A father in Massachusetts went to court to stop his 5-year-old from hearing kindergarten books about gender stereotypes. A federal judge ruled against him. Meanwhile, the Trump administration found California's policy of hiding student gender transitions from parents violated federal law. Two courts, two rulings, same underlying question: who actually gets to decide what's right for a child's health and identity?

My answer is not a judge. And it's not a politician.

\p>I write about health. I spend most of my time telling people that the basics matter more than the trends. Sleep. Food. Movement. Stress. The same principle applies here: the fundamentals of good medical care are clinical assessment, parental involvement, and time. None of those things live in a courtroom.

What Courts Are Actually Bad At

Judges are trained to weigh legal arguments. They are not trained to read a pediatric endocrinology study, assess a teenager's psychological history, or understand what puberty blockers do to bone density over 3 years. When a court decides whether a 14-year-old can access gender-affirming care, it is making a medical call with legal tools. That is a bad fit.

The fitness industry does this constantly: takes something that requires nuance and individual assessment, then flattens it into a rule. Courts are doing the same thing with gender care. One ruling covers thousands of kids with different histories, different families, different needs. Medicine doesn't work that way.

I'll grant the other side this: parental rights matter, and there are real cases where medical institutions moved too fast without enough family involvement. That concern is legitimate. But the answer to institutional overreach is not judicial overreach. It's better clinical standards, not more courtrooms.

Who Should Actually Be in the Room

The American Academy of Pediatrics, the Endocrine Society, and the American Psychological Association have all published guidelines on gender-affirming care for minors. You can disagree with their conclusions. But they are at least asking the right questions: What does the research show? What does this specific child need? What are the risks over time?

Courts ask: what does the law permit? Those are different questions.

The practical answer is a team: the child's doctor, a mental health professional, and the parents, working through a process that takes months, not a hearing that takes days. Most reputable pediatric gender clinics already work this way. The problem is that political pressure, from both directions, is dismantling that process. States are banning care outright. Other jurisdictions are mandating affirmation without adequate clinical review. Both moves take the decision away from the people who know the child.

Howard County, Maryland schools now require at least 65% of staff to complete LGBTQ+ training and have a Rainbow Representative in every building. Whether you think that's good or bad, it's a school system making a sweeping policy call that touches on health and identity for kids. Parents found out after the fact. That's the real problem: decisions getting made at the institutional level, fast, without the people who know individual children.

Slow down. Put the family and the doctor back in the center. Let courts handle what courts are actually good at: protecting kids from abuse, resolving genuine disputes between parents, enforcing existing law. The clinical question of what care a child needs belongs in a clinic.

The father in Massachusetts went to court because he felt shut out. That feeling is the real signal. When parents feel excluded from decisions about their kids' health, they go looking for any lever they can pull. Give them a real seat at the table in the exam room, and fewer of them will end up in a courtroom.