Amicus Curiae Brief — Edward Allyn Hudacko, Petitioner v. Regents of the University of California, et al.

Supreme Court briefSep 9, 2026

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No. 26--180

In the Supreme Court of the United States

EDWARD ALLYN HUDACKO,

PETITIONER,

REGENTS OF THE UNIVERSITY OF CALIFORNIA, ET AL.,

RESPONDENTS.

On Petition for a Writ of Certiorari to

the United States Court of Appeals

for the Ninth Circuit

BRIEF FOR AMICI CURIAE

OUR DUTY–USA, DR. MICHAEL LAIDLAW,

AND COLORADO PRINCIPLED PHYSICIANS,

IN SUPPORT OF PETITIONER

C. ERIN FRIDAY

OUR DUTY - USA

P.O. Box 442

San Carlos, CA

94070

MARY E. MCALISTER

Counsel of Record

Vernadette R. Broyles

CHILD & PARENTAL RIGHTS

CAMPAIGN, INC.

5425 Peachtree Pkwy, Suite 110

Norcross, GA 30092

(770) 448-4525

mmcalister@childparentrights.org

Counsel for Amici Curiae

TABLE OF CONTENTS

TABLE OF CONTENTS ............................................. i

TABLE OF AUTHORITIES ...................................... iii

INTRODUCTION AND INTEREST OF

AMICI CURIAE .......................................................1

SUMMARY OF ARGUMENT .....................................3

ARGUMENT ...............................................................5

This Case Illustrates Why the Court

Should Resolve the Circuit Split Over

What Materials Inform the “Clearly

Established-Law" Inquiry. .............................5

II.

Qualified Immunity Does Not Shield

Respondents’ Calculated Disregard of a

Known Court Order. .......................................7

The “Clearly Established” Inquiry

Cannot be Limited to Materially

Identical Prior Cases or Qualified

Immunity Will Permanently Shield

the First Violations of its Kind. ............10

Lower Courts Remain Divided Over

Whether

Hope’s

Obviousness

Principle Extends Beyond the

Eighth Amendment...............................12

A Close Factual Analogue is Not

Required Because Respondents

Exercised

Discretionary

Judgment...............................................13

Respondents

Were

Not

Disinterested Actors Confronting a

Novel Question in Good Faith with

Neutrality. .............................................18

Respondents’ Records Reflect the

Lack of Good-Faith DecisionMaking

and

Potential

Fraudulent Billing. .........................18

Respondents Placed SRIs Above

Petitioner’s Parental Rights. ..........20

WPATH’s Own Standards Are

Neither Neutral Nor Settled

Science. ........................................... 22

Respondent

Orr’s

Advocacy

Confirms

Institutional

Interest in the Outcome, Not

Neutral Administration. .................24

III. The Well-Documented Medical Harms in

the

Record

Underscore

the

Egregiousness of Respondents’ Conduct .....25

CONCLUSION ..........................................................27

iii

TABLE OF AUTHORITIES

Cases

Angeli v. Kluka, 192 So. 3d 1209 (Fla. 1st DCA

2016) .......................................................................17

Ashcroft v. al-Kidd, 563 U.S. 731 (2011)). ........ 4, 8, 11

Eknes-Tucker v. Governor of Ala., No. 2:22-cv184-LCB (M.D. Ala.) ..............................................24

Eknes-Tucker v. Governor of Alabama, 80

F.4th 1205 (11th Cir. 2023) .....................................2

Harlow v. Fitzgerald, 457 U.S. 800 (1982). ................8

Hershey v. Bossier City, 156 F.4th 555 (5th

Cir. 2025)................................................................13

Hoggard v. Rhodes, 141 S.Ct. 2421 (2021) 9, 10-11, 14

Hope v. Pelzer, 536 U.S. 730 (2002) ................ 4, 11, 12

Hudacko v. Regents of Univ. of Cal., No. 247360, 2025 WL 2965766 (9th Cir. Oct. 21,

2025) ............................................................. 4, 10, 14

Kisela v. Hughes, 584 U.S. 100 (2018) ....................4, 9

McCoy v. Alamu, 593 U.S. 8 (2021) ..........................11

Medina v. Planned Parenthood S. Atl., 606

U.S. 357 (2025).........................................................9

Mullenix v. Luna, 577 U.S. 7 (2015) .........................14

Parham v. J.R., 442 U.S. 584 (1972) ..........................5

Pearson v. Callahan, 555 U.S. 223 (2009) ..................8

Rosales v. Bradshaw, 72 F.4th 1145 (10th Cir.

2023) .......................................................................13

Schulkers v. Kammer, 955 F.3d 490 (6th Cir.

2020) .......................................................................15

Slone v. Herman, 983 F.2d 107 (8th Cir. 1993) ........15

Taylor v. Riojas, 592 U. S. 7 (2020) ..........................11

Troxel v. Granville, 530 U.S. 57, 65 (2000) .... 4, 10, 15

United States v. Gonzales, 520 U.S. 1 (1997) ...........14

United States v. Lanier, 520 U.S. 259 (1997) ...........11

United States v. Skrmetti, 605 U.S. 495 (2025)......2, 3

Walters v. Grossheim, 990 F.2d 381 (8th Cir.

