Expert witness

Patrick W. Lappert, M.D.

Plastic surgery · testified for the side defending the laws

Dr. Lappert, a retired plastic and reconstructive surgeon retained by state and other defendants, argues that gender-affirming hormone therapy and surgery in minors and adults are experimental interventions resting on low-quality (Level IV-V) evidence, not on any genuine "standard of care," and that the WPATH Standards of Care and allied guidelines are consensus statements rather than science. He characterizes gender surgeries as cosmetic rather than reconstructive, because they begin and end in the patient's subjective distress rather than in an objective structural or functional defect, and he catalogs their complications (sterilization, loss of sexual sensation, urinary and fistula complications, and, in his terms, castration and mutilation). He treats sex as an objectively and near-universally verifiable binary fact and gender as a subjective, culturally variable, and non-fixed trait, and argues social, medical, and surgical transition form one continuous "affirmation" pathway rather than separable, independently justifiable steps. He favors a "watchful waiting"/psychotherapeutic model, citing desistance data, and argues that patients presenting with suicidality or other psychiatric symptoms are, under ordinary surgical practice, incompetent to give informed consent for elective surgery. He draws repeatedly on international reviews (Cass, Cochrane, and the Finnish and Swedish reassessments) to argue that other health systems have retreated from pediatric gender-affirming care.

Cases and documents

The documents are listed as the archive holds them. A document labeled with its kind alone, such as "Expert report", is one the archive attributes to the expert. One labeled "Mentions or contains" names the expert or includes the expert's testimony, and is not attributed to the expert.

