Amicus Brief: International Partners for Ethical Care, Inc. v. Ferguson

In 2023, the state of Washington enacted laws facilitating runaway minors’ access to “gender affirming treatment” without parental notice or consent. Petitioners, including a group of parents who do not wish to expose their children to such treatment, challenged these laws on multiple grounds, including an infringement of parental rights. The Ninth Circuit affirmed the district court’s ruling that Petitioners lacked standing because their injuries were, in the court’s view, self-imposed and insufficiently concrete to satisfy Article III’s requirements. Petitioners are seeking certiorari in the Supreme Court.

The Manhattan Institute and senior fellow Leor Sapir filed an amicus brief supporting the petition for certiorari. The brief explains why the best available scientific evidence shows that social transition and “gender affirming” medical interventions carry risks of serious harms sufficient to establish standing.

Decades of research establish that most children with gender dysphoria reconcile with their natal sex by adulthood. Social transition may increase the persistence of these dysphoric feelings and, in turn, the likelihood of unnecessary medicalization.

The best available evidence does not show that puberty blockers, cross-sex hormones, and related interventions are in minors’ best interests. The U.S. Department of Health and Human Services’ final review of treatment for pediatric gender dysphoria, released in November 2025, concludes that the evidence for benefit of pediatric medical transition is very uncertain, while evidence for harms such as infertility, sexual dysfunction, bone-related conditions, and other long-term effects is less uncertain.

The "gender affirming" model of care also raises serious ethical concerns under widely accepted principles of medical ethics. Minors are often unable to grasp the long-term consequences of infertility and sexual dysfunction, making informed consent deeply questionable. Given the scientific uncertainty and the prospect of harm, parental guidance is not merely advisable but essential.

Removing parents from critical decisions about their children’s social transition and “gender-affirming” medical interventions infringes upon Petitioners’ well-established parental rights. The Court should grant certiorari and make clear that Washington’s laws inflict a present injury sufficient to establish standing.

Ilya Shapiro is a senior fellow and director of Constitutional Studies at the Manhattan Institute. Follow him on Twitter here.

Leor Sapir is a senior fellow at the Manhattan Institute.

John Ketcham is a legal policy fellow and director of Cities at the Manhattan Institute.

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