1993) .......................................................................15

Ziglar v. Abbasi, 582 U.S. 120 (2017) .....................4, 9

Statutes

California Family Code § 3083 ................................16

California Family Code § 6925 .................................16

California Family Code § 6910 .................................16

Other Authorities

Azeen Ghorayshi, U.S. Study on Puberty

Blockers Goes Unpublished Because of

Politics, Doctor Says, N.Y. TIMES (Oct. 23,

2024). ......................................................................22

Brief of Our Duty-USA as Amicus Curiae

Supporting Appellant/Petitioner for

Rehearing, Hudacko v. Regents of Univ. of

Cal., No. 24-7360 (9th Cir. Mar. 3, 2025) .............24

Christel J.M. de Blok et al., Breast Cancer

Risk in Transgender People Receiving

Hormone Treatment: Nationwide Cohort

Study in the Netherlands, 365 BMJ l1652

(2019). .....................................................................27

Dan Chen et al., Psychosocial Functioning in

Transgender Youth after 2 Years of

Hormones, N. ENGL. J. MED. (2023). .....................22

Emily Bazelon, The Battle Over Gender

Therapy, N.Y. TIMES (June 15, 2022). ...................23

Janet Y. Lee et al., Low Bone Mineral Density

in Early Pubertal Transgender/Gender

Diverse Youth: Findings From the Trans

Youth Care Study, 4 J. ENDOCRINE SOC'Y

bvaa065 (2020). ......................................................22

Johanna Olson-Kennedy et al., Histrelin

Implants for Suppression of Puberty in

Youth with Gender Dysphoria: A

Comparison of 50 mcg/Day (Vantas) and 65

mcg/Day (Supprelin LA), 6 TRANSGENDER

HEALTH 36 (2021). .................................................21

Johanna Olson-Kennedy et al., Impact of

Early Medical Treatment for Transgender

Youth: Protocol for the Longitudinal,

Observational Trans Youth Care Study, 8

JMIR RSCH. PROTOCOLS e14434 (2019).................21

Leor Sapir, WPATH: It's Just Our Opinion,

Judge, CITY J. (Aug. 27, 2026)...............................23

National Institutes of Health study, The

Impact of Early Medical Treatment in

Transgender Youth ................................................16

Press Release, Fed. Trade Comm’n, FTC,

States Sue World Professional Association

for Transgender Health Over Deceptive

Claims Regarding the Treatment of Children

(June 17, 2026),......................................................23

Press Release, U.S. Dep’t of Justice, Office of

Pub. Affairs, Justice Department Secures

Agreement with Mount Sinai to End

Pediatric “Gender-Affirming Care” (Sept. 4,

2026), ......................................................................19

Sallie Baxendale, The Impact of Suppressing

Puberty on Neuropsychological Function: A

Review, 113 ACTA PAEDIATRICA 1156 (2024). ........26

Scott A. Keller, Qualified and Absolute

Immunity at Common Law, 73 STAN. L. REV.

1337, 1347-49 (2021)..............................................15

vii

U.S. Dep’t of Health & Human Servs., Wolves

in White Coats: How Doctors and Hospitals

Pushed and Profited from the Fraud of

“Gender Medicine”, at 9, 15, 17 (Aug. 13,

2026). ......................................................................20

U.S. Dept. Of Health and Human Services,

Treatment for Pediatric Gender Dysphoria:

Review of Evidence and Best Practices (Nov.

2025) ............................................................. 1, 26, 27

UCSF Child & Adolescent Gender Ctr.,

Pioneering UCSF Clinic Helps Transgender

Youth Be Themselves (Nov. 23, 2015) ...................20

UCSF Health Risk Mgmt., Toolbox for Patient

Care ........................................................................17

INTRODUCTION AND

INTEREST OF AMICI CURIAE 1

Our Duty-USA is a secular nonprofit whose

nationwide

members

have

varied

political

backgrounds, ethnicities, and sexual orientations but

share the experience of raising former and current

trans-identified children. Our Duty members also

have children who have ceased identifying as

“transgender” after adopting that identity. Many have

had their parental rights ignored when they tried to

be involved in the medical decisions for their children

and have experienced acute coercion from medical

providers who wished to subject confused children to

irreversible medical procedures.

Michael Laidlaw, MD is a university-trained,

board-certified endocrinologist in private practice for

twenty years. He has co-authored many medical

publications on the topic of gender dysphoria,

including the U.S. Department of Health and Human

Services’ peer-reviewed study of the evidence for

pediatric gender-transition interventions (“the HHS

Review”). 2 He has served as an expert witness in

All parties were timely notified of the filing of this brief.

This brief was not authored in whole or in part by counsel for any

party and no person or entity other than amici curiae or their

counsel has made a monetary contribution toward the brief’s

preparation or submission.

U.S. DEPT. OF HEALTH AND HUMAN SERVICES,

TREATMENT FOR PEDIATRIC GENDER DYSPHORIA: REVIEW OF

EVIDENCE

AND

BEST

PRACTICES (Nov.

2025)

https://opa.hhs.gov/gender-dysphoria-report.

numerous legal cases involving adolescent gender

dysphoria, including United States v. Skrmetti, 605

U.S. 495 (2025), in which this Court upheld a state’s

prohibition on sex-rejecting interventions for minors,

and Eknes-Tucker v. Governor of Alabama, 80 F.4th

1205 (11th Cir. 2023) (also captioned Boe v. Marshall).

Colorado Principled Physicians is a nonprofit

organization whose members have varied political

backgrounds. Its membership includes physicians in

the state of Colorado who offer services to their

patients as guided by the Hippocratic Oath: First, do

no harm. They understand that this Oath requires

rejecting medical interventions that damage their

patients’ health. Colorado Principled Physicians has a

direct interest in this case as its members believe that

medicalization of perfectly healthy young bodies is

antithetical to the practice of medicine.

Amici have significant interest in the

preservation of parental rights and in ending the

promotion of a belief system that reflexively affirms

any wrong-sex identification and encourages

individuals to believe there can be a mismatch

between their brains and bodies. Amici’s goal, that

children grow up accepting their immutable sex

regardless of whether they conform to rigid

stereotypes of that sex, is thwarted when state actors

trample on parents’ inalienable rights to protect their

children from harmful and unnecessary medical

treatment.

SUMMARY OF ARGUMENT

As this Court has recognized, our society has

been grappling with “the weight of fierce scientific and

policy debates about the safety, efficacy, and propriety

of [gender dysphoria] treatments in an evolving field.”

