An Ohio court will decide the fate of a transgender teen who is in what the judge describes as a "gut-wrenching situation."
The 17-year-old identifies as a boy. Neither he nor his family can be named, according to court instructions. The teen's parents want court authority to stop their child from getting the treatment and therapy that was recommended by his medical team in what it characterizes as a possible life-or-death situation.
Medical experts testified that the father's ongoing refusal to call the child by his chosen name and the parents' rejection of the teen's gender identity have triggered suicidal feelings.
The teen was hospitalized in 2016. He has been diagnosed with depression, an anxiety disorder and gender dysphoria, according to court records. Gender dysphoria is a psychiatric diagnosis the American Psychiatric Association defines as "a conflict between a person's physical or assigned gender and the gender with which he/she/they identify."
The teen is in the temporary legal custody of Hamilton County Job and Family Services and lives with his maternal grandparents, who want custody and are supportive of the teen's gender identity. He wants to stay with them.
The teen's court-appointed guardian believes that the grandparents, not the parents, should have custody and says they are best suited to help the child.
The medical team from Cincinnati Children's Hospital Medical Center, where the child had been in treatment, testified that the teen is improving mentally and emotionally through therapy and because his grandparents have created a supportive environment. However, they believe the teen should start treatment as soon as possible to decrease his suicide risk.
According to a transcript of closing arguments, the grandparents said they are prepared to make medical decisions with the child, which may include starting hormone therapy.
"We think the grandparents are the ones who have an open mind and will ... make this sort of decision best for the child," argued attorney Paul Hunt, who represents the guardian ad litem, or the child's court-appointed guardian. "The parents have clearly indicated that they're not open to it."
The teen's parents did not respond to CNN's request for comment.
But in her written closing argument, their attorney, Karen Brinkman, argued that the parents maintain that they love their child and said that the child's mother said the child has "nothing to fear" from her and that she wants to have a relationship with her child. She also acknowledged that if the parents are granted custody, they want the child to continue to live with the maternal grandparents, "not in an effort to avoid parenting their child, but because they believe that the current living arrangement is in (the teen's) best interest."
Citing the teen's mental state, Brinkman said, "it does not appear that this child is even close to being able to make such a life-altering decision at this time."
"If the maternal grandparents were to be given custody, it would simply be a way for the child to circumvent the necessity of parents' consent," Brinkman said. "[The] Parents believe custody of the child should be restored to them, so they can make the medical decisions they believe are in their child's best interest until [the child] turns 18 years of age."
But Donald Clancy of the Hamilton County Prosecutor's Office argued that the reason why the parents don't want their child to receive hormone replacement therapy is because it is also against their religious beliefs. "Father testified that any kind of transition at all would go against his core beliefs and allowing the child to transition would be akin to him taking his heart out of his chest and placing it on the table," according to a transcript of Clancy's closing argument.
Clancy said that although the father testified he "fully accepts" his child, he also testified that having the teen come home would "warp" his siblings' perception of reality.
Hamilton County Job and Family Services temporarily placed the teen in his grandparents' home after the child had been hospitalized.
In November 2016, the teen had contacted a crisis chat service to say he felt unsafe in his parents' home, according to the complaint. The teen reported that his father told him to kill himself, because he was "going to hell anyway," according to a transcript of the closing arguments.
The complaint further states that an investigation found that the parents temporarily stopped their child's mental health counseling. And the therapist got an email from the mother saying they were seeking "Christian" therapy instead. The teen said he was forced to sit in a room and listen to Bible readings for over six hours at a time, according to the complaint.
The parents' attorney denied the allegations in court. Brinkman said the parents' objection to medical treatment, particularly hormone treatment, for "this gender thing" does not come solely from their religious belief. Brinkman argued that they "have done their due diligence contacting medical professionals, collecting thousands of hours of research and relying on ... their observation of their own child ... that led them to the conclusion that this is not in their child's best interest."
In her written argument, she said the teen's parents don't believe the hormones are a "medically necessary form of treatment" and feel the treatment "would do more harm than good."
The teen's lawyer, Thomas Mellott, said his parents had him enrolled at a Catholic school where he was made to wear dresses and answer to his birth name.
"It caused additional trauma and anxiety," Mellott said. "When you lack all hope, and when he thought this would all continue to happen to him, the suicidal ideation became more pronounced, and that is how he ended up where he was."
The grandparents' attorney, Jeffrey Cutcher, told the court he would also like the grandparents to help the child legally change his name, as even seeing his birth name on documents has caused trauma.
"The name has become a very big trigger," Mellott said. "It has gotten to the point where my client mentioned that he doesn't want to think about college at this point because the marketing materials he's getting keep using the birth name.
"He gets really good grades. He is academically inclined and participates in the band and was really engaged in school, and then all the sudden, this happened," the attorney said. "It's been incredibly hard."
The grandparents' attorney argued that the court needed to act quickly.
"What we want to do in the coming months around May is plan for a high school graduation, throughout the summer and fall, plan for entrance into college. We don't want to be planning for a funeral," Cutcher said in his closing argument.
"There is really strong data that says supporting an authentic child decreases future health risks," said Dr. Michelle Forcier, a pediatrician who is not involved in this case but works with transgender patients, some as young as 4 years old. She is also an associate professor of pediatrics at the Warren Alpert Medical School of Brown University.
"Parents or other family members don't have to understand, but they do have to say 'I love you and support you, and let's get this figured out together.' "
Corinne Green, policy coordinator for the Transgender Law Center, said "this is a really critical time in a child's life, and it can be frustrating for the process to take so long to help him. There can be significant harm in delaying or withholding care of any kind." Her group is also not involved in the case
"If your child had asthma and was turning blue, you wouldn't deny them their albuterol inhaler or say 'let's wait,' " Forcier said. "If this were cancer or diabetes, we wouldn't be having this conversation, but people get funny when it comes to medical care when gender is involved, and that's harmful."
The juvenile court judge, calling it "obviously a gut-wrenching situation for all of you to face," has said she will issue a ruling by Friday.
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