Expert Witness Profiler

Tag: Transgender

  • Adolescent Health Expert’s Testimony on Brain-Scan Studies Excluded

    Adolescent Health Expert’s Testimony on Brain-Scan Studies Excluded

    A.C. is a transgender boy who attends Martinsville High School. Prior to attending Martinsville High School, he attended John R. Wooden Middle School (“Wooden Middle”). While attending Wooden Middle, A.C. sought to use the boys’ restroom, the restroom he felt most comfortable using, but was denied access by the School District. The School District offered him the use of the school’s single-sex restroom instead.

    A.C. filed the instant lawsuit against the School District, citing Title IX and Equal Protection violations.

    The School District designated Dr. Kristopher E. Kaliebe as an expert witness to offer opinions concerning the care of youth with gender dysphoria. Plaintiff A.C. filed a motion to exclude the testimony of Kaliebe while Defendant Metropolitan School District of Martinsville filed a motion to exclude the testimony of James D. Fortenberry, M.D., M.S., who has been disclosed as an expert by Plaintiff.

    Psychiatry Expert Witness

    Kristopher Edward Kaliebe, MD is a Professor of Psychiatry at University of South Florida, in Tampa Florida. He is Board Certified in Psychiatry, Child and Adolescent Psychiatry and Forensic Psychiatry. He is a Distinguished Fellow at the American Academy of Child and Adolescent Psychiatry (AACAP). His clinical work has been primarily in University clinics, Federally Qualified Health Centers and juvenile corrections.

    Want to know more about the challenges Kristopher Kaliebe has faced? Get the full details with our Challenge Study report.

    Adolescent Health Expert Witness

    Dr. James Dennis Fortenberry is Professor of Pediatrics at Indiana University School of Medicine. He served as Division Chief from 2015 – 2020. He also holds an adjunct appointment in epidemiology in the Fairbanks School of Public Health and is a member of the Center for Sexual Promotion at Indiana University.

    Fortenberry is a member of the World Professional Association for Transgender Health, the Society for Adolescent Health & Medicine, the International Academy for Sex Research, the American STD Association, and the Society for Scientific Study of Sex. He is past president of the International Academy for Sex Research, and past-president of the American STD Association, a fellow of the Society for Scientific Study of Sex, and past chair of the Board of Directors of the American Sexual Health association.

    Fortify your strategy by reviewing a Challenge Study detailing grounds for excluding James D. Fortenberry’s expert testimony. 

    Discussion by the Court

    A.C.’s Motion to Exclude Testimony of Kaliebe

    A.C. argued that Kaliebe is not qualified to render opinions concerning gender dysphoria and social transition, Kaliebe’s opinions generally are not reliable, and Kaliebe’s opinions are irrelevant in assessing the damages caused for the emotional distress and physical discomfort A.C. experienced.

    A.C. narrows in on the fact Kaliebe has no clinical experience on the issue at hand in this case – the denial of a form of social transition, restroom usage, to a gender dysphoric youth.

    The School District details how Kaliebe’s testimony is relevant (1) to dispute whether their position regarding bathroom access is the cause of any irreparable injury to A.C.; (2) to the balancing harms analysis set forth in the permanent injunction consideration; and (3) to demonstrate that the public’s interest would not be served by a permanent injunction. However, there is no argument as to how this testimony relates to damages.

    Given the Court’s granting of the permanent injunction, the merits of the permanent injunction request are no longer an issue for trial. Therefore, the Court decided that Kaliebe’s proposed testimony is no longer relevant.

    The School District’s Motion to Exclude Testimony of Fortenberry

    The School sought to exclude the testimony of James D. Fortenberry, who opined that A.C. would suffer adverse effects if he is denied continued use of the boys’ restroom. The School District also sought to exclude Fortenberry’s testimony as to the genetic or brain-scan studies suggesting that there is a biological component to gender identity because those are areas outside his alleged expertise.