Skrmetti, 605 U.S. at 525. The debate over

transgenderism touches nearly every institution in

American life. This case sits at its most consequential

intersection—parenting itself.

At its core, this case asks whether a state actor

may disregard the clear, unambiguous language of a

family court order that required the consent of both

parents, or a further court order, before subjecting a

child to a medical intervention designed to halt that

child’s naturally occurring puberty. It also asks

whether sophisticated state actors may, without

consequence, violate one of this Nation’s oldest

fundamental rights: the right to direct the upbringing

of one’s child.

The lower court erroneously answered the

question in the positive based on a misapplication of

the doctrine of qualified immunity, a defense that has

been stretched well beyond its origins into a nearcategorical shield against all but the most egregious

constitutional violation that has not been blessed by

precedent squarely on point.

Justice Thomas has warned that this Court has

drifted from the common law immunities that existed

when the Civil Rights Act of 1871 was enacted toward

a regime that treats immunity as the default. Ziglar

v. Abbasi, 582 U.S. 120, 159 (2017) (Thomas, J.,

concurring in part and concurring in the judgment)

(quoting Ashcroft v. al-Kidd, 563 U.S. 731, 741

(2011)). Justice Sotomayor has likewise cautioned

that qualified immunity should be restrained. Kisela

v. Hughes, 584 U.S. 100, 121 (2018) (Sotomayor, J.,

dissenting).

This case shows why that caution is warranted

and why the Supreme Court should weigh in. The

Ninth Circuit held below that Hudacko cited no

clearly established law creating a parental liberty

interest in this precise context, notwithstanding the

panel’s own acknowledgment that parents’ rights of

parents in the “care, custody, and control of their

children” are well-established. Hudacko v. Regents of

Univ. of Cal., No. 24-7360, 2025 WL 2965766, at *4

(9th Cir. Oct. 21, 2025) (quoting Troxel v. Granville,

530 U.S. 57, 65 (2000)). Setting aside the fact that a

minor child’s purported consent cannot lawfully

override a parent’s own —a principle this Court has

long recognized 3 — the panel’s limiting interpretation

of “existing precedent” effectively immunizes any

first-of-its-kind

violations

established

constitutional rights. This court’s guidance is needed

to clarify the “clearly established” standard, including

whether the obviousness principle recognized in Hope

v. Pelzer, 536 U.S. 730 (2002) extends beyond the

Eighth Amendment.

The well-pled facts here demonstrate that

reasonable officials in Respondents’ positions would

Parham v. J.R., 442 U.S. 584 (1972).

have known their conduct was unlawful. California

law has long required parental consent for a minor’s

medical treatment. This edict is neither novel nor

obscure. Respondents, moreover, were not naïve or

uninformed actors. They were sophisticated

professionals who possessed the governing custody

order and proceeded in contravention of that order, to

surgically implant a puberty-suppressing mechanism

in Petitioner’s son.

The last part of this brief details the medical

harms associated with puberty blockers, underscoring

the gravity of Respondents’ neglect of the legal

framework and departure from a reasonable standard

of care.

ARGUMENT

This Case Illustrates Why the Court

Should Resolve the Circuit Split Over

What Materials Inform the “Clearly

Established-Law" Inquiry.

This case presents the Court with a question of

national significance, and one on which the circuits

are deeply split, regarding the breadth of its qualified

immunity jurisprudence. The district court granted

Respondents’ motion to dismiss Hudacko’s §1983

parental rights claim on qualified immunity grounds.

This, despite the fact that Hudacko clearly alleged

that Respondents were aware of the custody order

requiring either Hudacko’s consent or a court order

before performing any gender surgery on Hudacko’s

child, were aware that Hudacko had not consented

and that there had not been a court order, and were

manifestly aware—despite the Ninth Circuit panel’s

assertions to the contrary—that the procedure they

performed was “surgery.”

The factual allegations in this case are simple.

Hudacko lost almost all legal custody over one of his

two sons. He was obviously a good enough parent to

retain custody of his non-trans-identified son, but

because his belief that sex-rejecting interventions

(“SRIs”) would be harmful to his other son, S.H., a

family court judge deemed him unworthy to parent

him. 4 Simply, bad parents are those who refuse to

alter their child’s body to mimic the opposite sex

regardless of the medical risks. The fact that Hudacko

retained power over “gender identity related surgery”

was a small miracle, given that the beliefs of his judge,

the minor’s counsel, UCSF’s attorney and the medical

providers treating his trans-identified son, were

contrary to his own.

Judge Hiromoto, the judge who decided

Hudacko’s custody case, has a trans-identified son 5

herself, a fact she publicly announced during a CLE

course. Following Judge Hiromoto’s resolution of

Hudacko’s family court matter, she participated,

along with Respondents Asaf Orr and Daniel Harkins,

minor’s counsel, in a Contra Costa County Bar

153a.

See Petitioner’s Appendix (“Pet. Appx.”) at 147a, 150a-

For purposes of accuracy, amici use scientific sex-based

terms; thus, the judge’s “son” refers to his immutable sex, not his

chosen female identity.

Association CLE program for minor’s counsel, during

which the presenters discussed Hudacko’s case and

provided the participants with access to the case

documents. 6 During that program, Judge Hiromoto

stated that Respondent Harkins, “went in and

systematically debunked all of the studies that [she]

was given by [Hudacko] in opposition,” and held

Harkin’s report up as a model, explaining that what

attracted her to it was its “objective view” grounded in

“the science,” and advising them that minor’s

counsel’s own reports should likewise identify “the

parent who should be given the decisions in this

area.” 7 Moreover, each of S.H.’s medical providers

were stalwart advocates of pediatric SRIs as more

fully discussed in Section II.D, below.

II.

Qualified Immunity Does Not Shield

Respondents’ Calculated Disregard of a

Known Court Order.

The judicially created doctrine of qualified

immunity shields government officials from liability

See, recording of Contra Costa County Bar Ass’n Fam. L.

