EXHIBIT(S) - 10 - Wylie C. Hembree, et al.s article, Endocrine Treatment of Gender-Dysphoria/Gender Incongruent Persons: An Endocrine Society Clinical Practice Guideline July 15, 2024 (2024)

EXHIBIT(S) - 10 - Wylie C. Hembree, et al.s article, Endocrine Treatment of Gender-Dysphoria/Gender Incongruent Persons: An Endocrine Society Clinical Practice Guideline July 15, 2024 (1)

EXHIBIT(S) - 10 - Wylie C. Hembree, et al.s article, Endocrine Treatment of Gender-Dysphoria/Gender Incongruent Persons: An Endocrine Society Clinical Practice Guideline July 15, 2024 (2)

  • EXHIBIT(S) - 10 - Wylie C. Hembree, et al.s article, Endocrine Treatment of Gender-Dysphoria/Gender Incongruent Persons: An Endocrine Society Clinical Practice Guideline July 15, 2024 (3)
  • EXHIBIT(S) - 10 - Wylie C. Hembree, et al.s article, Endocrine Treatment of Gender-Dysphoria/Gender Incongruent Persons: An Endocrine Society Clinical Practice Guideline July 15, 2024 (4)
  • EXHIBIT(S) - 10 - Wylie C. Hembree, et al.s article, Endocrine Treatment of Gender-Dysphoria/Gender Incongruent Persons: An Endocrine Society Clinical Practice Guideline July 15, 2024 (5)
  • EXHIBIT(S) - 10 - Wylie C. Hembree, et al.s article, Endocrine Treatment of Gender-Dysphoria/Gender Incongruent Persons: An Endocrine Society Clinical Practice Guideline July 15, 2024 (6)
  • EXHIBIT(S) - 10 - Wylie C. Hembree, et al.s article, Endocrine Treatment of Gender-Dysphoria/Gender Incongruent Persons: An Endocrine Society Clinical Practice Guideline July 15, 2024 (7)
  • EXHIBIT(S) - 10 - Wylie C. Hembree, et al.s article, Endocrine Treatment of Gender-Dysphoria/Gender Incongruent Persons: An Endocrine Society Clinical Practice Guideline July 15, 2024 (8)
  • EXHIBIT(S) - 10 - Wylie C. Hembree, et al.s article, Endocrine Treatment of Gender-Dysphoria/Gender Incongruent Persons: An Endocrine Society Clinical Practice Guideline July 15, 2024 (9)
  • EXHIBIT(S) - 10 - Wylie C. Hembree, et al.s article, Endocrine Treatment of Gender-Dysphoria/Gender Incongruent Persons: An Endocrine Society Clinical Practice Guideline July 15, 2024 (10)
 

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FILED: NASSAU COUNTY CLERK 07/15/2024 12:48 PM INDEX NO. 612363/2024NYSCEF DOC. NO. 14 RECEIVED NYSCEF: 07/15/2024 Exhibit 10FILED: NASSAU COUNTY CLERK 07/15/2024 12:48 PM INDEX NO. 612363/2024NYSCEF DOC. NO. 14 RECEIVED NYSCEF: 07/15/2024 CL IN IC A L P RA CT I CE G UI DE L I NE Endocrine Treatment of Gender-Dysphoric/ Gender-Incongruent Persons: An Endocrine Society* Clinical Practice Guideline Wylie C. Hembree,1 Peggy T. Cohen-Kettenis,2 Louis Gooren,3 Sabine E. Hannema,4 Walter J. Meyer,5 M. Hassan Murad,6 Stephen M. Rosenthal,7 Joshua D. Safer,8 Vin Tangpricha,9 and Guy G. T’Sjoen10 Downloaded from https://academic.oup.com/jcem/article/102/11/3869/4157558 by guest on 07 March 2024 1 New York Presbyterian Hospital, Columbia University Medical Center, New York, New York 10032 (Retired); 2VU University Medical Center, 1007 MB Amsterdam, Netherlands (Retired); 3VU University Medical Center, 1007 MB Amsterdam, Netherlands (Retired); 4Leiden University Medical Center, 2300 RC Leiden, Netherlands; 5University of Texas Medical Branch, Galveston, Texas 77555; 6Mayo Clinic Evidence- Based Practice Center, Rochester, Minnesota 55905; 7University of California San Francisco, Benioff Children’s Hospital, San Francisco, California 94143; 8Boston University School of Medicine, Boston, Massachusetts 02118; 9Emory University School of Medicine and the Atlanta VA Medical Center, Atlanta, Georgia 30322; and 10Ghent University Hospital, 9000 Ghent, Belgium *Cosponsoring Associations: American Association of Clinical Endo- crinologists, American Society of Andrology, European Society for Pediatric Endocrinology, European Society of Endocrinology, Pedi- atric Endocrine Society, and World Professional Association for Transgender Health. Objective: To update the “Endocrine Treatment of Transsexual Persons: An Endocrine Society Clinical Practice Guideline,” published by the Endocrine Society in 2009. Participants: The participants include an Endocrine Society–appointed task force of nine experts, a methodologist, and a medical writer. Evidence: This evidence-based guideline was developed using the Grading of Recommendations, Assessment, Development, and Evaluation