    Fortenberry’s Testimony on Harm Caused to Transgender Youth

    A.C. convincingly argued that most of Fortenberry’s testimony is necessary and relevant to demonstrate the types of harm – both physical and emotional – that transgender youth suffer. Fortenberry’s opinion that “forced use of facilities that contravene [A.C.’s] gender experience and identity are reasonably expected to cause adverse effects on relationships with his school, his safety at school, and his mental health” speaks to the harm A.C. experienced when he was denied access to the boys’ restroom prior to this Court’s grant of a preliminary injunction. Similarly, testimony about how youth react to the denial of access to appropriate restrooms and suicidality rates in transgender youth provides relevant background to the harms affiliated with gender dysphoria. A.C. testified that he made comments to his mom about not wanting to live trapped in a female’s body. This testimony is directly related to suicidal ideations in transgender youth.

    Fortenberry’s Testimony on Studies Demonstrating there is a Biological Component to Gender Identity

    However, A.C. has not successfully demonstrated how Fortenberry’s testimony that “gender expression/identity is not a ‘choice’” or testimony about genetic or brain-scan studies is relevant information that can help a jury understand gender dysphoria as it relates to A.C. specifically. A.C. argued that testimony about brain scans is necessary to explain his opinion that being transgender is not a choice. But A.C. did not explain how transgender status being a choice, opposed to a biological making, makes the harm he faced by the School District’s actions more or less probable. For this reason, the Court barred Fortenberry from discussing whether or not gender identity is a choice and from discussing genetic or brain-scan studies.

    The School District also argued that reports of the experiences of other young people with gender dysphoria should be excluded because it is hearsay, confusing to the jury, and unduly prejudicial. Fortenberry may communicate what he observed and heard to establish the basis of his opinion.

    Therefore, the Court held that while Fortenberry may testify about the harm caused to transgender youth who are denied the ability to socially transition,
    and the suicide rates of transgender youth, he may not testify about whether
    transgender status is a choice or studies demonstrating there is a biological component to gender identity.

    Held

    • The Court granted A.C.’s motion to exclude the testimony of Kristopher Kaliebe.
    • The Court granted in part and denied in part the School District’s motion to exclude the testimony of James Fortenberry.

    Key Takeaway:

    Evidence is relevant if it has any tendency to make a fact more or less probable than it would be without the evidence; and the fact is of consequence in determining the action. In this case, Fortenberry’s testimony is relevant to demonstrate the type of harms – both physical and emotional – that A.C. was caused by the School District restricting his access to the boys’ restroom. His testimony as to the danger of suicidality in transgender young persons is necessary to demonstrate how serious gender dysphoria is.

    Case Details:

    Case Caption: A.C. V. Metropolitan School District Of Martinsville Et Al
    Docket Number: 1:21cv2965
    Court Name: United States District Court, Indiana Southern
    Order Date: August 27, 2025
  • Prison Management Expert Allowed to Opine on PREA Compliance

    Prison Management Expert Allowed to Opine on PREA Compliance

    Plaintiff C. Jay Smith is a transgender woman who has been housed in men’s prisons for decades. The facts at issue in this case pertain to Plaintiff’s incarceration at San Quentin State Prison from 2013 to 2019, though she has been housed at the California Medical Facility in Vacaville since June 2019.

    Plaintiff filed a motion to exclude the testimony of Defendants’ expert, Captain Rusty Hickethier.

    Prison Management Expert Witness

    Rusty Hickethier is currently a Captain (A) and PREA Coordinator for California Department of Corrections and Rehabilitation. Prior to this role, he was a Correctional Lieutenant working for the PREA Compliance Unit for CDCR Headquarters, assisting with ensuring the agency maintains compliance with the Federal Standards as well as assisting with DOJ PREA Audits.

    Previously, he was a Correctional Sergeant at CSP-Sacramento which houses primarily Level IV maximum and high security incarcerated person as well as those requiring specialized mental health programming and high-risk medical concerns. Hickethier has over 17 years of service with CDCR.

    Get the full story on challenges to Rusty Hickethier’s expert opinions and testimony with an in-depth Challenge Study. 