Section, Gender and Transgender Issues in Custody Matters (Oct.

2022),

saved

with

transcription

added

https://rumble.com/v44zo9i-gender-and-transgender-issueswith-largesubtitles.html?e9s=src_v1_sa%2Csrc_v3_sa_o%2Csrc_v1_upp_a

Counsel for amici personally attended the program. Up until late

August of 2026, the link created by the program itself was

available through the course provider. Suspiciously, it was

recently been taken down. However, the recording was saved to

the Rumble platform.

Id. at minutes 36:02–38:21.

so long as their actions do not violate clearly

established rights of which a reasonable person would

have known. See Harlow v. Fitzgerald, 457 U.S. 800,

818 (1982). There are two prongs to the qualified

immunity inquiry: (1) whether the government

official’s conduct violated a plaintiff’s constitutional

right and (2) whether that right was clearly

established at the time of the alleged violation. See

Pearson v. Callahan, 555 U.S. 223, 232 (2009).

“Qualified immunity gives government officials

breathing room to make reasonable but mistaken

judgments about open legal questions. When properly

applied, it protects ‘all but the plainly incompetent or

those who knowingly violate the law.’” Ashcroft, 563

U.S. at 743.

Because the doctrine of qualified immunity offers

immunity from suit, not just a defense to liability, it

serves as a complete blockade, preventing courts from

delineating the specific contours of constitutional

rights, such as the fundamental parental right to

make medical decisions for one’s child at issue in this

case. See Pearson, 555 U.S. at 236. Thus, because

courts never reach the issue of whether a

constitutional right was violated, instead tossing the

case out because the right was not “clearly

established,” under the specific fact pattern in a given

case, the law is never able to develop, no new fact

patterns violating established rights can ever be

delineated, and plaintiffs are left completely without

remedy when their rights are trampled upon.

As justices of this Court have noted, qualified

immunity doctrine has strayed far from its initial

roots when it was judicially created. Justice Thomas,

for example, has made clear that he believes that the

qualified immunity doctrine, is “on shaky ground.”

Hoggard v. Rhodes, 141 S.Ct. 2421 (2021)(Thomas, J.,

statement respecting denial of certiorari). This

statement follows from his broader point that

qualified immunity has expanded well beyond the

common-law doctrines of good faith and probable

cause that originally gave rise to it. See Ziglar, 582

U.S. at 158–159. In light of the expansion of the

doctrine, which he characterized as “representing

precisely the sort of free-wheeling policy choices that

the Court has previously disclaimed the power to

make” and “substituting the Court’s own policy

preferences for the mandates of Congress,” Justice

Thomas asserted that the Court should “reconsider its

qualified immunity jurisprudence” in the appropriate

case. Id. at 159–160 (quotation marks and citation

omitted) (cleaned up). Last year, Justice Thomas

renewed his call to revisit the doctrine’s proper

bounds. Medina v. Planned Parenthood S. Atl., 606

U.S. 357, 391 (2025) (Thomas, J., concurring). Justice

Sotomayor has likewise cautioned, in dissent, that

qualified immunity should not become an “absolute

shield” against constitutional accountability. See

Kisela, 584 U.S. at 109.

The state doctors and attorney for the state

hospital in Hudacko’s case are not the sort of officials

who enjoyed common law immunity. The purported

justification for shielding officials from liability

through qualified immunity—giving them breathing

room for error where split-second decisions need to be

made, such as police officers reacting in the moment

to a potentially dangerous situation—is also lacking

here. No exigent circumstances were present and

Respondents had a great deal of time to consider the

situation and the ramifications of their decision.

As Justice Thomas pointed out, it does not make

sense for state actors like these, “who have time to

make calculated choices about enacting or enforcing

unconstitutional policies” to “receive the same

protection as a police officer who makes a split-second

decision to use force in a dangerous setting.” Hoggard,

141 S.Ct. at 2421-2422.

This case is the perfect vehicle for the Court to

bound the reach of qualified immunity while not

disturbing immunity for officers making crucial splitsecond, life-or-death judgment calls.

A. The

“Clearly

Established”

Inquiry Cannot be Limited to

Materially Identical Prior Cases

or Qualified Immunity Will

Permanently Shield the First

Violations of its Kind.

The lower court held that Hudacko’s right to

direct his minor son’s medical treatment was not

“clearly established” because no prior case addressed

whether a hospital and its physicians violate a

father’s constitutional rights by performing SRIs in

contravention of a court order and his objection.

Hudacko, 2025 WL 2965766, at *4. That holding is

difficult to square with the panel’s own

acknowledgment that “the rights of parents in the

‘care, custody, and control of their children’ is a wellestablished liberty interest under the Fourteenth

Amendment.” Id. (quoting Troxel, 530 U.S. at 65). The

level of specificity the Ninth Circuit required is overly

granular and leads to the inevitable result that a

constitutional right can never become clearly

established in the context of novel fact patterns. A

rule that requires precedent with nearly identical fact

patterns before any violation can be “clearly

established” does not calibrate immunity to

reasonable mistakes of law, but manufactures a static

blockade that no plaintiff, however egregiously

wronged, can ever overcome the first time a particular

abuse of power occurs. This self-perpetuating defect

leaves the right un-clearly established for the next

parent, the next child, and the next hospital that

repeats the same conduct, regardless of how many

plaintiffs experience a similar constitutional

violation.

This Court has held that qualified immunity does

not require “a case directly on point,” Ashcroft, 563

U.S. at 741, and that officials may be on notice their

conduct is unlawful “even in novel factual

circumstances,” where a general constitutional rule

applies with “obvious clarity.” Hope, 536 U.S. at 741;

accord Taylor v. Riojas, 592 U. S. 7, 8–9 (2020) (per

curiam) (no closely analogous case required where

“any reasonable officer should have realized” the

violation); McCoy v. Alamu, 593 U.S. 8 (2021 (per

curiam) (remanding for failure to consider Taylor’s

obviousness principle).