approach to describe the strength of recommendations and the quality of evidence. The task force commissioned two systematic reviews and used the best available evidence from other published systematic reviews and individual studies. Consensus Process: Group meetings, conference calls, and e-mail communications enabled consensus. Endocrine Society committees, members and cosponsoring organizations reviewed and commented on preliminary drafts of the guidelines. Conclusion: Gender affirmation is multidisciplinary treatment in which endocrinologists play an important role. Gender-dysphoric/gender-incongruent persons seek and/or are referred to endocrinologists to develop the physical characteristics of the affirmed gender. They require a safe and effective hormone regimen that will (1) suppress endogenous sex hormone secretion determined by the person’s genetic/gonadal sex and (2) maintain sex hormone levels within the normal range for the person’s affirmed gender. Hormone treatment is not recommended for prepubertal gender-dysphoric/gender-incongruent persons. Those clinicians who recommend gender-affirming endocrine treatments—appropriately trained diagnosing clinicians (required), a mental health provider for adolescents (required) and mental health ISSN Print 0021-972X ISSN Online 1945-7197 Abbreviations: BMD, bone mineral density; DSD, disorder/difference of sex development; Printed in USA DSM, Diagnostic and Statistical Manual of Mental Disorders; GD, gender dysphoria; Copyright © 2017 Endocrine Society GnRH, gonadotropin-releasing hormone; ICD, International Statistical Classification of Received 24 July 2017. Accepted 24 August 2017. Diseases and Related Health Problems; MHP, mental health professional; VTE, venous First Published Online 13 September 2017 thromboembolism. doi: 10.1210/jc.2017-01658 J Clin Endocrinol Metab, November 2017, 102(11):3869–3903 https://academic.oup.com/jcem 3869FILED: NASSAU COUNTY CLERK 07/15/2024 12:48 PM INDEX NO. 612363/2024NYSCEF DOC. NO. 14 RECEIVED NYSCEF: 07/15/2024 3870 Hembree et al Guidelines on Gender-Dysphoric/Gender-Incongruent Persons J Clin Endocrinol Metab, November 2017, 102(11):3869–3903 professional for adults (recommended)—should be knowledgeable about the diagnostic criteria and criteria for gender-affirming treatment, have sufficient training and experience in assessing psychopathology, and be willing to participate in the ongoing care throughout the endocrine transition. We recommend treating gender-dysphoric/gender-incongruent adolescents who have entered puberty at Tanner Stage G2/B2 by suppression with gonadotropin-releasing hormone agonists. Clinicians may add gender-affirming hormones after a multidisciplinary team has confirmed the persistence of gender dysphoria/gender incongruence and sufficient mental capacity to give informed consent to this partially irreversible treatment. Most adolescents have this capacity by age 16 years old. We recognize that there may be compelling reasons to initiate sex hormone treatment prior to age 16 years, although there is minimal published experience treating prior to 13.5 to 14 years of age. For the care of peripubertal youths and older adolescents, we recommend that an expert multidisciplinary team comprised of medical Downloaded from https://academic.oup.com/jcem/article/102/11/3869/4157558 by guest on 07 March 2024 professionals and mental health professionals manage this treatment. The treating physician must confirm the criteria for treatment used by the referring mental health practitioner and collaborate with them in decisions about gender-affirming surgery in older adolescents. For adult gender-dysphoric/gender-incongruent persons, the treating clinicians (collectively) should have expertise in transgender-specific diagnostic criteria, mental health, primary care, hormone treatment, and surgery, as needed by the patient. We suggest maintaining physiologic levels of gender-appropriate hormones and monitoring for known risks and complications. When high doses of sex steroids are required to suppress endogenous sex steroids and/or in advanced age, clinicians may consider surgically removing natal gonads along with reducing sex steroid treatment. Clinicians should monitor both transgender males (female to male) and transgender females (male to female) for