Boe v. Marshall M.D. Ala. · 2025

5 more documents

Dekker v. Weida 11th Cir. · 2026

12 more documents
  • Deposition: Exhibit 95 - Deposition of Patrick Lappert, Kadel v. Folwell, 1:19-cv-00272 (M.D Open(opens another site) · In the case's documents
  • Mentions or contains: deposition: Affidavit of William C. Miller Open(opens another site) · In the case's documents
  • Mentions or contains: declaration: Exhibit D - Lappert Deposition Transcript Excerpts Open(opens another site) · In the case's documents
  • Mentions or contains: deposition: Exhibit Affidavit Declaration of Shani Rivaux Open(opens another site) · In the case's documents
  • Mentions or contains: deposition: Affidavit Declaration of Omar Gonzalez-Pagan Open(opens another site) · In the case's documents
  • Mentions or contains: deposition: Exhibit List (Notice of Filing, Part 2 of 10) Open(opens another site) · In the case's documents
    40 attachments
    1. Exhibit 41 - LGBT Health Disparities Policy, ACOP
    2. Exhibit 42 - AMA Letter to Natl Gov. Assoc. (April 26, 2021)
    3. Exhibit 43 - AMA/GLMA Issue Brief on health insurance coverage for gender-affirming care
    4. Exhibit 44 - AMA Resolution H-185.950
    5. Exhibit 45 - APA, Guidelines for Psychological Practice with Transgender and Gender Non-conforming People
    6. Exhibit 46 - APA Resolution on Gender Identity Change Efforts (Feb. 2021)
    7. Exhibit 47 - APA Position Statement Trans and Gender Diverse Youth (July 2020)
    8. Exhibit 48 - APA Position Statement on Access to Care (July 2018)
    9. Exhibit 49 - Endocrine Society Transgender Health Position Statement
    10. Exhibit 50 - Pediatric Endocrine Society Opposition to Bills that Harm Transgender Youth (April 2021)
    11. Exhibit 51 - SAHM Statement in Opposition of State Legislation Barring Evidence Based Treatment
    12. Exhibit 52 - WMA Statement on Transgender People (Oct. 2015)
    13. Exhibit 53 - Van Meter Pediatric Endocrinology Excerpt
    14. Exhibit 54 - Humana Pharmacy Coverage Policy, commercial insurance coverage policy for testosterone 5/18/2022
    15. Exhibit 55 - Aetna Clinical Policy Bulletin, coverage of Progestins 4/27/2023
    16. Exhibit 56 - Aetna, Clinical Policy Bulletin, gender affirming surgery 6/22/2023
    17. Exhibit 57 - Aetna, Clinical Policy Bulletin, GnRHa 2/23/2023
    18. Exhibit 58 - Humana, Medical Coverage Policy, cover of gender affirmation surgery 9/22/2022
    19. Exhibit 59 - Molina Healthcare, Coverage criteria for Gender Dysphoria Hormone Therapy July 2023
    20. Exhibit 60 - Molina Clinical Policy, Gender Affirmation Treatment and Procedures (Marketplace) - 2/8/2023
    21. Exhibit 61 - UHC Gender Dysphoria Treatment (commercial), 4/1/2023
    22. Exhibit 62 - Ctrs. for Medicare & Medicaid Servs., EPSDT A Guide for States: Coverage in the Medicaid Benefit for Children and Adolescents
    23. Exhibit 63 - Ctrs. for Medicare & Medicaid Servs., CMCS Informational Bulletin (July 21, 2022)
    24. Exhibit 64 - Ctrs. for Medicare & Medicaid Servs., Decision Memo for Gender Dysphoria and Surgery (Aug. 20, 2016)
    25. Exhibit 65 - Office of the Press Secretary, Presidential Memo (Aug. 25, 2017)
    26. Exhibit 66 - FDA, Indications and Usage Section of Labeling for Human Prescription Drug and Biological Products (Draft Guidance) (2018)
    27. Exhibit 67 - FDA, Understanding Unapproved Use of Approved Drugs "Off Label," (2018)
    28. Exhibit 68 - U.S. Drug Enforcement Administration, Drug Scheduling, July 10, 2018
    29. Exhibit 69 - U.S. Comm. on Civil Rights Statement on State Laws Targeting LGBTQ Community, (April 18, 2016)
    30. Exhibit 70 - U.S. Comm. on Civil Rights Statement on Military Ban (Aug. 18, 2017)
    31. Exhibit 71 - Dept of Health & Human Servs., Departmental Appeals Bd., Appellate Div., Decision No. 2576 (May 30, 2014)
    32. Exhibit 72 - OASH, Gender-Affirming Care and Young People
    33. Exhibit 73 - SAMHSA, Ending Conversion Therapy (Oct. 2015)
    34. Exhibit 74 - SAMHSA, Moving Beyond Change Efforts (2023)
    35. Exhibit 75 - NCTSN, Gender-Affirming Care is Trauma-Informed Care
    36. Exhibit 76 - U.S. Presidential Proclamation, Transgender Day of Visibility, 2022
    37. Exhibit 77 - U.S. Presidential Proclamation, Transgender Day of Visibility, 2023
    38. Exhibit 78 - Executive Order, Preventing and Combating Discrimination on the Basis of Gender Identity or Sexual Orientation (Jan. 20, 2021)
    39. Exhibit 79 - Medicaid Coverage for Gender-Affirming Care, Williams Institute (Dec. 2022)
    40. Exhibit 80 - Excerpts from trial transcript Vol. 5 (Levine), Brandt v. Rutledge, 4:21-CV-00450-JM (E.D. Ark.)
  • Mentions or contains: deposition: Exhibit List (Notice of Filing, Part 4 of 10) Open(opens another site) · In the case's documents
    40 attachments
    1. Exhibit 121 - On Gender Dysphoria, 2017 Dhejne
    2. Exhibit 122 - Long-Term Follow-up of Transsexual Persons Undergoing Sex Reassignment Surgery, 2011 Dhejne
    3. Exhibit 123 - Endocrine Treatment of Gender-Dysphoric/Gender-Incongruent Persons, 2017 Hembree et al.
    4. Exhibit 124 - Interrogating Gender-Exploratory Therapy, 2023 Ashley
    5. Exhibit 125 - Transgender Surgery & Christian Anthropology, Presentation by Patrick W. Lappert
    6. Exhibit 126 - What is Psychiatry, American Psychiatric Association
    7. Exhibit 127 - Lewiss Child and Adolescent Psychiatry, Fifth Edition, 2018
    8. Exhibit 128 - Memo Outlining Evidence for Change for Gender Identity Disorder in the DSM-5, 2013 Zucker, et al.
    9. Exhibit 129 - A Developmental, Biopsychosocial Model for the Treatment of Children with Gender Identity Disorder, 2012 Zucker
    10. Exhibit 130 - APA Statement on Zucker (2008)
    11. Exhibit 131 - Working for Inclusion: Time for Congress to Enact Federal Legislation to Address Workplace Discrimination Against Lesbian, Gay, Bisexual, and Transgender Americans, Briefing Report
    12. Exhibit 132 - Position Statement on Conversion Therapy, APA (Dec. 2018)
    13. Exhibit 133 - Do Clinical Data from Transgender Adolescents Support the Phenomenon of Rapid Onset Gender Dysphoria, 2022 Bauer et al.
    14. Exhibit 134 - American Society of Plastic Surgeons, State Focus on Gender Affirmation Intensifies, Feb. 25, 2021,
    15. Exhibit 135 - Plastic surgeon: Sex-change operation utterly unacceptable and a form of child abuse, Sept. 9, 2019,
    16. Exhibit 136 - Transphobic tweets linked to Oxford sociology professor, The Oxford Student (Oct. 26, 2018)
    17. Exhibit 137 - Long-term outcomes of the treatment of central precocious puberty, 2016 Guaraldi, et al.
    18. Exhibit 138 - Fertility of Women Treated during Childhood with Triptorelin (Depot Formulation) for Central Precocious Puberty, 2021 Martinerie, et al.
    19. Exhibit 139 - Gender dysphoria in childhood, 2016 Ristori & Steensman
    20. Exhibit 140 - Gender Identity 5 Years After Social Transition, 2022 Olson et al.
    21. Exhibit 141 - Puberty Suppression in Adolescents With Gender Identity Disorder, 2011 de Vries, et al.
    22. Exhibit 142 - Understanding the Well-Being of LGBTQI+ Populations, 2020 Natl Academies of Sciences, Engineering, and Medicine
    23. Exhibit 143 - The Health of Lesbian, Gay, Bisexual and Transgender People, 2011 Natl Academies of Sciences, Engineering, and Medicine
    24. Exhibit 144 - The Right to the Best Care for Children Does Not Include the Right to Medical Transition, 2019 Laidlaw, et al.
    25. Exhibit 145 - Strangers in a Strange Land, 2020 Donovan & Sotomayor
    26. Exhibit 146 - Effect of antidepressant medications on semen parameters and male fertility, 2020 Beeder & Samplaski
    27. Exhibit 147 - The effect of antidepressants on fertility, 2016 Casilla-Lennon, et al.
    28. Exhibit 148 - Trends in Gender-affirming Surgery in Insured Patients in the U.S., 2018 Lane et al.
    29. Exhibit 149 - Gender-Affirming Treatment of Gender Dysphoria in Youth, 2022 Clayton et al.
    30. Exhibit 150 - AAP News, Risk of Pseudotumor Cerebri added to Labeling for Gonadotropin-Releasing Hormone Agonists, (2022)
    31. Exhibit 151 - Longitudinal Impact of Gender-Affirming Endocrine Intervention on the Mental Health and Well-Being of Transgender Youths, 2020 Achille et al.
    32. Exhibit 152 - Long-Term Effect of Gender-Affirming Hormone Treatment on Depression and Anxiety Symptoms in Transgender People, 2020 Aldridge et al.
    33. Exhibit 153 - Off-Label Medication use in Children, More Common than We Think: A Systematic Review of the Literature, 2018 Allen et al.
    34. Exhibit 154 - Association Between Gender-Affirming Surgeries and Mental Health Outcomes, 2021 Almazan et al.
    35. Exhibit 155 - Top Surgery and Chest Dysphoria Among Transmasculine and Nonbinary Adolescents and Young Adults, 2022 Ascha et al.
    36. Exhibit 156 - Hormone Therapy, Mental Health, and Quality of Life Among Transgender People: A Systematic Review, 2021 Baker et al.
    37. Exhibit 157 - GRADE Guidelines: 3 Rating the Quality of Evidence, 2011 Balshem et al.
    38. Exhibit 158 - Harry Benjamin, The Transsexual Phenomenon (1966)
    39. Exhibit 159 - Anabolic Steroid Abuse and Dependence, 2002 Brower et al.