The demand for a materially similar prior case

was, in fact, already rejected by this Court in the very

decision Hope relied upon. In United States v. Lanier,

520 U.S. 259, 271 (1997) this Court held that the

“clearly established” standard governing civil

qualified immunity and the “fair warning” standard

governing criminal liability under 18 U.S.C. section

242 are the same test in different postures, because

“the qualified immunity test is simply the adaptation

of the fair warning standard” to the civil context. Id.

at 270-271. Lanier directly rejected any requirement

that prior decisions involve a “fundamentally similar”

factual situation, holding that convictions may stand,

and immunity by extension may be denied, “despite

notable factual distinctions between the precedents

relied on and the cases then before the Court, so long

as the prior decisions gave reasonable warning that

the conduct then at issue violated constitutional

rights.” Id. at 269. This holding was not limited to

Lanier’s facts.

The Court granted certiorari in Hope specifically

to decide whether the Eleventh Circuit’s demand for

materially similar precedent “comport[ed] with our

decision in Lanier,” and held that it did not, because

Lanier “makes clear that officials can still be on notice

that their conduct violates established law even in

novel factual circumstances.” Hope, 536 U.S. at 730,

741. Thus, the Ninth Circuit’s demand for a

materially identical prior case is contrary to Hope.

B. Lower Courts Remain Divided

Over

Whether

Hope’s

Obviousness Principle Extends

Beyond the Eighth Amendment. 8

The confusion this Court is implored to resolve is

whether the obviousness standard extends beyond

Eighth Amendment cases, an inquiry Justice Thomas

Petition identifies this conflict on page 33.

has invited in Hoggard, 141 S.Ct. at 2421-2422. The

Fifth Circuit in Hershey v. Bossier City, 156 F.4th 555,

559 (5th Cir. 2025) (Ho, J., concurring) limited Hope

and Taylor to “the Eighth Amendment claims of

incarcerated criminals”, but the Tenth Circuit applied

the obviousness standard to a Fourth Amendment

claim. See Rosales v. Bradshaw, 72 F.4th 1145, 1156–

59 (10th Cir. 2023).

Lower courts have not merely neglected Hope,

but have split over its very availability outside the

prison context, a division with direct consequences for

Respondents, who fall squarely within the category of

state actors who lack historical common-law

immunity. 9 Whether Hershey’s categorical limitation

would apply to bar Respondents from invoking Hope’s

more lenient standard, a limitation with no

counterpart in this Court’s own precedent, is a

question worthy of this Court’s guidance.

C. A Close Factual Analogue is Not

Required Because Respondents

Exercised

Discretionary

Judgment.

The

“discretionary

judgment”

premise

underlying

qualified

immunity’s

specificity

requirement is absent from these facts so the Court

need not resort to the closely analogous precedent

standard.

Qualified immunity’s demand for

particularized precedent exists to protect officials

The result is a doctrine that extends its most protective

standard to those in custodial or criminal settings while leaving

parents and other law-abiding citizens with no comparable

safeguard.

making split-second or genuinely ambiguous

judgment calls, such as the officer deciding whether a

fleeing suspect poses a threat, Mullenix v. Luna, 577

U.S. 7, 12 (2015). Respondents faced no such dilemma.

The custody order governing medical decisionmaking for S.H. required that Petitioner consent to

“any gender identity related surgeries” without

exception. 10 Respondents were aware of the custody

agreement as of September 29, 2020, almost a year

before the surgery. 11 Respondents and S.H.’s mother

were considering the surgical implant as of February

2021. 12 S.H.’s mother took time to preserve her son’s

sperm. 13 Respondents knew that Hudacko would not

consent. 14 No one made an effort to get a clarifying or

overriding court order. Respondents “rolled the dice”

because their desire to block S.H.’s puberty

outweighed their fear that Hudacko would be able to

successfully sue them for violating his parental rights.

The Ninth Circuit erroneously “put aside the

custody order” in its ruling as if the order carried no

legal force. 15 That is incorrect. A hospital that

proceeds against the specific terms of a known court

order is not exercising the kind of discretionary

judgment that the clearly established inquiry was

designed to protect, Instead, it is disregarding a

Pet. Appx. at 152a. Read naturally, “any” “has an

expansive meaning, that is, ‘one or some indiscriminately of

whatever kind.’” United States v. Gonzales, 520 U.S. 1, 5 (1997).

Pet. Appx. at 157a.

Id. at 161.

Id. at 236a.

Pet. Appx. at 170a-171a.

Hudacko, 2025 WL 2965766, at *2.

known, particularized, ministerial command. Cf.

Scott A. Keller, Qualified and Absolute Immunity at

Common Law, 73 STAN. L. REV. 1337, 1347-49 (2021)

(common-law immunity as of 1871 protected

discretionary duties requiring judgment, not the

disregard of specific legal commands). Objective

reasonableness cannot include violating a court order.

See Walters v. Grossheim, 990 F.2d 381, 384 (8th Cir.

1993) (denying qualified immunity because

noncompliance with a court order “was not objectively

reasonable,” even where the official relied on advice of

counsel); Slone v. Herman, 983 F.2d 107, 110 (8th Cir.

1993) (qualified immunity doctrine unavailable where

officials “disagreed with a court order”).

The Sixth Circuit confronted a strikingly similar

dynamic in Schulkers v. Kammer, 955 F.3d 520 (6th

Cir. 2020). There, state social workers continued to

enforce a “Prevention Plan” barring a mother from

being alone with her children, even after their own

supervisor instructed them to lift the restriction. Id.

at 545. The court denied qualified immunity for the

parents’ due process claims without pointing to any

materially similar case, holding instead that the

“fundamental right of parents to make decisions

concerning the care, custody, and control of their

children” was itself sufficient, because family

integrity is “the paradigmatic example of a

substantive due process” liberty interest. Id. at 540

(quoting Troxel, 530 U.S. at 66).