reproductive organ cancer risk when surgical removal is incomplete. Additionally, clinicians should persistently monitor adverse effects of sex steroids. For gender-affirming surgeries in adults, the treating physician must collaborate with and confirm the criteria for treatment used by the referring physician. Clinicians should avoid harming individuals (via hormone treatment) who have conditions other than gender dysphoria/gender incongruence and who may not benefit from the physical changes associated with this treatment. (J Clin Endocrinol Metab 102: 3869–3903, 2017) Summary of Recommendations 1.2. We advise that only MHPs who meet the fol- lowing criteria should diagnose GD/gender in- 1.0 Evaluation of youth and adults congruence in children and adolescents: (1) 1.1. We advise that only trained mental health pro- training in child and adolescent developmental fessionals (MHPs) who meet the following cri- psychology and psychopathology, (2) competence teria should diagnose gender dysphoria (GD)/ in using the DSM and/or the ICD for diagnostic gender incongruence in adults: (1) competence purposes, (3) the ability to make a distinction in using the Diagnostic and Statistical Manual between GD/gender incongruence and conditions of Mental Disorders (DSM) and/or the In- that have similar features (e.g., body dysmorphic ternational Statistical Classification of Diseases disorder), (4) training in diagnosing psychiatric and Related Health Problems (ICD) for di- conditions, (5) the ability to undertake or refer for agnostic purposes, (2) the ability to diagnose GD/ appropriate treatment, (6) the ability to psycho- gender incongruence and make a distinction socially assess the person’s understanding and between GD/gender incongruence and conditions social conditions that can impact gender-affirming that have similar features (e.g., body dysmorphic hormone therapy, (7) a practice of regularly at- disorder), (3) training in diagnosing psychiatric tending relevant professional meetings, and (8) conditions, (4) the ability to undertake or refer knowledge of the criteria for puberty blocking and for appropriate treatment, (5) the ability to gender-affirming hormone treatment in adoles- psychosocially assess the person’s understanding, cents. (Ungraded Good Practice Statement) mental health, and social conditions that can 1.3. We advise that decisions regarding the social impact gender-affirming hormone therapy, and transition of prepubertal youths with GD/gender (6) a practice of regularly attending relevant incongruence are made with the assistance of professional meetings. (Ungraded Good Practice an MHP or another experienced professional. Statement) (Ungraded Good Practice Statement).FILED: NASSAU COUNTY CLERK 07/15/2024 12:48 PM INDEX NO. 612363/2024NYSCEF DOC. NO. 14 RECEIVED NYSCEF: 07/15/2024 doi: 10.1210/jc.2017-01658 https://academic.oup.com/jcem 3871 1.4. We recommend against puberty blocking and the criteria for the endocrine phase of gender gender-affirming hormone treatment in pre- transition before beginning treatment. (1 |s) pubertal children with GD/gender incongruence. 3.2. We recommend that clinicians evaluate and ad- (1 |ss) dress medical conditions that can be exacerbated 1.5. We recommend that clinicians inform and by hormone depletion and treatment with sex counsel all individuals seeking gender-affirming hormones of the affirmed gender before begin- medical treatment regarding options for fertility ning treatment. (1 |s) preservation prior to initiating puberty sup- 3.3. We suggest that clinicians measure hormone pression in adolescents and prior to treating with levels during treatment to ensure that endog- hormonal therapy of the affirmed gender in both enous sex steroids are suppressed and admin- adolescents and adults. (1 |s) istered sex steroids are maintained in the Downloaded from https://academic.oup.com/jcem/article/102/11/3869/4157558 by guest on 07 March 2024 normal physiologic range for the affirmed gender. (2 |ss) 2.0 Treatment of adolescents 3.4. We suggest that endocrinologists provide edu- 2.1. We suggest that adolescents who meet diagnostic cation to transgender individuals undergoing criteria for GD/gender incongruence, fulfill cri- treatment about the onset and time course of teria for treatment, and are requesting treatment physical