    40. Exhibit 160 - Transgender and Gender-Nonbinary Patient Satisfaction after Transmasculine Chest Surgery, 2021 Bustos et al.
  • Mentions or contains: deposition: Exhibit List (Notice of Filing, Part 5 of 10) Open(opens another site) · In the case's documents
    40 attachments
    1. Exhibit 161 - Regret after Gender-affirmation Surgery: A Systematic Review and Metaanalysis of Prevalence, 2021 Bustos et al.
    2. Exhibit 162 - Effects of Long-Term Exogenous Testosterone Administration on Ovarian Morphology, Determined by Transvaginal (3D) Ultrasound in Female-to-Male Transsexuals, 2017 Caanen et al.
    3. Exhibit 163 - Short-term Outcomes of Pubertal Suppression in a Selected Cohort of 12 to 15 Year Old Young People with Persistent Gender Dysphoria in the UK, 2021 Carmichael at al.
    4. Exhibit 164 - Psychosocial Functioning in Transgender Youth after 2 Years of Hormones, 2023 Chen et al.
    5. Exhibit 165 - Pubertal Delay as an Aid in Diagnosis and Treatment of a Transsexual Adolescent, 1998 Cohen-Kettenis & van Goozen
    6. Exhibit 166 - Hormonal Treatment Reduces Psychobiological Distress in Gender Identity Disorder, Independently of the Attachment Style, 2013 Colizzi et al.
    7. Exhibit 167 - Psychological Support, Puberty Suppression, and Psychosocial Functioning in Adolescents with Gender Dysphoria, 2015 Costa et al.
    8. Exhibit 168 - Young Adult Psychological Outcome After Puberty Suppression and Gender Reassignment, 2014 de Vries et al.
    9. Exhibit 169 - An Analysis of All Applications for Sex Reassignment Surgery in Sweden, 1960-2010: Prevalence, Incidence, and Regrets, 2014 Dhejne et al.
    10. Exhibit 170 - Gender Nonconforming Youth: Current Perspectives, 2017 Ehrensaft
    11. Exhibit 171 - What makes clinical research ethical?, 2000 Emanuel et al.
    12. Exhibit 172 - Treatment of Central Precocious Puberty, 2019 Eugster
    13. Exhibit 173 - Cross-Sex Hormone Treatment and Psychobiological Changes in Transsexual Persons: Two-Year Follow-Up Data, 2016 Fisher et al.
    14. Exhibit 174 - Chest Surgery in Female to Male Transgender Individuals, 2017 Frederick et al.
    15. Exhibit 175 - Off-Label Use of Drugs in Children, 2014 Galinkin et al.
    16. Exhibit 176 - Association of Gender-Affirming Hormone Therapy With Depression, Thoughts of Suicide, and Attempted Suicide Among Transgender and Nonbinary Youth, 2022 Green
    17. Exhibit 177 - Feminizing Genital Gender-Confirmation Surgery, 2018 Hadj-Moussa et al.
    18. Exhibit 178 - Satisfaction with Male-to-Female Gender Reassignment Surgery, 2014 Hess et al.
    19. Exhibit 179 - Effects of Different Steps in Gender Reassignment Therapy on Psychopathology, 2014 Heylens, et al.
    20. Exhibit 180 - Supporting Sexuality and Improving Sexual Function in Transgender Persons, 2019 Holmberg et al.
    21. Exhibit 181 - Outcome of Vaginoplasty in Male-to-Female Transgenders: A Systematic Review of Surgical Techniques, 2015 Horbach et al.
    22. Exhibit 182 - The Quality of Evidence for Medical Interventions Does Not Improve or Worsen: A Metaepidemiological Study of Cochrane Reviews, 2020 Howick et al.
    23. Exhibit 183 - Testosterone Treatment and MMPI2 Improvement in Transgender Men, 2015 Keo-Meier et al.
    24. Exhibit 184 - Bone Mass in Young Adulthood Following Gonadotropin-Releasing Hormone Analog Treatment and Cross-Sex Hormone Treatment in Adolescents with Gender Dysphoria, 2015 Klink et al.
    25. Exhibit 185 - Fertility Options in Transgender and Gender Diverse Adolescents, 2017 Knudson & De Sutter
    26. Exhibit 186 - Australian Children and Adolescents with Gender Dysphoria, 2021 Kozlowska et al.
    27. Exhibit 187 - Body Dissatisfaction and Mental Health Outcomes of Youth on Gender-Affirming Hormone Therapy, 2020 Kuper et al.
    28. Exhibit 188 - Transgender Men Who Experienced Pregnancy After Female-to-Male Gender Transitioning, 2014 Light, et al.
    29. Exhibit 189 - Psychosocial Assessment in Transgender Adolescents, 2020 Lopez de Lara.
    30. Exhibit 190 - Christy Mallory et al., Conversion Therapy and LGBT Youth 2 (2019 ed.)
    31. Exhibit 191 - Successful Oocyte Cryopreservation Using Letrozole as an Adjunct to Stimulation in a Transgender Adolescent after GnRH Agonist Suppression, 2021 Martin et al.
    32. Exhibit 192 - Experience of Chest Dysphoria and Masculinizing Chest Surgery in Transmasculine Youth, 2021 Mehringer et al.
    33. Exhibit 193 - Breast Augmentation in Male-to-Female Transgender Patients: Technical Considerations and Outcomes, 2019 Miller et al.
    34. Exhibit 194 - Guiding the ConversationTypes of Regret after Gender-Affirming Surgery and Their Associated Etiologies, 2021 Narayan et al.
    35. Exhibit 195 - Individual Treatment Progress Predicts Satisfaction with Transition-Related Care for Youth with Gender Dysphoria, 2021 Nieder et al.
    36. Exhibit 196 - Sexual Experiences in Transgender People, 2018 Nikkelen & Baudewijntje.
    37. Exhibit 197 - Quality of Life of Treatment-Seeking Transgender Adults, 2018 Nobili et al.
    38. Exhibit 198 - Chest Reconstruction and Chest Dysphoria in Transmasculine Minors and Young Adults: Comparisons of Nonsurgical and Postsurgical Cohorts, 2018 Olson-Kennedy et al.
    39. Exhibit 199 - Mental Health of Transgender Children Who Are Supported in Their Identities, 2016 Olson, et al.
    40. Exhibit 200 - Association Between Gender Confirmation Treatments and Perceived Gender Congruence, Body Image Satisfaction, and Mental Health in a Cohort of Transgender Individuals, 2018 Owen-Smith, et al.
  • Mentions or contains: deposition: Exhibit List (Notice of Filing, Part 7 of 10) Open(opens another site) · In the case's documents
    40 attachments
    1. Exhibit 237A - (Placeholder) Dekker medical records
    2. Exhibit 238 - GAPMS Decision Tree Checklist
    3. Exhibit 239 - GAPMS GnRH for treatment of gender dysphoria
    4. Exhibit 240 - GAPMS GnRH for treatment of gender dysphoria
    5. Exhibit 241 - GAPMS Cross Sex Hormone Therapy 5/20/2022
    6. Exhibit 242 - GAPMS Cross Sex Hormone Therapy Report (edited) - 5/20/2022
    7. Exhibit 243 - GAPMS Cross Sex Hormone Therapy 11/2/2016
    8. Exhibit 244 - GAPMS Gender Confirmation Surgery (incomplete) 7/19/2017
    9. Exhibit 245 - DUR Meeting Transcript 9/26/2015
    10. Exhibit 246 - DUR Quarterly Report - 2015
    11. Exhibit 247 - DUR Meeting Minutes 1/16/2016
    12. Exhibit 248 - DUR Meeting Minutes 9/24/2016
    13. Exhibit 249 - Pharmacy log 5/31/2016
    14. Exhibit 250 - AHCA review of research 7/25/2016
    15. Exhibit 251 - AHCA review of state practice 8/17/2016
    16. Exhibit 252 - Arlene Elliot research regarding Medicaid coverage of care in other states July 27, 2016
    17. Exhibit 252A - Arlene Elliot research regarding Medicaid coverage of care in other states July 27, 2016
    18. Exhibit 252B - Arlene Elliot research regarding Medicaid coverage of care in other states July 27, 2016
    19. Exhibit 252C - Arlene Elliot research regarding Medicaid coverage of care in other states July 27, 2016
    20. Exhibit 253 - Aetna clinical criteria for cross-sex hormone therapy 8/18/2016
    21. Exhibit 254 - Arlene Elliot email re GnRH coverage 8/29/2016
    22. Exhibit 255 - Rebecca Borgert email regarding Endocrine Society guidelines 8/29/2016
    23. Exhibit 256 - AHCA GAPMS routing and tracking form for puberty suppression therapy 8/31/2016
    24. Exhibit 257 - Special services criteria re GnRH coverage 9/20/2016 (updated 11/17/17)
    25. Exhibit 258 - AHCA letter to Childrens Medical Services re drug criteria and coverage 10/6/2016
    26. Exhibit 259 - AHCA tracking form for GAPMS research re puberty suppression 9/26/2016
    27. Exhibit 260 - AHCA GAPMS routing and tracking form for cross-sex hormone therapy 11/2/2016
    28. Exhibit 261 - FL House letter to AHCA re drug treatment for gender dysphoria 11/22/2016
    29. Exhibit 262 - DUR transcript 3/23/2017
    30. Exhibit 263 - Draft GAPMS re gender-affirming surgery 7/19/2017
    31. Exhibit 264 - Email exchange re Medicaid coverage of gender affirming surgery June 2018
    32. Exhibit 264A - Email exchange re Medicaid coverage of gender affirming surgery June 2018
    33. Exhibit 265 - AHCA routing form tracking response to MCO question about Medicaid coverage of surgery June 2018
    34. Exhibit 266 - AHCA document closing the project re responding to MCO question about Medicaid coverage of surgery June 2018
    35. Exhibit 267 - Email from Theresa Kumar to Jesse Botcher 10/18/2019
    36. Exhibit 268 - Email from DD Pickle to Krisin Sokoloski 1/5/2022
    37. Exhibit 269 - AHCA approval of Simply Healthcares provider manual 3/24/2022
    38. Exhibit 269A - AHCA approval of Simply Healthcares provider manual 3/24/2022
    39. Exhibit 269B - AHCA approval of Simply Healthcares provider manual 3/24/2022
    40. Exhibit 269C - AHCA approval of Simply Healthcares provider manual 3/24/2022
  • Mentions or contains: deposition: Exhibit List (Notice of Filing, Part 8 of 10) Open(opens another site) · In the case's documents
    40 attachments
    1. Exhibit 270 - Email re commercial plan coverage 3/24/2022