Critically, what defeated immunity in Schulkers

was not a factually matched precedent but the

officials’ continued disregard of a specific instruction,

which is precisely Respondents’ posture here. If a

supervisor’s internal directive was enough to place the

social workers on clear notice, a standing judicial

order, carrying far greater legal force, places

Respondents on equal notice.

A Supprelin implant is a surgical procedure.

First, the manufacturer explicitly describes the

implant as a “surgical procedure.” 16 Second, S.H.‘s

insurer calls the procedure a surgery. 17 Either

Respondents

fraudulently

billed

Hudacko’s

insurance, or it was a surgery. Third, Respondents

cannot feign ignorance, as UCSF was a participant in

the ten-million-dollar National Institutes of Health

study, The Impact of Early Medical Treatment in

Transgender Youth, (“NIH Study”) about these very

procedures.

California law independently forecloses any

claim of reasonable uncertainty. California Family

Code §6910 defines who may consent to a minor’s

medical care with section 6925 forbidding sterilitycausing interventions without parental consent, and

section 3083 confirms that parental authority to

exercise legal control turns on legal custody as defined

by the governing order. Respondents had the order,

and the fact that they disregarded it and proceeded

based on their own desired goals without seeking

further court guidance is not sufficient to provide

them immunity. Outside the transgender culture-war

context, it is difficult to imagine a court permitting

medical providers to rely on their own construction of

a court order to proceed with a non-emergency,

Pet. Appx. at 202a.

Id. at 160a.

sterilizing surgery over the express objection of a

parent who held veto power over precisely that

decision. 18

The standard Respondents violated was not novel

to their own institution either. UCSF’s own “Toolbox”

for providers from 2024 instructs staff in terms that

track settled California law rather than announces

anything new. Namely, it directs that when there is

“disagreement between parents about treatment,”

“[t]reatment should not be provided until the conflict

is resolved,” providers must “[a]lways ask for the court

documents in order to determine the legal rights of the

parents” and where the parents cannot resolve the

conflict and time permits, “the parents should get a

court order.” 19

UCSF’s articulation to its own staff of the

standard of conduct a reasonable provider in

Respondents’ position was required to follow was

based on the underlying legal standard of the

California

Family

Code,

which

pre-dates

Respondents’ actions. An actor who deviates from

settled law and his own institution’s written policy on

precisely the question presented has forfeited any

claim to qualified immunity.

Cf. Angeli v. Kluka, 192 So. 3d 1209 (Fla. 1st DCA

2016)(surgeon not liable for proceeding over a father’s objection

where no court order specified whose consent controlled). The

absence of an order is dispositive in distinguishing Angeli here.

UCSF Health Risk Mgmt., Toolbox for Patient Care, at 2,

https://web.archive.org/web/20240525153742/https://rm.ucsfme

dicalcenter.org/sites/g/files/tkssra3726/f/wysiwyg/Child_Custody

_and_Consent.pdf (last visited Sept. 4, 2026).

The Ninth Circuit completely ignored these facts.

Nor did the Ninth Circuit ever answered whether

state medical providers who know that consent is

required for medical procedures on children through

California law and their own institutions policies, has

a court order that states no surgeries are to be

performed without the father’s consent, and who has

billed for an intervention as a surgery, is merely

mistaken as opposed to “plainly incompetent or

knowingly violating the law.” Clearly the answer is

the latter.

D. Respondents

Were

Not

Disinterested Actors Confronting

a Novel Question in Good Faith

with Neutrality.

Respondents’ claim for qualified immunity

depends on the premise that reasonable officials in

their position could have believed that they could

proceed with the surgery without Hudacko’s consent.

That premise assumes the Respondents were neutral

and disinterested professionals applying settled

medical consensus, not architects of the medical

interventions they performed on S.H.

Respondents’

Records

Reflect the Lack of GoodFaith Decision-Making and

Potential

Fraudulent

Billing.

The Respondents were laser-focused on

subjecting S.H. to SRIs. On June 8, 2021, Respondent

Rosenthal documented that S.H. would receive

estrogen and a puberty blocker. 20 That progress note

failed to reflect a diagnosis of gender dysphoria.

Instead, it states only that a gender “checklist” had

been completed. 21

On August 4, 2021, a Supprelin puberty-blocker

was surgically implanted into S.H. at a hefty cost of

$209,820.34. 22 By February of 2022, per Dr. Laidlaw’s

review of S.H.’s records, Dr. Rosenthal’s progress note

reflects a new diagnosis of “Endocrine Disorder.” This

designation is now known to be used to hide from

insurance carriers that the treatments are related to

SRIs. Just as billing for a procedure as surgery and

then denying that the procedure was surgery is likely

insurance fraud, this change in diagnosis raises an

insurance fraud question—the type of fraudulent

billing practices that are being investigated by the

U.S. Department of Justice. 23

HHS’s recent report on billing practices in

pediatric gender medicine identifies this exact

pattern—an endocrine-disorder code substituted for a

gender-related diagnosis—as a nationwide practice

generating over $40 million in puberty-blocker

billings, and findings that pediatric gender clinics

Pet. Appx. at 169a-171a.

Id.

Pet. Appx. at 239a.

See Press Release, U.S. Dep’t of Justice, Office of Pub.

Affairs, Justice Department Secures Agreement with Mount

Sinai to End Pediatric “Gender-Affirming Care” (Sept. 4, 2026),

https://www.justice.gov/opa/pr/justice-department-securesagreement-mount-sinai-end-pediatric-gender-affirming-care.

“functioned as a revenue booster” for hospital

systems. 24

Respondents Placed SRIs

Above Petitioner’s Parental

Rights.

Respondents were neither disinterested nor

inexperienced actors confronting an unsettled

question in good faith. UCSF built a culture of

sidelining parents. UCSF’s own institutional

materials confirm how it views parental rights. A

UCSF Child and Adolescent Gender Center (CAGC)

transition policy document provided to S.H. dated

February 20, 2022, and reviewed by Amici Laidlaw

states that “starting at age 16 years,” the clinic will

“spend

time

during

visits

without

your

parent/guardian present.”