changes induced by sex hormone should initially undergo treatment to suppress treatment. (2 |sss) pubertal development. (2 |ss) 2.2. We suggest that clinicians begin pubertal hor- 4.0 Adverse outcome prevention and long-term care mone suppression after girls and boys first exhibit physical changes of puberty. (2 |ss) 4.1. We suggest regular clinical evaluation for phys- 2.3. We recommend that, where indicated, GnRH ical changes and potential adverse changes in analogues are used to suppress pubertal hor- response to sex steroid hormones and laboratory mones. (1 |ss) monitoring of sex steroid hormone levels every 2.4. In adolescents who request sex hormone treat- 3 months during the first year of hormone ment (given this is a partly irreversible treatment), therapy for transgender males and females and we recommend initiating treatment using a then once or twice yearly. (2 |ss) gradually increasing dose schedule after a mul- 4.2. We suggest periodically monitoring prolactin tidisciplinary team of medical and MHPs has levels in transgender females treated with estro- confirmed the persistence of GD/gender in- gens. (2 |ss) congruence and sufficient mental capacity to give 4.3. We suggest that clinicians evaluate transgender informed consent, which most adolescents have persons treated with hormones for cardiovas- by age 16 years. (1 |ss). cular risk factors using fasting lipid profiles, di- 2.5. We recognize that there may be compelling abetes screening, and/or other diagnostic tools. reasons to initiate sex hormone treatment prior (2 |ss) to the age of 16 years in some adolescents with GD/ 4.4. We recommend that clinicians obtain bone gender incongruence, even though there are mineral density (BMD) measurements when risk minimal published studies of gender-affirming factors for osteoporosis exist, specifically in those hormone treatments administered before age 13.5 who stop sex hormone therapy after gonadec- to 14 years. As with the care of adolescents tomy. (1 |ss) $16 years of age, we recommend that an ex- 4.5. We suggest that transgender females with no pert multidisciplinary team of medical and known increased risk of breast cancer follow MHPs manage this treatment. (1 | sss) breast-screening guidelines recommended for 2.6. We suggest monitoring clinical pubertal devel- non-transgender females. (2 |ss) opment every 3 to 6 months and laboratory 4.6. We suggest that transgender females treated parameters every 6 to 12 months during sex with estrogens follow individualized screening hormone treatment. (2 |ss) according to personal risk for prostatic disease and prostate cancer. (2 |sss) 4.7. We advise that clinicians determine the medical 3.0 Hormonal therapy for transgender adults necessity of including a total hysterectomy and 3.1. We recommend that clinicians confirm the di- oophorectomy as part of gender-affirming sur- agnostic criteria of GD/gender incongruence and gery. (Ungraded Good Practice Statement)FILED: NASSAU COUNTY CLERK 07/15/2024 12:48 PM INDEX NO. 612363/2024NYSCEF DOC. NO. 14 RECEIVED NYSCEF: 07/15/2024 3872 Hembree et al Guidelines on Gender-Dysphoric/Gender-Incongruent Persons J Clin Endocrinol Metab, November 2017, 102(11):3869–3903 5.0 Surgery for sex reassignment and clinical evaluation of both youth and adults, defines in gender confirmation detail the professional qualifications required of those who diagnose and treat both adolescents and adults. 5.1. We recommend that a patient pursue genital We advise that decisions regarding the social transition gender-affirming surgery only after the MHP and of prepubertal youth are made with the assistance of a the clinician responsible for endocrine transition mental health professional or similarly experienced therapy both agree that surgery is medically professional. We recommend against puberty blocking necessary and would benefit the patient’s overall followed by gender-affirming hormone treatment of pre- health and/or well-being. (1 |ss) pubertal children. Clinicians should inform pubertal 5.2. We advise that clinicians approve genital gender- children, adolescents, and adults seeking gender- affirming surgery only after completion of at least confirming treatment of their options for fertility preser- Downloaded from https://academic.oup.com/jcem/article/102/11/3869/4157558 by guest