Parker Tirrell, et al. v. P Frank Edelblut, et al.

2024 DNH 073
District Court, D. New Hampshire·Decided September 10, 2024·No. 24-cv-251-LM-TSM·Published·Cited by 2 cases

Opinion

UNITED STATES DISTRICT COURT FOR THE DISTRICT OF NEW HAMPSHIRE

Parker Tirrell, et al.

v. Case No. 24-cv-251-LM-TSM Opinion No. 2024 DNH 073 P Frank Edelblut, et al.

ORDER

Two minor plaintiffs, by and through their respective parents and next

friends, bring this action against the Commissioner of the New Hampshire

Department of Education, members of the New Hampshire State Board of

Education, the Pemi-Baker Regional School District and members of its School

Board, and the Pembroke School District and members of its School Board.1

Plaintiffs allege that defendants’ enforcement of a recently enacted New Hampshire

law prohibiting transgender girls (i.e., people who were born biologically male but

who identify as female) from participating in girls’ sports violates their rights under

the Equal Protection Clause of the Fourteenth Amendment to the United States

Constitution and Title IX of the Education Amendments of 1972, 20 U.S.C. § 1681

et seq. Presently before the court is plaintiffs’ motion for a preliminary injunction.

See doc. no. 7. The State defendants object. See doc. no. 59. Neither the Pemi-Baker

defendants nor the Pembroke defendants take a position on plaintiffs’ motion. See

1 This order will refer to the Commissioner and the members of the New

Hampshire State Board of Education collectively as “the State defendants.” It will refer to the Pemi-Baker Regional School District and members of its School Board collectively as “the Pemi-Baker defendants.” It will refer to the Pembroke School District and members of its School Board collectively as “the Pembroke defendants.” doc. no. 50 at 8 n.5; doc. no. 56. The court held a hearing on plaintiffs’ motion on

August 27, 2024. For the following reasons, plaintiffs’ motion for a preliminary

injunction (doc. no. 7) is granted.

STANDARD OF REVIEW

“A preliminary injunction is an extraordinary remedy never awarded as of

right.” Winter v. Nat. Res. Def. Council, Inc., 555 U.S. 7, 24 (2008). To obtain a

preliminary injunction, the movant must demonstrate that: (1) she is likely to

succeed on the merits; (2) she is likely to suffer irreparable harm in the absence of

preliminary relief; (3) the balance of equities is in her favor; and (4) an injunction is

in the public interest. Arborjet, Inc. v. Rainbow Treecare Sci. Advancements, Inc.,

794 F.3d 168, 171 (1st Cir. 2015). Of these, likelihood of success on the merits and

irreparable injury are the most important factors. González-Droz v. González-Colon,

573 F.3d 75, 79 (1st Cir. 2009). When, as here, the defendants are government

entities or officials sued in their official capacities, the balance of equities and the

public interest factors merge. Does 1-6 v. Mills, 16 F.4th 20, 37 (1st Cir. 2021).

FINDINGS OF FACT2

I. Background on Gender Identity and Gender Dysphoria

The phrase “gender identity” is an accepted medical term for a person’s

innate sense of gender. Everyone has a gender identity, and it may or may not align

2 Except where otherwise indicated, these findings of fact are based upon the

plaintiffs’ representations in their memorandum and their uncontested evidentiary submissions attached to their motion for a preliminary injunction. See doc. nos. 7-1, 7-3 through 7-6. None of the defendants contest the plaintiffs’ factual assertions for purposes of the preliminary injunction motion.

2 with their biological sex or anatomy. A transgender girl is a person who was born

with a male anatomy but whose gender identity is female.

Transgender people experience a medical condition known as gender

dysphoria. Gender dysphoria is a medical condition recognized in the American

Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders

(“DSM-V”). Gender dysphoria results from a lack of alignment between one’s birth

sex and gender identity. It is highly treatable, but if left untreated, gender

dysphoria may result in anxiety or depression, eating disorders, substance abuse,

and even suicide. The prevailing standards of care for the treatment of gender

dysphoria are developed by the World Professional Association for Transgender

Health (“WPATH”) in collaboration with the Endocrine Society.3 Under these

prevailing standards, treatment for gender dysphoria generally involves some

combination of (1) a social transition in which the person adopts a new name,

pronouns, appearance, and clothing, and (2) medical or surgical interventions that

allow the patient to live more consistently with their gender identity. Social

acceptance of one’s gender identity is critical to the successful treatment of gender

dysphoria.

3 WPATH is an international, multidisciplinary professional association that

promotes evidence-based care for transgender individuals. The Endocrine Society is a global membership organization that represents professionals in the fields of adult and pediatric endocrinology. The standards of care for gender dysphoria developed by these associations have been endorsed by the American Medical Association, the American Academy of Pediatrics, the American Psychiatric Association, and the American Psychological Association.

3 When a transgender girl and her parents seek treatment for gender

dysphoria prior to or shortly after the onset of puberty, providers may prescribe

puberty-blocking medication to prevent the development of physical characteristics

that conflict with the child’s gender identity. When this occurs, the transgender girl

will not experience male puberty and will not experience physical changes caused

by testosterone, such as male muscular development, facial hair, or an Adam’s

apple. The provider may thereafter prescribe hormones to induce female puberty. If

this course of treatment is followed, the transgender girl typically has the same

levels of estrogen and testosterone as other girls and significantly lower

testosterone than pubescent boys.

Before puberty, there are no significant differences in athletic performance

between boys and girls. After puberty, boys on average perform better than girls in

most sports. Disparities in testosterone production drive this divergence—not sex

chromosomes or sexual anatomy. After puberty, boys produce much more

testosterone than girls, which results in increased muscle mass and strength. A

transgender girl who does not experience male puberty and who receives hormone

therapy to induce female puberty will not have an athletic advantage over other

girls as a result of being born with a male anatomy.

II. Parker Tirrell

Plaintiff Parker Tirrell is a fifteen-year-old transgender girl who has just

begun her sophomore year at Plymouth Regional High School. She knew she was a

girl at an early age, and preferred dressing as a girl when at home, engaging in

4 stereotypically female childhood activities, and socializing with other girls. At age

twelve, Parker, who had not yet begun living as a girl in all aspects of her life,

began experiencing mental distress. She and her parents sought mental health

treatment. During the summer between her seventh- and eighth-grade years,

Parker was evaluated at a health clinic by a team of providers that specialize in

diagnosing and treating gender dysphoria in children and adolescents. Ultimately,

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