In addition, each of the Respondents was

personally invested in SRIs for minors. Dr. Rosenthal

was the co-founder of the CAGC, a co-author of

WPATH’s Standards of Care,” Version 8 (“SOC 8”),

who now serves as its treasurer, and one of the

principal investigators for the NIH Study. 25

U.S. Dep’t of Health & Human Servs., Wolves in White

Coats: How Doctors and Hospitals Pushed and Profited from the

Fraud of “Gender Medicine”, at 9, 15, 17 (Aug. 13, 2026).

UCSF Child & Adolescent Gender Ctr., Pioneering UCSF

Clinic Helps Transgender Youth Be Themselves (Nov. 23, 2015)

https://www.ucsf.edu/news/2015/11/284401/pioneering-ucsfclinic-helps-transgender-youth-be-themselves;

World

Prof’l

Ass’n for Transgender Health, Standards of Care for the Health

of Transgender and Gender Diverse People, Version 8: Full

Contributor

List

(updated

July

26,

2021),

https://www.wpath.org/wp-content/uploads/2024/11/SOC8-Full24

Respondent Diane Ehrensaft was also a co-founder of

CAGC, contributor to SOC 8, and along with Dr. Lee,

a co-investigator on the NIH Study. 26

Respondent Rosenthal and Dr. Johanna OlsonKennedy who led the NIH Study, have coauthored at

least sixteen studies since 2016 relating to that study

or to pediatric SRIs generally. Several of those

publications raise questions relevant to the bias of

Rosenthal. One examined the same category of

puberty-blocker implant S.H. received and stated its

purpose in part was to inform “decisions about

insurance coverage of Supprelin and/or Vantas for

youth with gender dysphoria,” while collecting no

safety data, reserving that for an unspecified future

study. 27 What is more, Rosenthal served on the

Advisory Board for Endo Pharmaceuticals, the

manufacturer of Supprelin. 28

A related arm of the NIH study was designed to

track bone density in puberty-blocker recipients, a

Contributor-List-FINAL-UPDATED-09232021.pdf;

WPATH,

Executive

Committee

and

Board

Directors,

https://wpath.org/about/EC-BOD/ (last visited Sept. 3, 2026);

Johanna Olson-Kennedy et al., Impact of Early Medical

Treatment for Transgender Youth: Protocol for the Longitudinal,

Observational Trans Youth Care Study, 8 JMIR Rsch. Protocols

e14434 (2019).

See notes 25, 27 and 28.

Johanna Olson-Kennedy et al., Histrelin Implants for

Suppression of Puberty in Youth with Gender Dysphoria: A

Comparison of 50 mcg/Day (Vantas) and 65 mcg/Day (Supprelin

LA), 6 TRANSGENDER HEALTH 36 (2021).

See also, SUPPRELIN LA (histrelin acetate)

Prescribing Information, Endo USA, Inc.,

https://www.accessdata.fda.gov/drugsatfda_docs/label/2012/022

058s009lbl.pdf (last visited Sept. 7, 2026).

population-level concern given the risk described in

Part III below. Baseline results were published in

2020, 29 but to the amici’s knowledge, the final results

have never been published. When asked by the New

York Times in 2024 why the data had not been

released, Dr. Olson-Kennedy stated she feared the

results would be “weaponized” politically. 30

A separate published arm of the same study

followed 315 adolescents aged twelve to twenty who,

like S.H., were taking high-dose cross-sex hormones.

Two of the 315 subjects died by suicide during the

study period, and the authors identified suicidal

ideation, present in eleven subjects, as the most

common adverse event reported. 31

WPATH’s Own Standards

Are Neither Neutral Nor

Settled Science.

WPATH’s own conduct reveals an organization

that tolerates no genuine dissent internally, while

insisting publicly that its guidance is settled science,

until that guidance was challenged in court. Facing

suit by the Federal Trade Commission and four

Janet Y. Lee et al., Low Bone Mineral Density in Early

Pubertal Transgender/Gender Diverse Youth: Findings From the

Trans Youth Care Study, 4 J. Endocrine Soc’y bvaa065 (2020).

Azeen Ghorayshi, U.S. Study on Puberty Blockers Goes

Unpublished Because of Politics, Doctor Says, N.Y. Times (Oct.

23, 2024).

Dan Chen et al., Psychosocial Functioning in

Transgender Youth after 2 Years of Hormones, N. ENGL. J. MED.

(2023).

states 32 over the same Standards of Care two

Respondents helped author, WPATH has now

disclaimed SOC-8’s authority entirely, arguing in its

motion to dismiss that the document is merely

“opinion” addressing an area of “medical and scientific

uncertainty,” not a trustworthy clinical standard. 33

Historically, WPATH has enforced a culture of

intolerance for dissent for years. When longtime

member Dr. Kenneth Zucker, cited fifteen times in the

Standards of Care version 7, reported that most young

children referred to his clinic stopped identifying as

transgender by adulthood, protestors disrupted his

presentation at a USPATH conference. WPATH’s

response was to cancel his next lecture. 34 Zucker was

the psychologist whom Hudacko asked Judge

Hiromoto to assess S.H. She declined the request. 35

The ill-repute of WPATH was publicly displayed

in Eknes-Tucker, where its internal communications

In June 2026, the Federal Trade Commission and four

states sued WPATH, alleging that the organization provided

medical providers the means to make false and unsubstantiated

claims to parents in order to sell pediatric gender-transition

services. Press Release, Fed. Trade Comm’n, FTC, States Sue

World Professional Association for Transgender Health Over

Deceptive Claims Regarding the Treatment of Children (June 17,

2026), https://www.ftc.gov/news-events/news/pressreleases/2026/06/ftc-states-sue-world-professional-associationtransgender-health-over-deceptive-claims-regarding-treatmentchildren.