    2. Exhibit 271 - Communication from Peter Ring re procedures billed to treat gender dysphoria 4/7/2022
    3. Exhibit 272 - Email from Andy Bardos to Andrew Sheeran re Cantor and legal research 4/11/2022
    4. Exhibit 273 - Email forwarded by Andrew Sheeran from Ashley Lukis scheduling a call with James Cantor 4/13/2022
    5. Exhibit 274 - Email from Andrew Sheeran to Miriam Grossman 4/14/2022
    6. Exhibit 275 - Email exchange between Andrew Sheeran and Romina Brignardello Petersen 4/18/2022
    7. Exhibit 276 - Email from Susan Williams to Shantrice Green re GAPMS on cross-sex hormone therapy 4/20/2022
    8. Exhibit 277 - Email from Amy Zitiello to Vern Hamilton regarding FDOH guidance 4/20/2022
    9. Exhibit 277A - Email from Amy Zitiello to Vern Hamilton regarding FDOH guidance 4/20/2022
    10. Exhibit 278 - Email from Cody Farill regarding data from Magellan about drug coverage - 4/20/2022
    11. Exhibit 279 - Communication between Jason Weida and Dr. Michelle Cretella 4/21/2025
    12. Exhibit 280 - Communication between Romina Brignardello-Petersen and Jason Weida regarding types of surgeries on which to focus 4/25/2022
    13. Exhibit 281 - Communication between Jason Weida and Vern Hamilton regarding planned response to Dr. Zitiellos question about FDOH guidance 4/29/2022
    14. Exhibit 282 - Draft GAPMS on gender affirming surgery (with handwritten notes) - May 2022
    15. Exhibit 283 - Jason Weida communication regarding report from Romina Brignardello-Petersen 5/5/2022
    16. Exhibit 283A - Jason Weida communication regarding report from Romina Brignardello-Petersen 5/5/2022
    17. Exhibit 283B - Jason Weida communication regarding report from Romina Brignardello-Petersen 5/5/2022
    18. Exhibit 283C - Jason Weida communication regarding report from Romina Brignardello-Petersen 5/5/2022
    19. Exhibit 283D - Jason Weida communication regarding report from Romina Brignardello-Petersen 5/5/2022
    20. Exhibit 283E - Jason Weida communication regarding report from Romina Brignardello-Petersen 5/5/2022
    21. Exhibit 284 - Jason Weida communication regarding articles provided to him by Dr. Van Mol 5/6/2022
    22. Exhibit 285 - Dr. Van Mol communication with Jason Weida and Matthew Brackett about gender affirming care 5/7/022
    23. Exhibit 286 - Dr. Van Mols edits to June 2022 GAPMS memo 5/13/2022
    24. Exhibit 286A - Dr. Van Mols edits to June 2022 GAPMS memo 5/13/2022
    25. Exhibit 286B - Dr. Van Mols edits to June 2022 GAPMS memo 5/13/2022
    26. Exhibit 287 - Text message from Jason Weida regarding Eknes-Tucker and James Cantor 5/17/2022
    27. Exhibit 288 - Email from Shantrice Green to Susan Williams and Kelly Rubin regarding the GAPMS memo on cross-sex hormone therapy 5/20/2022
    28. Exhibit 289 - Draft of GAPMS cross-sex hormone therapy memo 5/20/2022
    29. Exhibit 290 - Jason Weida asks Dr. Van Mol for assistance locating specific witnesses 5/21/2022
    30. Exhibit 291 - Email between Dr. Van Mol and Jason Weida regarding reimbursement 5/21/2022
    31. Exhibit 292 - Invoices from Romina Brignardello-Petersen 5/24/2022
    32. Exhibit 292A - Invoices from Romina Brignardello-Petersen 5/24/2022
    33. Exhibit 293 - Template denial for requesting rule workshop June 2022
    34. Exhibit 294 - Projected Rulemaking Timeline June 2022
    35. Exhibit 295 - Gender Dysphoria/Transgender Health Care Non-Legislative Pathway June 2022
    36. Exhibit 296 - Gender Dysphoria/Transgender Health Care Policy Pathway June 2022
    37. Exhibit 297 - AHCA GAPMS routing and tracking form for June 2022 GAPMS 6/1/2022
    38. Exhibit 297A - AHCA GAPMS routing and tracking form for June 2022 GAPMS 6/1/2022
    39. Exhibit 298 - Communication between Ashley Peterson and Jason Weida regarding an inventory of gender affirming care 6/3/2022
    40. Exhibit 298A - Communication between Ashley Peterson and Jason Weida regarding an inventory of gender affirming care 6/3/2022
  • Mentions or contains: deposition: Exhibit List (Notice of Filing, Part 9 of 10) Open(opens another site) · In the case's documents
    40 attachments
    1. Exhibit 299 - (Redacted) Email communication between AHCA and Magellan regarding coverage of GnRH to treat gender dysphoria
    2. Exhibit 300 - AHCA communication regarding the Special Services Criteria for puberty blockers 6/10/2022
    3. Exhibit 301 - Communication between Jason Weida and Dr. Van Mol about a witness for the July 8th hearing 6/14/2022
    4. Exhibit 302 - Email communication between Dr. Christopher Cogle and Jeffrey English 6/27/2022
    5. Exhibit 303 - Communication regarding meeting between Miriam Grossman, Dr. Van Mol, Jason Weida, Andrew Sheeran, and Holtzman Vogel regarding July 8th hearing 6/30/2022
    6. Exhibit 304 - Communication between Dr. Van Mol and AHCA - 7/2/2022
    7. Exhibit 305 - Brief of the July 8th rule hearing 7/8/2022
    8. Exhibit 306 - Transcript from July 8th rule hearing 7/8/2022
    9. Exhibit 307 - Email from Miriam Grossman 7/10/2022
    10. Exhibit 308 - Email communications with Jason Weida and Dr. Van Mol 7/14/2022
    11. Exhibit 309 - Communications regarding AHCAs development of public comment binder provided to the consultants 7/19/2022
    12. Exhibit 310 - Invoice from Dr. Van Meter 8/4/2022
    13. Exhibit 311 - Communication to Jason Weida regarding witnesses for a hearing 8/10/2022
    14. Exhibit 312 - Invoices from Dr. Van Mol 8/11/2022
    15. Exhibit 313 - Email communications regarding implementation of 59G-1.050(7) - 8/22/2022
    16. Exhibit 313A - Email communications regarding implementation of 59G-1.050(7) - 8/22/2022
    17. Exhibit 314 - Communication between AHCA and EOG regarding planned communications about June 2022 GAPMS and 59G-1.050(7) - 8/22/2022
    18. Exhibit 315 - SMMC Policy Transmittal draft regarding non-coverage of gender dysphoria treatments August 22, 2022
    19. Exhibit 316 - AHCA Medicaid Health Care Alert regarding prohibition on coverage for gender affirming care
    20. Exhibit 317 - AHCA draft response to media regarding gender affirming care 9/1/2022
    21. Exhibit 318 - List of appeals for denials of hormone therapy 12/19/2022
    22. Exhibit 319 - List of requests for surgery to treat gender dysphoria 12/19/2022
    23. Exhibit 320 - AHCA After the Fact Request form for Quentin Van Meter 6/13/2022
    24. Exhibit 321 - AHCA After the Fact Request form for Andre Van Mol 5/26/2022
    25. Exhibit 322 - Draft of welcome/opening remarks for July 8th rule hearing
    26. Exhibit 323 - Endocrine Society public comment
    27. Exhibit 324 - Yale public comment
    28. Exhibit 325 - American Academy of Pediatrics public comment
    29. Exhibit 326 - Florida Medicaid, Comment Summary for Rule 59G-1.050 (20 pages)
    30. Exhibit 327 - Florida Medicaid, Comment Summary for Rule 59G-1.050 (17 pages)
    31. Exhibit 328 - Email communication between Van Mol and Weida and attachment
    32. Exhibit 328A - Email communication between Van Mol and Weida and attachment
    33. Exhibit 329 - Florida Medicaid & G/TAT, Andrea Van Mol May 2022
    34. Exhibit 330 - GAPMS Specially Modified Foods
    35. Exhibit 331 - GAPMS Scleral Contact Lenses
    36. Exhibit 332 - GAPMS Fractional Exhaled Nitric Oxide
    37. Exhibit 333 - GAPMS Breast Pump
    38. Exhibit 334 - Email from Miriam Grossman July 7, 2022
    39. Exhibit 335 - Proposed media response from Brock Juarez to Taryn Fenske 8/29/2022
    40. Exhibit 336 - Order striking Van Meter
  • Mentions or contains: deposition: Exhibit List (Notice of Filing, Part 10 of 10) Open(opens another site) · In the case's documents
    21 attachments
    1. Exhibit 337 - Email communication between Van Meter and AHCA Counsel
    2. Exhibit 338 - AHCA Microsoft Teams Meeting Invite
    3. Exhibit 339 - Email communication between Van Meter and Jason Weida
    4. Exhibit 340 - AHCA Van Meter Invoice
    5. Exhibit 341 - HCA Hearing on General Medicaid Policy
    6. Exhibit 342 - Email communication between Devona Pickle and Van Meter
    7. Exhibit 343 - Email communication between consultants, counsel, and Van Meter
    8. Exhibit 344 - AHCA Teams Meeting Invites
    9. Exhibit 344A - AHCA Teams Meeting Invites
    10. Exhibit 345 - Email communication between AHCA and consultants
    11. Exhibit 346 - Email communication between Sheeran and Brignardello-Petersen
    12. Exhibit 347 - Email communication between Van Mol and Weida
    13. Exhibit 348 - Van Mol comments to Alstott letter
    14. Exhibit 349 - Email communication between Weida Van Meter, Van Mol and Grossman
    15. Exhibit 350 - Email communication between Cantor and Weida
    16. Exhibit 351 - Sex Differences in Verbal Fluency during Adolescence, 2013 Soleman
    17. Exhibit 352 - Oestrogens are Not Related to Emotional Processing, Soleman 2016
    18. Exhibit 353 - Puberty suppression and executive functioning, 2015 Staphorsius
    19. Exhibit 354 - Alterations in the inferior fronto-occipital fasciculus, van Heesewijk
    20. Exhibit 355 - Spreadsheet summarizing Florida Medicaid coverage
    21. Exhibit 356 - DOJ, Dear State Attorneys General Letter re Transgender Youth (March 31, 2022)

