Kilkenny, R. v. Kilkenny, D.

Superior Court of Pennsylvania·Decided October 6, 2023·No. 375 EDA 2023·Unpublished

Opinion

J-A17016-23

NON-PRECEDENTIAL DECISION - SEE SUPERIOR COURT OP 65.37

R.S.K. : IN THE SUPERIOR COURT OF : PENNSYLVANIA : v. : : : D.L.K. : : Appellant : No. 375 EDA 2023

Appeal from the Order Entered March 10, 2023 In the Court of Common Pleas of Bucks County Civil Division at No(s): 2012-61169

BEFORE: KING, J., SULLIVAN, J., and PELLEGRINI, J.*

MEMORANDUM BY SULLIVAN, J.: FILED OCTOBER 6, 2023

D.L.K. (“Mother”) appeals from the order which: (1) directed a

pharmacy to fill a prescription for a puberty-blocking drug to be administered

to her minor child, K.K. (born in July 2009); (2) directed K.K.’s pediatric

endocrinologist to administer the drug to K.K.; and (3) deferred any ruling on

Mother’s petitions to modify custody until Mother undergoes the psychological

evaluation which the trial court ordered her to complete in 2020. We affirm.

Mother and R.S.K. (“Father”) were married in 2000 and have been

divorced since 2013. They have four children, two of whom are minors subject

to a custody order. One of the minor children, K.K., was born as a female but

identifies as a male. As K.K. does not wish to identify as a female, he has

been working with physicians and therapists for several years to obtain

____________________________________________

* Retired Senior Judge assigned to the Superior Court. J-A17016-23

treatment for gender dysphoria and to prevent the development of female

physical attributes during puberty. In this regard, K.K. received a puberty-

blocking Supprelin implant in 2020, and since April 2022 has been receiving

bi-annual puberty-blocking Triptodur injections.

Since the parties separated in 2011, they have collectively filed dozens

of competing petitions to modify custody, find each other in contempt of court,

and for contempt hearings. Numerous custody orders have been entered in

this contentious action, some of which have temporarily given Father sole legal

and sole physical custody. Presently, Father and Mother have shared legal

custody of the minor children, and Father has primary physical custody of

them. See Trial Court Orders, 8/31/21 and 5/16/22.1

In August 2020, the trial court ordered both Mother and Father to

undergo a psychological evaluation by a designated evaluator, Donald

Seraydarian, Ph.D., as part of the custody evaluation process through Court

Conciliation and Evaluation Service (“CCES”). Father complied with that

directive. Mother has not. Mother attempted to circumvent the court’s

directive by claiming that she was assessed by Family Services; however, the

trial court deemed that assessment incomplete and non-compliant, and on

several occasions has ordered her to comply with its August 2020 directive.

____________________________________________

1 In its opinion, the trial court incorrectly stated that Father presently has sole

legal custody of the minor children. See Trial Court Opinion, 3/29/23, at 3.

-2- J-A17016-23

In March 2022, the trial court conducted a hearing regarding K.K.’s

gender transition care. The court heard testimony from, inter alia: K.K.’s

pediatric endocrinologist, Laurissa Kashmer, M.D.; K.K.’s primary physician,

Scott Blore, M.D.; and K.K.’s therapist, Marjorie Morgan, LPC. See Domestic

Court Sheet, 3/1/22, at 1. The trial court also conducted an in camera

interview of K.K., with counsel and a court reporter present. See id.

Unfortunately, the proceedings were not transcribed. As such, there is no

record of the evidence and testimony provided to the trial court. At the

conclusion of the hearing, the trial court entered its ruling that K.K. may

continue to receive injectable puberty blockers, “but not the medical

procedure.”2 Id. K.K. thereafter received a Triptodur injection in April 2022.

See N.T., 1/27/23, at 43.

In May 2022, the trial court conducted a hearing. Following the hearing,

the court entered a custody order which specified that, inter alia, the custody

order entered on August 31, 2021 (granting Mother and Father shared legal

custody over the minor children, and granting Father primary physical custody

over them) would remain in effect, and that only Mother and Father could

attend medical and other appointments for the minor children. See Custody

Order, 5/16/22, at unnumbered 1.

____________________________________________

2 We understand this ruling to mean that, in lieu of surgically removing/receiving another Supprelin implant, K.K. would instead start receiving injections of a puberty blocking drug.

-3- J-A17016-23

In June 2022, the trial court conducted a hearing. At the hearing, the

court heard testimony from, inter alia, Dr. Kashmer, Dr. Blore, and Jeremy

Gunn, Esquire, as counsel for, inter alia, Pantherx Rare Pharmacy (“Panther

Pharmacy”). See Domestic Court Sheet, 6/14/22. The evidentiary portion of

the hearing was not transcribed. Thus, there is no record of the evidence and

testimony provided to the trial court. However, the trial court’s “Decision” at

the end of the proceedings was transcribed. Therein, the court directed that,

prior to obtaining a second medical opinion regarding K.K., Mother must first

consult with Dr. Kashmer and Dr. Blore. See N.T., 6/14/22, at 3-4; see also

Domestic Court Sheet, 6/14/22 at 1 (providing that “[n]o second

opinion/appt. on Gender Dysphoria can be made by [M]other, until Mother

consults with Dr. Kashmer and Dr. Blore”). The court also ordered that

Father’s fiancé be removed as a contact for the minor children with respect to

all medical providers. See N.T., 6/14/22, at 4; see also Domestic Court

Sheet, 6/14/22 at 1 (providing that “[fiancé] is to be removed as a contact for

[the minor children] in the medical offices”).

On October 3, 2022, the trial court entered an order directing Dr.

Kashmer to execute a prescription for K.K.’s bi-annual Triptodur injection and

to administer the injection to K.K. as soon as possible, in October 2022.

However, when Dr. Kashmer attempted to execute the prescription through

Panther Pharmacy, she was unable to do so because Mother had contacted

the pharmacy and stated that she had shared legal custody of K.K., she did

-4- J-A17016-23

not consent to the Triptodur injection, and K.K. still had a Supprelin implant

which had not been removed. Based on Mother’s representations, Panther

Pharmacy declined to fill the prescription due to its legal concerns regarding

Mother’s communication.

In November 2022, Father filed an emergency petition to find Mother in

contempt of the October 3, 2022 order directing that K.K. receive a Triptodur

injection, and sought recovery of his attorneys’ fees as a sanction against

Mother. Father also sought sole legal custody related to K.K.’s medical and

psychological care.

In response, Mother filed an amended petition for modification of

custody. Therein, Mother alleged that Father was not acting in the minor

child’s bests interests and that Father did not keep her updated regarding

K.K.’s gender transition care. Mother also claimed that Dr. Kashmer was lying

under oath and was non-credible and suspicious. Mother further averred that

Father’s legal counsel, Susan Smith, Esquire, was having sexual relations with

Father, thereby making counsel incredible and causing Mother mental

anguish. Mother additionally claimed that there are no records showing that

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