Leor Sapir, WPATH: It's Just Our Opinion, Judge, City

J. (Aug. 27, 2026), https://www.city-journal.org/article/wpath-ftclawsuit-gender-medicine.

Emily Bazelon, The Battle Over Gender Therapy, N.Y.

TIMES (June 15, 2022).

Pet. Appx. at 153a.

produced in discovery included admissions that its

authors failed to properly apply the GRADE

evidentiary

framework

and

suppressed

unfavorable systematic review from Johns Hopkins;

omitted any chapter addressing the ethics of the

interventions it recommends; used the term

“recommend” for interventions its own authors

acknowledged lacked supporting literature; aimed its

guidance toward securing insurance coverage and

litigation protection; and removed age minimums for

SRIs for political reasons, over the objection of its own

experts. 36

Respondent Orr’s Advocacy

Confirms an Institutional

Interest in the Outcome,

Not

Neutral

Administration.

Respondent Orr, attorney for UCSF, was also

involved in the NIH Study. 37 In his self-authored

LinkedIn summary, Orr describes his work as

including efforts to “expand access to transitionrelated care for Medicaid recipients, including

puberty-delaying medications and facial feminization

surgery,” and to support “attorneys representing

affirming parents in custody disputes around the

2d Supp. Expert Report of Michael K. Laidlaw, M.D. at

6-40, Eknes-Tucker v. Governor of Ala., No. 2:22-cv-184-LCB

(M.D. Ala.).

Brief of Our Duty-USA as Amicus Curiae Supporting

Appellant/Petitioner for Rehearing, Hudacko v. Regents of Univ.

of Cal., No. 24-7360 (9th Cir. Mar. 3, 2025), ECF No. 13.2.

country.” 38 By his own account, Orr’s professional

mission includes advocating for the parent who favors

transition-related treatment in the very type of

custody dispute presented here — not the neutral

administration of legal interests. Orr is also one of the

authors of Schools in Transition, the guide that

counsels that granting custody to the “affirming

parent” is in the best interest of the child and contains

exemplars for schools to create social transition plans

without parental knowledge. 39

This is the backdrop against which this Court

needs to decide if qualified immunity protects these

Respondents. Were they just mistaken government

officials or purposeful advocates of these controversial

treatments?

III.

The Well-Documented Medical Harms in

the Record Underscore the Egregiousness

of Respondents’ Conduct.

Gonadotropin-releasing

hormone

agonists,

commonly called puberty blockers, act on the pituitary

gland to halt the signaling that triggers puberty. They

do not carry an FDA-approved indication for treating

Asaf

Orr,

Profile,

https://www.linkedin.com/in/asaforresq/ (archived and last

visited on Sept. 5, 2026).

Asaf Orr et al., Schools in Transition: A Guide to

Supporting Transgender Students in K-12 Schools (Aug.3, 2015)

pages

33,

–

59.

https://assets.aclu.org/live/uploads/publications/schools_in_tran

sition_6.3.16.pdf (last visited on Sept. 5, 2026.

gender dysphoria. 40 They are, however, being

administered off-label to children who are beginning

or proceeding through normal pubertal development,

halting that healthy development and, in males,

sharply lowering testosterone and suppressing sperm

production. 41

The medical literature documents several

serious, and, in some respects, irreversible,

consequences of this off-label use. First, infertility and

sexual dysfunction: the addition of cross-sex

hormones such as estrogen may cause permanent

testicular damage and sterility. 42 Second, impaired

bone development: puberty is the period in which peak

bone density is established, and suppressing puberty

can prevent a patient from ever attaining that peak,

exposing him to a lifelong elevated risk of serious bone

fractures. 43 Third, effects on brain development: the

suppression of puberty has been shown to affect brain

structure and the development of social and cognitive

function, with effects that are complex and often sexspecific. 44 Fourth, high-dose cross-sex estrogen, used

off-label to alter secondary sex characteristics in natal

males, produces abnormally elevated estrogen levels

associated

with

increased

risk

thromboembolism, 45 a 46-fold increased incidence of

breast cancer relative to males not undergoing SRIs,

Pet. Appx. at 162a and 166a.

HHS Review, supra n. 2 at 116.

Id. at 125.

Id. at 116-117.

Sallie Baxendale, The Impact of Suppressing Puberty on

Neuropsychological Function: A Review, 113 ACTA PAEDIATRICA

1156 (2024).

HHS Review, supra note 2 at 126-27.

though the absolute risk remains lower than that of

females, 46 brain neoplasms including meningiomas

and prolactin-secreting tumors, 47 and sexual

dysfunction including decreased libido and erectile

dysfunction. 48

CONCLUSION

For the aforementioned reasons, Amici Curiae

respectfully ask this Court to grant the petition for

certiorari.

September 9, 2026

MARY E. MCALISTER

Counsel of Record

Vernadette R. Broyles

CHILD & PARENTAL RIGHTS CAMPAIGN

5425 Peachtree Pkwy, Suite 110

Norcross, GA 30092

(770) 448-4525

mmcalister@childparentrights.org

C. ERIN FRIDAY

OUR DUTY - USA

P.O. BOX 442

San Carlos, CA 94070

Counsel for Amici Curiae

Christel J.M. de Blok et al., Breast Cancer Risk in

Transgender People Receiving Hormone Treatment: Nationwide

Cohort Study in the Netherlands, 365 BMJ l1652 (2019).

Lourdes Villa-Zapata & Andrea Gomez-Lumbreras,

Reply: Exploring Safety in Gender-Affirming Hormonal

Treatments, 59 ANNALS OF PHARMACOTHERAPY 493 (2025).

HHS Review, supra note 2 at 128.

This is a copy of a public record, reproduced as it was published. It is not legal advice, and it may not be the version a court would rely on. Check the official source before you cite it.