Maxwell Kadel v. Dale Folwell 4th Cir. · 2022

3 more documents

How courts have treated his testimony

Each ruling that discusses his testimony, by what it did for the side that called him. The counts are the profile's own, for the rulings it lists.

Discounted, criticized or limited: 3Neither: 2
Helped the side that called him: 0Credited against the side that called him: 0Discounted, criticized or limited: 3Neither: 2
2022

Brandt v. Griffin (formerly Brandt v. Rutledge)

NeitherAdmitted over objection

U.S. District Court, E.D. Arkansas · Daubert / pretrial motion to exclude · court order

His role: retained by defendants (State of Arkansas)

In a text order (8/30/2022), the district court denied plaintiffs' motions to exclude the expert testimony of Dr. Patrick W. Lappert and Dr. Mark Regnerus, allowing them to testify at the bench trial.

“ORDER denying 153 , 155 motions to exclude the expert testimony of Dr. Patrick W. Lappert and Dr. Mark Regnerus; and granting in part and denying in part 164 motion in limine.”

Dylan Brandt v. Tim Griffin: Originating court document filed consisting of notice of appeal, Findings of Fac

Source: Dylan Brandt v. Tim Griffin: Originating court document filed consisting of notice of appeal, Findings of Fac

2023

Brandt v. Griffin (formerly Brandt v. Rutledge)

Discounted, criticized or limitedExcluded

U.S. District Court, E.D. Arkansas · trial (bench trial, findings of fact and conclusions of law) · court order

His role: retained by defendants (State of Arkansas)

In its post-trial Findings of Fact and Conclusions of Law (6/20/23), the court found that Dr. Lappert, a plastic surgeon recruited by Alliance Defending Freedom, has no training or experience in mental health or gender dysphoria, never provided gender-affirming surgery, and testified 'more from a religious doctrinal standpoint' than as a Daubert-qualified expert. The court found his testimony on cosmetic-surgery ethics and surgical risk outside the context of gender transition was of unclear relevance, held that he was not qualified to offer relevant opinions, and found he did not meet Daubert's requirements.

“Dr. Lappert has no training or professional experience in mental health or gender dysphoria and has never provided gender-affirming surgery.”

Dylan Brandt v. Tim Griffin: Originating court document filed consisting of notice of appeal, Findings of Fac

“The ADF is not a scientific organization, but a Christian-based legal advocacy group.”

Dylan Brandt v. Tim Griffin: Originating court document filed consisting of notice of appeal, Findings of Fac

“The relevance of Dr. Lappert’s testimony was unclear. The Court finds that he is not qualified to offer relevant opinions given his lack of experience related to gender dysphoria.”

Dylan Brandt v. Tim Griffin: Originating court document filed consisting of notice of appeal, Findings of Fac

“Dr. Lappert does not meet the requirements under Daubert to give opinions relevant to this case.”

Dylan Brandt v. Tim Griffin: Originating court document filed consisting of notice of appeal, Findings of Fac

“Dr. Lappert acknowledged that his opinions were his own and were inconsistent with his peers and the American Society of Plastic Surgeons.”

Dylan Brandt v. Tim Griffin: Originating court document filed consisting of notice of appeal, Findings of Fac

“Most of the State’s expert witnesses, Professor Mark Regnerus, Dr. Stephen Lappert, and Dr. Paul Hruz, were unqualified to offer relevant expert testimony and offered unreliable testimony.”

Dylan Brandt v. Tim Griffin: Originating court document filed consisting of notice of appeal, Findings of Fac

Source: Dylan Brandt v. Tim Griffin: Originating court document filed consisting of notice of appeal, Findings of Fac

2023

Dekker v. Weida

NeitherCriticized

U.S. District Court, N.D. Florida · trial (final order) · court opinion

His role: Consultant to Florida's Medicaid agency (AHCA), not a testifying expert in this case

In striking down Florida's Medicaid exclusion, the court described the view, below the surface of the rule's adoption and of some defense testimony, that transgender identity is not real, and cited his radio remarks as an example.

“An AHCA consultant, Dr. Patrick Lappert—a surgeon who has never performed gender-affirming surgery—said in a radio interview that gender-affirming care is a “lie,” a “moral violation,” a “huge evil,” and “diabolical.””

Dekker v. Weida: Order

Source: Dekker v. Weida: Order

2023

Doe v. Ladapo

Discounted, criticized or limitedCriticized

U.S. District Court, N.D. Florida · preliminary injunction · court order

His role: Defense expert (“another defense expert”, in the court's words)

The court found that an unspoken suggestion ran below the surface of some defense experts' testimony: that transgender identity is not real. It gave his public statements as an example, noting he is a surgeon who has never performed gender-affirming surgery.

