A teenage boy alleges he was given the female hormone estrogen after he was diagnosed with oppositional defiant disorder while in custody at a Los Angeles County juvenile hall last summer, a complaint filed in Los Angeles Superior Court last month states.
The boy, then 16, was given the medication without his or his parents' consent, but took it anyway because he feared if he didn't, he would face more severe punishment, court documents allege.
He alleges the medication caused him to develop an enlarging of his breast tissue and he suffered from symptoms of depression, anxiety, insomnia and headaches, among other problems, the complaint states.
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The boy was released in April after nearly a year in custody. He has returned home, but his parents say he's not the same.
"He has fallen into depression," said his father, who NBC4 is not identifying because his son is a minor. "He always wants to be in his room; he won't socialize."
The family filed a complaint in Los Angeles Superior Court on June 23. It alleges medical battery, medical negligence, and civil rights, privacy and due process violations. It also alleges that the defendants interfered or tried to interfere with his constitutional rights by threatening severe consequences if he refused to take the medication.
An NBC4 investigation has highlighted several problems in recent years at the county's juvenile lockups as violence has risen as the number of uses of pepper spray by probation officers has spiked and as staff grapple with a rising mental health caseload.
The complaint says the boy was taken off the medication after suffering from negative side effects. The parents allege it was only then that they were informed that their son had been on any medication, and were told he was "accidentally" given estrogen.
The Los Angeles County Department of Health Services, which oversees medical care services at county juvenile lockups, said it cannot comment on the case, citing medical and juvenile court privacy laws and the pending litigation.
In an emailed statement, the department said doctors and clinicians do not prescribe estrogen or any hormone for the treatment of behavioral health issues under any circumstance in the juvenile halls and camps.
The agency said that hormonal treatment is prescribed only among females for indications including contraception and dysmenorrhea/oligomenorrhea which involve infrequent menstrual periods and pain; it is also used among males for gender dysphoria/gender incongruence, which is described by a local pediatrician when someone feels their body genetics are not their identity.
"Any statement or suggestion that estrogen has been or is used for treatment of behavioral health disorders is inaccurate," the statement said.
Wesley Ouchi, the family's lawyer, said his client has never been diagnosed with any of those conditions.
"At no point did my client ever tell doctors that he experienced any symptoms associated with those conditions either," he said. "I have no idea why they would even believe he had Oppositional Defiant Disorder because there is no psychological testing and there was no psychiatric testing.”
The Mayo Clinic describes ODD as a condition where children display frequent patterns of anger and irritability against authority figures and is diagnosed by a doctor or mental health professional. Treatments include psychotherapy and training for the child.
A portion of the boy's medical records while in custody, obtained by NBC4 with his parents' consent, lists the boy’s condition as ODD in July 2019 and the medication prescribed - estradiol.
Dr. Ilan Shapiro, the medical director for Health Education and Wellness and a pediatrician for AltaMed, said using these types of hormones to treat ODD is not the first choice. He believes therapy is most important in treating ODD.
"Most of the times when a kid actually has ODD, oppositional defiant disorder, he's asking for help," said Shapiro, who is not involved in this boy's case.
According to the court documents, the boy was given his first estrogen pill on June 25, 2019, two days into his detainment at Eastlake Juvenile Hall, also known as Central Juvenile Hall, for an undisclosed criminal offense, according to the complaint.
The complaint states doctors took blood and urine samples and confirmed he had "slightly elevated levels of testosterone."
He was prescribed 30 doses of estradiol, the female hormone estrogen, for a diagnosis of oppositional defiant disorder, or ODD, which is correlated with "elevated levels of testosterone and delinquency in male youths," the complaint states.
The lawsuit says the boy was taken off estrogen after receiving 13 or more doses of estrogen and suffering negative side effects. The complaint alleges the parents were told by medical staff their son was prescribed the drug "accidentally."
It was the first time the boy was told that he was prescribed any medications or vaccines, the complaint states. He said he was never informed the doctors were prescribing him any medications, according to the complaint.
When he asked a nurse to explain the medications to him she told him it was treatment for a small "nodule" on his left chest, the complaint states.
When he found out he was given estrogen, he told staff he was going to refuse taking it, but was told he couldn't, the documents show.
He felt "pressured" and "threatened" to take the estrogen, as he did not want to get written up and reported to the judge, according to the complaint. At the time, the probation department was recommending that the boy be sent to the state's Department of Juvenile Justice (DJJ) youth lockup, the harshest level of punishment for children in California.
"The Juvenile Court Judge indicated that he would send Plaintiff to 'DJJ,' if he were to misbehave or receive negative 'case notes,' at the Juvenile Hall," the complaint states. "However, the Juvenile Court Judge also indicated that he would consider a less severe disposition or sentence, if Plaintiff were to continue to behave and 'run a good program,' while at the Juvenile Hall."
The complaint alleges he took the dosage of estrogen and it almost immediately caused him to experience negative physical, emotional and psychological effects. He immediately developed gynocomastia, the enlarging of his breast tissue, that did not exist prior to taking the estrogen pills, court documents state.
The complaint alleges the boy was given an experimental medical treatment that they give to other minors at the Juvenile Hall, a practice the complaint says is not an accepted, safe, or supported form of medical treatment for 'oppositional defiant disorder.
It's given to boys without consent to address "symptoms of 'oppositional defiant disorder,' criminality, and delinquency," the complaint states.
The defendants, the complaint states, "prescribed the estrogen as an experimental treatment for Plaintiff's 'oppositional defiant disorder,' in order to counteract the elevated levels of testosterone in his body, which may be associated with increased delinquency in male youths."
His father said he feels like his and his son's rights were violated.
"When my son came out I thought that we're going to get my son back, but definitely not, we didn't get my son back."