surgical interventions inherit the foundational uncertainties present earlier in the continuum of care,” the policy says. “In this context, plastic surgeons cannot rely on the presence of a prior medical intervention, referral, or letter of support as a proxy for surgical indication or adolescent readiness.”
“Wednesday’s hearing at the Supreme Court of Texas is understatedly important. Even though I believe my case falls within the state’s two-year statute of limitations — and hopefully SCOTX will agree — detrans Texans deserve better,” Aldaco told The Daily Wire.
Barbara Wood and Three Oaks Counseling did not immediately respond to The Daily Wire’s request for comment.
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