“an unspoken suggestion running just below the surface in some of the proceedings that led to adoption of the statute and rules at issue—and just below the surface in the testimony of some of the defense experts—is that transgender identity is not real, that it is made up”

DOE v. LADAPO: Order on Motion for Preliminary Injunction

“Another defense expert, Dr. Patrick Lappert—a surgeon who has never performed gender-affirming surgery—said in a radio interview that gender-affirming care is a “lie,” a “moral violation,” a “huge evil,” and “diabolical.””

DOE v. LADAPO: Order on Motion for Preliminary Injunction

Source: DOE v. LADAPO: Order on Motion for Preliminary Injunction

2024

Maxwell Kadel v. Dale Folwell (consolidated with Anderson v. Crouch on appeal)

Discounted, criticized or limitedLimited

Court of Appeals for the Fourth Circuit (describing the ruling of the U.S. District Court, M.D.N.C.) · Daubert / summary judgment (district court ruling, described on appeal) · court opinion

His role: retained by defendants

The Fourth Circuit's en banc opinion recounts that the M.D.N.C. district court granted in part and denied in part the plaintiffs' motions to exclude defendants' experts: it excluded testimony based on unreliable methodology and on topics outside an expert's specific experience, but held that Dr. Lappert, a surgeon, was qualified to opine on the risks associated with gender-affirming surgery -- limiting him to that subject matter within his specialty.

“the court found that Dr. Patrick Lappert, a surgeon, was qualified to opine on the risks associated with surgery used to treat gender dysphoria.”

Maxwell Kadel v. Dale Folwell, 2024(opens another site)

“Dr. Patrick Lappert, a surgeon, was qualified to opine on the risks associated with surgery used to treat gender dysphoria.”

Shauntae Anderson v. William Crouch: Published authored opinion filed

Source: Maxwell Kadel v. Dale Folwell, 2024(opens another site)

Not in the archive: The Fourth Circuit opinion (chunk/doc for Kadel/Anderson) and the E.D. Ark. Brandt findings both reference the underlying district-court Daubert order in Kadel v. Folwell (M.D.N.C., referenced as '620 F. Supp. 3d 339 (M.D.N.C. 2022)' and 'J.A. 3690-93, 3697') that actually granted-in-part/denied-in-part the motion to exclude Lappert -- only the Fourth Circuit's summary of it is in these files, not the M.D.N.C. order itself. Similarly, Doe v. Ladapo and Dekker v. Weida (/rid 124312) both cite 'Trial Tr.' pages (e.g., ECF No. 239 at 129-31) containing Lappert's actual trial testimony in Dekker, and the Boe v. Marshall brief refers to an unspecified prior court ruling regarding Lappert that is 'neither excluded...in toto' -- none of these underlying transcripts or that specific order are among the files reviewed. The Boe v. Marshall Daubert motion itself, and any order resolving it, are also not present -- only the government's opposition brief is.

Cases and roles

CaseYearsArenaRetained byWhat he filed
Boe v. Marshall
M.D. Ala. (Middle District of Alabama, Northern Division), Civil Action No. 2:22-cv-00184-LCB-CWB
2022-2024youth care bancounsel for Defendants (Alabama Attorney General Steve Marshall, in his official capacity, et al.) EXPERT REPORTEXPERT REPORTLappert deposition transcript, 4/3/2024Response in Opposition to Motion (Daubert)Notice (Other)Exhibit 17 - Lappert ReportExhibit Lappert ReportExhibit Lappert Deposition Transcript
+1 moreResponse in Opposition to Motion (Daubert)
Dekker v. Weida
N.D. Fla. (Tallahassee Division), Case No. 4:22-cv-00325-RH-MAF
2022-2023insurance-Medicaidcounsel for the defendants (Florida Medicaid administration, sued as Jason Weida / Simone Marstiller, Secretary) Exhibit Ex 19 Dr. Lappert Expert ReportPlaintiffs' Motion to Partially Exclude Expert Testimony of Dr. LappertExhibit A - Lappert ReportExhibit B - Lappert RebuttalExhibit D - Lappert Deposition Transcript Excerpts (not extracted)Exhibit E - Lappert Declaration (Brandt)Exhibit 95 - Deposition of Patrick Lappert, Kadel v. Folwell (text not extracte…Plaintiffs' memorandum re-filed from Kadel v. Folwell, re Lappert exclusion
Maxwell Kadel v. Dale Folwell
M.D.N.C., No. 1:19-CV-272; appealed to the 4th Cir. (per docket documents in this corpus)
2019-2022insurance-Medicaidnot established (his own filed documents in this corpus do not state the retaining party; opposing motions describe him only as the defense's expert, consistent with the North Carolina State Health Plan being the defendant) JOINT APPENDIX by Dale Folwell and Dee Jones (4th Cir.)JOINT APPENDIX by Dale Folwell and Dee Jones (4th Cir.)JOINT APPENDIX Vol. 1JOINT APPENDIX Vol. 2JOINT APPENDIX Vol. 3JOINT APPENDIX Vol. 4JOINT APPENDIX Vol. 5JOINT APPENDIX Vol. 6
+1 moreJOINT APPENDIX Vol.

Typical stance

Gender surgeries are cosmetic, not reconstructive

He argues gender-affirming surgeries fail the definition of reconstructive surgery because they do not restore an objectively diagnosable structural or functional loss; because they begin and end in the patient's subjective sense of self, he classifies them as cosmetic/aesthetic surgery, and by extension not a covered medical necessity.

Seen in: Boe v. Marshall, Dekker v. Weida, Brandt v. Rutledge

The evidence for gender-affirming care is low-quality, not a standard of care

Applying an evidence-grading scale borrowed from the American Society of Plastic Surgery, he contends that the studies and guidelines (including WPATH's Standards of Care and Endocrine Society guidance) cited for gender-affirming care rank at Level IV-V (case series/expert opinion) and are therefore consensus statements, not a scientifically established standard of care.

“None of those documents present any evidence above Level-IV, and the bulk of them are Level-V.”

Boe v. Marshall: EXPERT REPORT

“It should be remembered that the WPATH standard of medical necessity is not supported in reliable scientific evidence, but only on rudimentary, low level, expert opinion/ consensus statement data, which is no support at all.”

Dekker v. Weida: Exhibit Ex 19 Dr. Lappert Expert Report

“As discussed previously, the WPATH document is not a standard of care.”

Dekker v. Weida: Exhibit B - Lappert Rebuttal

““Gender affirming” treatments (i.e., hormones and surgery) have not been proven effective, or even competently tested.”

Dekker v. Weida: Exhibit E - Lappert Declaration (Brandt)

Seen in: Boe v. Marshall, Dekker v. Weida, Brandt v. Rutledge

Watchful waiting resolves gender dysphoria without surgery

He argues that a psychotherapeutic "watchful waiting" approach, supported by desistance studies, resolves gender dysphoria in the large majority of minors without resort to hormones or surgery, and that this outcome data is of higher quality than the case-series evidence offered for affirmation care.

“there are startling and permanent differences in outcomes between “affirmation-care” as proposed by the plaintiffs, and the historically proven approach that begins in proven psychological care, and results in resolution nearly 90% of the time.”

Dekker v. Weida: Exhibit Ex 19 Dr. Lappert Expert Report

Seen in: Boe v. Marshall, Dekker v. Weida

Gender surgeries cause severe, often irreversible harm

Drawing on his own surgical experience, he describes gender-affirming surgeries as producing permanent loss of sexual function, fertility, and sensation, alongside urinary, fistula, and wound-healing complications, terming genital surgeries castration or mutilation.