on 07 March 2024 1 year of consistent and compliant hormone vation. Prior to treatment, clinicians should evaluate the treatment, unless hormone therapy is not desired presence of medical conditions that may be worsened or medically contraindicated. (Ungraded Good by hormone depletion and/or treatment. A multidis- Practice Statement) ciplinary team, preferably composed of medical and 5.3. We advise that the clinician responsible for en- mental health professionals, should monitor treat- docrine treatment and the primary care provider ments. Clinicians evaluating transgender adults for ensure appropriate medical clearance of trans- endocrine treatment should confirm the diagnosis of gender individuals for genital gender-affirming persistent gender dysphoria/gender incongruence. surgery and collaborate with the surgeon re- Physicians should educate transgender persons re- garding hormone use during and after surgery. garding the time course of steroid-induced physical (Ungraded Good Practice Statement) changes. Treatment should include periodic monitoring of 5.4. We recommend that clinicians refer hormone- hormone levels and metabolic parameters, as well as as- treated transgender individuals for genital sur- sessments of bone density and the impact upon prostate, gery when: (1) the individual has had a satisfactory gonads, and uterus. We also make recommendations for social role change, (2) the individual is satisfied transgender persons who plan genital gender-affirming about the hormonal effects, and (3) the individual surgery. desires definitive surgical changes. (1 |sss) 5.5. We suggest that clinicians delay gender-affirming genital surgery involving gonadectomy and/or Method of Development of Evidence-Based hysterectomy until the patient is at least 18 Clinical Practice Guidelines years old or legal age of majority in his or her The Clinical Guidelines Subcommittee (CGS) of the Endocrine country. (2 |ss). Society deemed the diagnosis and treatment of individuals with 5.6. We suggest that clinicians determine the timing of GD/gender incongruence a priority area for revision and breast surgery for transgender males based upon appointed a task force to formulate evidence-based recom- the physical and mental health status of the in- mendations. The task force followed the approach recom- mended by the Grading of Recommendations, Assessment, dividual. There is insufficient evidence to rec- Development, and Evaluation group, an international group ommend a specific age requirement. (2 |sss) with expertise in the development and implementation of evidence-based guidelines (1). A detailed description of the grading scheme has been published elsewhere (2). The task force Changes Since the Previous Guideline used the best available research evidence to develop the rec- ommendations. The task force also used consistent language Both the current guideline and the one published in 2009 and graphical descriptions of both the strength of a recom- contain similar sections. Listed here are the sections mendation and the quality of evidence. In terms of the strength contained in the current guideline and the corresponding of the recommendation, strong recommendations use the phrase “we recommend” and the number 1, and weak recommenda- number of recommendations: Introduction, Evaluation tions use the phrase “we suggest” and the number 2. Cross-filled of Youth and Adults (5), Treatment of Adolescents (6), circles indicate the quality of the evidence, such that sss Hormonal Therapy for Transgender Adults (4), Adverse denotes very low–quality evidence; ss, low quality; Outcomes Prevention and Long-term Care (7), and s, moderate quality; and , high quality. The task Surgery for Sex Reassignment and Gender Confirmation force has confidence that persons who receive care according to the strong recommendations will derive, on average, more (6). The current introduction updates the diagnostic benefit than harm. Weak recommendations require more classification of “gender dysphoria/gender incongru- careful consideration of the person’s circ*mstances, values, and ence.” It also reviews the development of “gender identity” preferences to determine the best course of action. Linked to and summarizes its natural development. The section on each recommendation is a description of the evidence