    Discussion by the Court

    Plaintiff stated that Defendants first designated Hickethier as a Federal Rule of Civil Procedure 30(b)(6) deponent, then disclosed him as a non-retained expert, and finally as a retained rebuttal expert. Plaintiffs urged that he is not a proper expert and should not be allowed to testify at trial.

    In response, Defendants have confirmed that they do not oppose Plaintiff’s motion to exclude Hickethier as a non-retained expert witness. The Court therefore granted the motion on this basis. The parties disputed, however, whether to exclude Hickethier as a rebuttal expert witness.

    Plaintiff argued that Hickethier cannot offer an opinion that San Quentin was compliant with Prison Rape Elimination Act (“PREA”) requirements because the evidence in the record—including Captain Hickethier’s 30(b)(6) testimony—establishes that it was not. Plaintiff also urged that, although not prohibited, it would be confusing to the jury to have someone testifying as both a 30(b)(6) witness and an expert.

    Defendants did not address Plaintiff’s arguments directly. Instead, they responded that to the extent Plaintiff’s expert is allowed to testify about PREA, they should be allowed to call Hickethier, a member of CDCR’s PREA Compliance Unit, as a rebuttal expert witness.

    Analysis

    The Court has concerns with the cursory manner in which Defendants have responded to this motion. And it is not clear whether, and to what extent, Captain Hickethier may try to contradict his own prior 30(b)(6) testimony. Nevertheless, the Court is not inclined to fashion an order based on suppositions about what the evidence at trial may show, and how Captain Hickethier may rely on that evidence, in fashioning any rebuttal testimony.

    Plaintiff may of course challenge any of Captain Hickethier’s testimony through vigorous cross-examination if he testifies, and the Court will have the opportunity to evaluate any objections in context. Additionally, if this case proceeds to trial, the Court will consider holding a voir dire hearing outside the presence of the jury to confirm in advance that experts, including Captain Hickethier, will only offer reliable and relevant opinions. 

    Held

    The Court granted the motion to exclude Captain Rusty Hickethier’s testimony as a non-retained expert witness, but denied the motion to exclude his testimony as a rebuttal expert.

    Key Takeaway:

    The Court finds it inappropriate to formulate an order predicated on suppositions regarding the evidence to be presented at trial and Captain Hickethier’s potential reliance on that evidence in his rebuttal testimony.

    Case Details:

    Case Caption: Smith V. Diaz Et Al
    Docket Number: 4:20cv4335
    Court: United States District Court, California Northern
    Order Date: March 31, 2025
  • Judge Declares Law Banning Transition Care Unconstitutional

    Judge Declares Law Banning Transition Care Unconstitutional

    More often than not, public school employees call students by the pronouns matching the gender on their birth certificate, no matter the child’s preference and it is a misdemeanor to use restrooms in public buildings that do not correspondent to the person’s gender at birth. If lawmakers advance bills that mandate the same, how do we expect discrimination against transgender individuals to diminish?

    Four transgender adults and seven parents of transgender minors challenged the constitutionality of a Florida statute that prohibited transgender minors from receiving widely accepted gender-affirming medical care and impose restrictions on how such care can be provided. The Plaintiffs had urged the Court to specifically block one part of the law that bars doctors and nurses from prescribing or administering transition-related medication to children, and another part that exposes medical providers to criminal liability and professional discipline for doing so.

    The kinds of care at issue are puberty blockers and cross-sex hormones. For many years, the State of Florida allowed use of these medications to
    treat gender dysphoria. Yet, while other states restricted the use of state funds to pay for transgender care, Florida was the first to restrict care for transgender adults who were not relying on Medicaid. “But then the political winds changed,” wrote Judge Robert L. Hinkle of Federal District Court in Tallahassee.

    Last June, Judge Hinkle temporarily blocked enforcement of parts of the law for the children of the three families who filed the lawsuit. He ruled specifically that three transgender children can be prescribed puberty blockers despite the new state law, which also added new hurdles for adults seeking similar care.

    Psychiatry Expert Witness

    Dr. Stephen B. Levine is an expert in gender dysphoria and gender identity. He is a Distinguished Life Fellow of the American Psychiatric Association and a professor with many years of experience in the fields of gender and sexuality.