“For natal males, all such surgeries involve castration—the removal of the testicles and mutilation of the penis in natal males.”

Boe v. Marshall: EXPERT REPORT

“This means that breast function has been completely and irreversibly sacrificed for the sake of producing a cosmetic result (a masculine appearing chest).”

Dekker v. Weida: Exhibit E - Lappert Declaration (Brandt)

“This surgery actually begins with the known expectation that the surgery will produce a loss of two essential human functions, namely: sexual arousal, and breast feeding.”

Dekker v. Weida: Exhibit Ex 19 Dr. Lappert Expert Report

Seen in: Boe v. Marshall, Brandt v. Rutledge, Dekker v. Weida

Suicidality and psychiatric distress should bar surgical consent

He argues that under ordinary surgical ethics, a patient reporting depression, anxiety, or suicidality would be treated as incompetent to consent to elective surgery, and that offering surgery to a patient with body dysmorphic disorder rather than referring for psychiatric care is a failure of diagnosis.

“In all other areas of surgery, a patient who reports major depression, anxiety, suicidal ideation, or suicide attempt would be considered incompetent to give informed consent for surgery.”

Boe v. Marshall: EXPERT REPORT

Seen in: Boe v. Marshall, Brandt v. Rutledge

Sex is an objective binary fact; gender is subjective

He treats biological sex as a fixed, near-universally verifiable fact determined at conception/birth, and gender identity as a subjective, culturally variable trait that lacks any objective diagnostic test, and rejects the framing of sex as "assigned."

“In 99.98% of cases, simple inspection correctly detects the sex of the subject.”

Dekker v. Weida: Exhibit Ex 19 Dr. Lappert Expert Report

“Sex is not “assigned at birth” but permanently “assigned” at conception by DNA.”

Dekker v. Weida: Exhibit E - Lappert Declaration (Brandt)

Seen in: Dekker v. Weida, Brandt v. Rutledge

Other countries have retreated from pediatric gender-affirming care

He cites reviews from England (Cass), Sweden, Finland, and the Cochrane Collaboration as evidence that national health systems with longer experience have concluded the evidence for pediatric hormonal and surgical transition is inadequate and have shifted toward psychological care first.

“almost all children and young people who are put on puberty blockers go on to sex hormone treatment.”

Boe v. Marshall: EXPERT REPORT

Seen in: Boe v. Marshall, Brandt v. Rutledge

Studies cited for gender-affirming care suffer self-selection bias

He performs a recurring, near-identical critique of the same widely-cited outcome studies (particularly Olson-Kennedy et al. on chest surgery), pointing to high drop-out/non-response rates, unvalidated subjective instruments, and short follow-up as reasons the studies cannot support clinical decision-making.

“This is a second example of self-selection bias.”

Boe v. Marshall: EXPERT REPORT

“This is a second example of self-selection bias.”

Dekker v. Weida: Exhibit E - Lappert Declaration (Brandt)

Seen in: Boe v. Marshall, Brandt v. Rutledge

How his positions have shifted

His earliest available document, the 2021 Brandt v. Rutledge declaration, frames gender-affirming hormones and surgery primarily as "experimental" (doc_id 112008), leaning heavily on newly released national reviews from England, Sweden, and Finland and the Cochrane Collaboration. By the 2023 Dekker v. Weida expert declaration and rebuttal report (doc_ids 111966, 112005), the framing sharpens into a formal cosmetic-vs-reconstructive taxonomy and a systematic critique of specific opposing experts (Schechter, Olson-Kennedy) using an evidence-grading rubric borrowed from the American Society of Plastic Surgery. By the 2024 Boe v. Marshall report (doc_id 101956), he adds the "continuum of care" framing (arguing social, medical, and surgical transition cannot be treated as separable) and updates his citations to the finalized WPATH Standards of Care v.8 and the interim Cass Review, while retaining, largely verbatim in places, his earlier critique of the Olson-Kennedy chest-surgery study first developed in the 2021 Brandt declaration.

Under cross-examination

His own answers in depositions.

How many people have had the surgeries · Boe v. Marshall

Question (paraphrased): Asked whether he knows how many minors in Alabama have undergone gender-affirming surgeries, and whether he has done any work to determine that number.

“I don't know that number.”

Boe v. Marshall: Exhibit Lappert Deposition Transcript
His own research · Boe v. Marshall

Question (paraphrased): Asked whether he has, himself, performed any studies

“No.”

Boe v. Marshall: Exhibit Lappert Deposition Transcript
Diagnosing gender dysphoria · Boe v. Marshall

Question (paraphrased): Asked to confirm he has never diagnosed an individual with gender dysphoria

“Correct.”

Boe v. Marshall: Exhibit Lappert Deposition Transcript
Treating gender dysphoria · Boe v. Marshall

Question (paraphrased): Asked whether he has ever treated a patient for gender dysphoria (after asking what counsel meant by “the treatment of gender dysphoria” when asked if he is an expert in it)

“No.”

Boe v. Marshall: Exhibit Lappert Deposition Transcript
Training · Boe v. Marshall

Question (paraphrased): Asked whether he has undergone any formal training regarding the treatment of gender dysphoria

“No.”

Boe v. Marshall: Exhibit Lappert Deposition Transcript

Testimony that travels

Sentences that appear word for word in his filings in different cases.

  • “This is a second example of self-selection bias.” in 2 documents: 101956, 112008
  • “My practice has included Primary Care, Family Medicine, Aerospace Medicine, General Surgery, Reconstructive Surgery for combat injured, cancer reconstructive surgeries including extensive experience with microvascular surgery, Pediatric Congenital Deformity, and the care of chronic wounds.” in 2 documents: 101956, 112008

Curriculum vitae

Current positions

  • Retired plastic surgeon; retired senior medical officer, USN; as of his most recent report (2024) maintains a limited practice in wound consultation, skin care, and laser services. source
    “Although I maintain a practice in wound consultation, skin care, and laser services, I retired from my surgical practice in 2020, after having practiced as a plastic and reconstructive surgeon for 30 years.”

Education and training

  • B.A., Biological Sciences, UC Santa Barbara, 1979 source
    “Bachelor of Arts in Biological Sciences at the University of California, Santa Barbara, 1979.”
  • M.D., Uniformed Services University of the Health Sciences, 1983 source
    “M.D., Doctor of Medicine degree at the Uniformed Services University of the Health Sciences, 1983 at Bethesda, Md.”
  • General Surgery Residency, Naval Hospital Oakland/UC Davis East Bay Consortium, 1987-1991; Chief Resident 1990-1991 source
    “General Surgery Residency at the Naval Hospital Oakland/ UC Davis East Bay Consortium, 1987-1991”
  • Plastic Surgery Residency, University of Tennessee-Memphis, 1992-1994 source
    “Plastic Surgery Residency at the University of Tennessee- Memphis, 1992-1994.”

