Given Consent to Remove One Ovary, Surgeon Excises Both

A patient who identifies as transgender and "nonbinary"—neither male nor female—has sued a Utah surgeon for breaching her duty of care during a gynecologic procedure to relieve the patient's acute "menstruation problems," according to a July 30 report in the Salt Lake Tribune.[1]

In early 2015, after enduring painful menstrual periods that could last for several weeks, Lesley Ann Shaw consulted with ob/gyn Rixt Luikenaar, MD, in Utah, who 5 years earlier had begun devoting much of her practice to working with transgender and gender-nonconforming patients.

Luikenaar advised Shaw of her plan to perform a hysterectomy, remove both fallopian tubes, and—in conformity with the patient's wish to retain an ovary in order one day to have a baby—excise a single ovary. Court papers show that Luikenaar and Shaw met several times over the next 2 months, in each instance discussing the surgery and its risks, along with Shaw's stated desire for a biological child.

"I absolutely thought we were all on the same page," Shaw told the Salt Lake Tribune in an interview. "I said to [Luikenaar], 'I'm only at peace having this surgery as long as one ovary is retained.'"

But after surgery, Shaw awoke and learned that Luikenaar had removed both ovaries, in a procedure known as a bilateral oophorectomy.

In her postoperative notes, Luikenaar explained that she had performed a bilateral oophorectomy because she had discovered endometrial tissue outside of Shaw's uterus. Subsequent testing of the tissue, however, found no evidence of endometriosis, Shaw's lawsuit claims. The suit also says that the bilateral oophorectomy has left Shaw in a permanent state of menopause.

As required by state law, Shaw's first step before bringing a claim against Luikenaar was to file a complaint with Utah's Division of Occupational and Professional Licensing (DOPL). A DOPL hearing, held in April 2016, concluded that removal of the second ovary wasn't medically necessary and that Luikenaar had breached the standard of care. Still, no disciplinary action was taken against the ob/gyn.

Shaw reportedly hesitated to bring a suit against Luikenaar, for fear that it might disrupt medical service to the transgender community.

In the end, though, Shaw decided to move forward with her claim: "I genuinely worry that other folks are not receiving good care but are afraid to come forward."