    Levine chaired a committee that crafted a pioneering set of standards of care for individuals suffering from gender dysphoria, and he has been a senior editor for three editions of the Handbook of Clinical Sexuality for Mental Health Professionals. He also founded a gender identity clinic in 1974, which he continues to lead as co-director.

    Levine did a psychiatric internship and residency at University Hospitals of Cleveland, working in that hospital’s Sexual Dysfunction Clinic. In 1993 the clinic separated from University Hospitals to become The Center for Marital and Sexual Health (now called DELR).

    Discover more cases with Stephen Levine as an expert witness by ordering his comprehensive Expert Witness Profile report.

    Discussion by the Court

    The challenged statute prohibited gender-affirming care for minors—for patients under age 18—subject to a grandfather provision allowing minors who were already receiving this care to continue do so. It restricted the manner in which gender-affirming care could be provided to adults and to grandfathered minors. Such laws deprive parents of their fundamental right to make medical decisions for their children and underestimate the impact denial of transition care has on the physical and mental health of the children.

    Judge Hinkle said that “gender identity is real” and that a “widely accepted standard of care” includes puberty blockers and hormone treatments that Florida unlawfully banned. He added, “The State of Florida can regulate as needed but cannot flatly deny transgender individuals safe and effective medical treatment.” Not just the Defendants, but also defense expert Dr. Stephen B. Levine with his extensive experience treating a significant number of transgender patients admitted it.

    Stephen B. Levine

    At a committee hearing, a minor from another state gave comments indicating she received gender-affirming care and a mastectomy, without meeting the prerequisites to such care under the Endocrine Society and WPATH guidelines.

    Hinkle noted that Levine’s testimony providing a legitimate, nondiscriminatory basis for restricting the availability of gender-affirming care for minors met the Daubert standard.

    Levine has repeatedly testified about the many risks associated with “affirming” transgender identity in children in various cases. According to Levine, both the long-term and short-term implications of life as a transgender individual are crucial when it comes to social transitioning. He has cited multiple studies from different nations that have documented the increased vulnerability of the adult transgender population to substance abuse, mood and anxiety disorders, suicidal ideation, and other health problems.

    Levine casts doubt on the claim that puberty blockers are completely reversible. He adds that there are social risks associated with delayed puberty. Levine writes, “individuals in whom puberty is delayed multiple years are likely to suffer at least subtle negative psychosocial and self-confidence effects.”

    However, at one point in this case, Levine testified that treatment with GnRH agonists and cross-sex hormones is sometimes appropriate. He would demand appropriate safeguards, as discussed below, but he would not ban the treatments. Levine suggested prerequisites to gender-affirming care.

    Held

    Hinkle found Levine’s arguments in favor of restricting the availability of gender-affirming care persuasive but sided with advocacy groups and three families who had said that the law deprived them of parents’ rights to make medical decisions for their transgender children.

    He declared key parts of a Florida law banning gender transition care for minors and imposing hurdles on adults seeking such care unconstitutional.

    Key Takeaway:

    Puberty blockers and other forms of gender transition care for children give transgender adolescents and their families time to weigh important medical decisions. Studies report that teens who had access to puberty blockers and hormone therapy require fewer gender-affirming surgeries as adults. Plaintiffs, in this case, challenged the constitutionality of a statute that denied transgender individuals safe and effective medical treatment.

    The legislation codified policies adopted last year by the Florida Board of Medicine and Board of Osteopathic Medicine — whose members are appointed by the governor — that banned hormone treatments for people under 18 unless they were already receiving such care.

    While laws prohibiting access to gender transition care might end up causing irreparable harm, it is equally important weigh in social risks associated with delayed puberty.

    Levine is of the opinion that ushering gender-dysphoric children toward social transition to the opposite sex is an experimental therapy that exposes these vulnerable children to more mental health risks.

    Case Details:

    Case Caption: Jane Doe V. Joseph A. Lapado
    Docket Number: 4:23cv114
    Court: United States District Court for the Northern District of Florida, Tallahassee Division
    Order Date: June 11, 2024