Past positions and roles

  • Staff General Surgeon, Naval Hospital Oakland, CA, 1991-1992; Associate Professor of Surgery, UC Davis-East Bay source
    “Staff General Surgeon at the Naval Hospital Oakland, CA 1991-1992”
  • Plastic and Reconstructive Surgeon and Department Chairman, Naval Medical Center Portsmouth, VA, 1994-2002 source
    “Plastic and Reconstructive Surgeon, Naval Medical Center, Portsmouth, VA 1994-2002”
  • Specialty Leader, Plastic and Reconstructive Surgery, Office of the Surgeon General, USN, 1997-2002 source
    “Specialty Leader, Plastic and Reconstructive Surgery, Office of the Surgeon General-USN, 1997-2002”
  • Clinical Assistant Professor, Dept. of Surgery, Uniformed Services University of the Health Sciences, 1995-2002; Teaching Faculty, Eastern Virginia Medical School, Division of Plastic Surgery, 1995-2002 source
    “Teaching Faculty at Eastern Virginia Medical School, Division of Plastic Surgery, 1995-2002”
  • Teaching faculty, Via College of Osteopathic Medicine, 2017-2020 (disclosed only in the Brandt v. Rutledge declaration, not in the later Boe/Dekker CV text) source
    “I also served on the teaching faculty of the Via College of Osteopathic Medicine, 2017-2020.”
  • Solo plastic surgery practice, Scottsbluff, Nebraska, then Northern Alabama (from 2005); retired from surgical practice in 2020 source
    “For reasons pertaining to the education of our six children, I moved my practice to Northern Alabama in 2005.”

Clinical practice

  • Broad general/plastic surgery practice across military and civilian settings; treated many thousands of patients source
    “As a physician and surgeon, I have treated many thousands of patients in 7 states and 4 foreign nations.”
  • Self-reports treating self-identified transgender patients in private practice for skin conditions related to hormone use and laser hair removal, and performing breast-reversal (detransition) surgeries; describes his practice as rated 'LGBTQ friendly' on social media source
    “In my private practice I have had occasion to treat many self-identified transgender patients for skin pathologies related to their use of high dose sex steroids, laser therapies for management of facial hair both in transitioners and detransitioners.”
  • States he has never performed a gender-affirmation surgery himself, as a matter of ethical opinion, though he characterizes the constituent surgical techniques as within his experience source
    “In 30 years of active practice as a plastic and reconstructive surgeon, I have never performed any gender affirmation surgery.”
  • Describes the specific transition-surgery procedures as within the scope of his surgical experience and says he instructed residents on them source
    “are within the scope of my experience. In fact, I instructed resident surgeons on these procedures.”

Publications and research

  • Lappert PW. Peritoneal Fluid in Human Acute Pancreatitis. Surgery. 1987 source
    “Lappert PW. Peritoneal Fluid in Human Acute Pancreatitis. Surgery. 1987 Sep;102(3):553-4”
  • Toth B, Lappert P. Modified Skin Incisions for Mastectomy. Plastic and Reconstructive Surgery. 1991 (co-authored, cited by defense brief as frequently-cited breast-reconstruction paper) source
    “Toth B, Lappert P. Modified Skin Incisions for Mastectomy: The Need for Plastic Surgical Input in Preoperative Planning. J Plastic and Reconstructive Surgery. 1991; 87: 1048-53”
  • Lappert P. Patch Esophagoplasty. J Plastic and Reconstructive Surgery. 1993 source
    “Lappert P. Patch Esophagoplasty. J Plastic and Reconstructive Surgery. 1993; 91 (5): 967-8”
  • Co-authored textbook chapter, Wound Management in the Military, Plastic Surgery: Indications, Operations, and Outcomes (Mosby, 2000) source
    “Wound Management in the Military. Lappert PW, Weiss DD, Eriksson E. Plastic Surgery: Indications, Operations, and Outcomes, Vol. 1; 53-63. Mosby. St. Louis, MO 2000”
  • Plaintiffs' Daubert brief characterizes his publication record as 7 items total (case reports/opinion pieces) and states he has not published in a peer-reviewed journal in over 25 years source
    “Dr. Lappert’s prior publications (seven in total) include case reports and opinion essays, and he has not published in”

Licenses, boards, honors

  • Board Certified in Surgery, American Board of Surgery, 1992-2002 (lapsed) source
    “Board Certified in Surgery — American Board of Surgery, 1992-2002”
  • Board Certified in Plastic Surgery, American Board of Plastic Surgery, 1997-2018 (recertified once in 2008; not recertified again, lapsed 2018) source
    “Board Certified in Plastic Surgery — American Board of Plastic Surgery, 1997-2018”
  • 'Resident's Choice' award, Naval Hospital Oakland, presented by Claude Organ, MD, past President, American College of Surgeons source
    “I was awarded the inaugural “Resident’s Choice” award given to the attending surgeon deemed most effective by the residents in training, and presented by Claude Organ, MD, past President, American College of Surgeons.”
  • Navy Commendation Medal, Meritorious Unit Citation (3rd award), Humanitarian Service Medal (Loma Prieta earthquake relief) source
    “Navy Commendation Medal - For service with Marine Fighter/Attack Squadron - 451”

Disclosed compensation

  • Boe v. Marshall: $400/hour for report preparation, deposition, and hearing, plus reimbursed travel expenses source
  • Dekker v. Weida: $400/hour for report preparation, deposition, and hearing, plus reimbursed travel expenses source
  • Brandt v. Rutledge: $400/hour for actual time devoted, including report drafting, travel, testimony, and consultation source

Testimony he lists himself

  • Brandt v. Rutledge 2021 · trial
  • Kadel v. Folwell 2019 · deposition
  • Dekker v. Weida 2022 · report

and 1 other matter he lists that are not in the litigation archive.

What the parties argued about him

Party filings, not rulings: motions, briefs and proposed findings.

  • Boe v. Marshall (): This is the United States' (intervenor-plaintiff) brief opposing a motion to exclude Dr. Lappert's testimony. It asserts that other courts did not exclude his testimony 'in toto,' but that is a party's characterization of other rulings, not a ruling by the Boe v. Marshall court itself; no order resolving the Boe v. Marshall motion is in these files. filing

Sources and method

Built from the litigation archive: 3 excerpts of opinions and oral arguments and 4 court documents that name him, and 16 filings of his own. Every mention was checked for identity (19 mentions of other people with the same surname were set aside). Every quote on this page (55) was checked word for word against its source; 7 that did not match were left out. Profile version 1. Gaps: No home address, phone, DOB, or family detail (beyond his own general reference to 'our six children,' which names no minor) appears in this file; none is reproduced here. The attached-CV text is present verbatim only in the Boe v. Marshall report exhibits (101956/102157/107133/107334, all near-identical); the Dekker declarations (111966/112004) restate the same biography in narrative form rather than as a CV. His own case list (in the 2024 Boe report) groups Brandt, Kadel, Dekker, and a Hamilton County, Ohio custody case together as cases where he 'testified at trial or deposition,' but his earlier 2023 Dekker declaration instead says he only 'submitted an expert report' in a Hamilton County, Ohio custody case -- the corpus does not resolve which is accurate, so a Hamilton County, Ohio custody case's role is marked 'report' and Dekker's is marked 'report' (the only role evidenced for it in this corpus) with this discrepancy flagged rather than resolved. No document in this corpus states who retained him in Kadel v. Folwell; that case's court rulings (quoted in the Dekker exclusion motion) indicate the court limited his testimony there to (1) surgical risks, (2) his anecdotal detransition-patient experience, and (3) WPATH's described surgeon role, after finding his broader opinions insufficiently supported -- that finding is from an adversarial brief, not his own admission, and is noted here as context only. Exhibit D (purporting to be Lappert deposition excerpts) and Exhibit 95 (the Kadel deposition) are present in the corpus only as page-number scaffolding with no extracted deposition text, so no direct deposition quotes from Kadel are available. No case-specific compensation figure was found for Kadel v. Folwell; only the general $400/hour rate recurs across Boe, Dekker, and Brandt. The CV nowhere states a specific current employer or clinical affiliation as of 2024 beyond the general reference to wound/skin/laser consultation; whether that practice is still active is not established beyond that one filing.

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