Detransitioners—whose existence has been dismissed in the prevailing narrative about the rise of gender fluidity—have found their voice. Names such as Prisha Mosley and Chloe Cole are now synonymous with efforts to expose the harms of puberty blockers, hormones, and irreversible surgeries. But Isabelle Ayala, a 20-year-old detransitioner from Hollywood, Florida, is a relatively unknown figure in this space. Her story, however, could be remembered as the one that toppled America’s growing gender industry.
“I never thought in a million years I could do this,” Ayala said of her decision to take on the American Academy of Pediatrics (AAP) for its alleged role in “transitioning” children. “I’m just some 20-year-old woman from Florida who likes video games and animals and music. I didn’t think I could—I would ever do this.”
With the help of her legal team, Ayala is suing the AAP and her healthcare providers, alleging civil conspiracy, fraud, and medical malpractice. The first detransitioner lawsuit in the nation to name the AAP, Ayala alleges the organization knowingly misled the public in publishing and disseminating a fraudulent policy statement that has been perceived by many as the authoritative guide for the treatment of gender-confused children in the U.S.
At the time of her purported treatment, Ayala was a vulnerable 14-year-old girl suffering from numerous mental health comorbidities, including autism, ADHD, and PTSD from a sexual assault at a young age. Her parents had recently separated, and she moved from Florida to Rhode Island with her father and his girlfriend. Her story, like so many others, involved social isolation and finding trans ideology online, where she discovered community, celebration, and was told—and eventually convinced—that she was “trans.”
After a single, brief meeting with Jason Rafferty, MD, MPH, EdM and Chair of the AAP’s LGBTQ+ Health and Wellness Committee, Ayala alleges she was recommended for testosterone injections. She said her mother initially refused to give consent, but in a follow-up meeting, Dr. Rafferty and his team convinced Isabelle’s mother to drop her objection by misrepresenting testosterone as the only available treatment and suggesting that if she did not receive the hormones, Ayala would commit suicide. Shortly thereafter, doctors put her on testosterone.
As documented in the complaint, Ayala now suffers from a slew of debilitating conditions, including vaginal atrophy, physical pain, and the triggering of an auto-immune disease only present in males in her family. Her pain and fatigue are so severe, Ayala said she had to quit her job at her local vet.
“Here I am, struggling with mental health issues, chronic pain, chronic fatigue, getting by paycheck [to] paycheck, paying out-of-pocket for all these treatments, doctor’s visits, medication, laser hair removal to just try and help me,” Isabelle said. “I didn’t think I could get justice.”
But after seeing an ad from Transition Justice offering to connect detransitioners with legal assistance, Ayala decided to give it a shot.
Attorneys at Campbell Miller Payne, a new law firm formed to represent detransitioners, answered her call.
“When we heard Isabelle’s story, we knew we had to help,” said Jordan Campbell, Ayala’s lead attorney. “Isabelle, like too many other vulnerable young adolescents, was an unknowing victim of a fraudulent medical regime that stems from the ideologies of a radical minority.”
Ayala didn’t just face malpractice at the hands of her medical team, as she and other detransitioners allege. According to the complaint, one of her key providers, Dr. Rafferty, was also the lead author of the 2018 AAP policy statement recommending pediatricians, parents, and schools nationwide adopt a “gender-affirming” model of care.
This model of care appears to have failed his own patient, who in 2017—at 14 years old—attempted suicide while under his watch. According to the complaint, Dr. Rafferty continued with his course of treatment despite her suicide attempt, prescribing Ayala more testosterone. Just a year later, Dr. Rafferty went on to recommend this course of treatment for countless more children through the policy statement he authored for the AAP.
Reflecting back on her experience with Dr. Rafferty, Ayala said, “The gender-affirming care model wasn’t even written yet. It was actively being written while [I] was a patient of his. So in hindsight, that makes me feel like a guinea pig.”
At 15, when Ayala moved back to Florida to live with her mom, she said Dr. Rafferty sent her with a year’s worth of testosterone refills and no plan for monitoring her health.
“He didn’t even bother to give me a phone call,” Ayala said. “I don’t think he checked up on me at all.”
In March of 2020, with the side effects becoming so severe, Ayala said she stopped testosterone cold turkey, under no guidance of Dr. Rafferty or any medical providers.
“I went into that summer really trying to express myself and pick up the pieces of what was happening to me and what I’ve been through,” she said. “It’s really sad. I was just a kid.”
The AAP policy statement “urging” a “gender-affirming approach” for children who identify as transgender or gender non-conforming has had serious consequences for America’s youth, many of whom now suffer from permanent and debilitating conditions as young adults. It’s long past time that medical professionals who are responsible for pushing children down this path face consequences too. And thanks to this little-known detransitioner from Florida, who “never in a million years” thought she could take on an organization as powerful as the AAP, they now might.
Justice for Ayala might never involve getting back her health, her sexual function, or her natural fertility. But it could mean getting significant monetary compensation for the damages she endured. Regardless of that outcome, it could mean that doctors finally think twice before prescribing life-altering drugs, hormones, and surgeries to minors. For Ayala, if she saves just one child from what she’s now suffering from, she’ll have won.
*Dr. Rafferty and the AAP did not return a request for comment.
Kelsey Bolar is the director of storytelling at Independent Women’s Forum (iwf.org). Learn more about IWF’s “Identity Crisis” documentary series here.