and theFILED: NASSAU COUNTY CLERK 07/15/2024 12:48 PM INDEX NO. 612363/2024NYSCEF DOC. NO. 14 RECEIVED NYSCEF: 07/15/2024 doi: 10.1210/jc.2017-01658 https://academic.oup.com/jcem 3873 values that the task force considered in making the recom- quality of the evidence was low. The second review mendation. In some instances, there are remarks in which the summarized the available evidence regarding the effect of task force offers technical suggestions for testing conditions, sex steroids on bone health in transgender individuals dosing, and monitoring. These technical comments reflect the best available evidence applied to a typical person being treated. and identified 13 studies. In transgender males, there was Often this evidence comes from the unsystematic observations no statistically significant difference in the lumbar spine, of the task force and their preferences; therefore, one should femoral neck, or total hip BMD at 12 and 24 months consider these remarks as suggestions. compared with baseline values before initiating mascu- In this guideline, the task force made several statements to linizing hormone therapy. In transgender females, there emphasize the importance of shared decision-making, general was a statistically significant increase in lumbar spine preventive care measures, and basic principles of the treatment of transgender persons. They labeled these “Ungraded Good BMD at 12 months and 24 months compared with Practice Statement.” Direct evidence for these statements was baseline values before initiation of feminizing hormone Downloaded from https://academic.oup.com/jcem/article/102/11/3869/4157558 by guest on 07 March 2024 either unavailable or not systematically appraised and consid- therapy. There was minimal information on fracture ered out of the scope of this guideline. The intention of these rates. The quality of evidence was also low. statements is to draw attention to these principles. The Endocrine Society maintains a rigorous conflict-of- interest review process for developing clinical practice guide- Introduction lines. All task force members must declare any potential conflicts of interest by completing a conflict-of-interest form. Throughout recorded history (in the absence of an en- The CGS reviews all conflicts of interest before the Society’s docrine disorder) some men and women have experi- Council approves the members to participate on the task force enced confusion and anguish resulting from rigid, forced and periodically during the development of the guideline. All conformity to sexual dimorphism. In modern history, others participating in the guideline’s development must also disclose any conflicts of interest in the matter under study, and there have been numerous ongoing biological, psycho- most of these participants must be without any conflicts of logical, cultural, political, and sociological debates over interest. The CGS and the task force have reviewed all disclo- various aspects of gender variance. The 20th century sures for this guideline and resolved or managed all identified marked the emergence of a social awakening for men and conflicts of interest. women with the belief that they are “trapped” in the Conflicts of interest are defined as remuneration in any amount from commercial interests; grants; research support; wrong body (3). Magnus Hirschfeld and Harry Benja- consulting fees; salary; ownership interests [e.g., stocks and min, among others, pioneered the medical responses to stock options (excluding diversified mutual funds)]; honoraria those who sought relief from and a resolution to their and other payments for participation in speakers’ bureaus, profound discomfort. Although the term transsexual advisory boards, or boards of directors; and all other financial became widely known after Benjamin wrote “The benefits. Completed forms are available through the Endocrine Transsexual Phenomenon” (4), it was Hirschfeld who Society office. The Endocrine Society provided the funding for this coined the term “transsexual” in 1923 to describe people guideline; the task force received no funding or remuneration who want to live a life that corresponds with their ex- from commercial or other entities. perienced gender vs their designated gender (5). Magnus Hirschfeld (6) and others (4, 7) have described other types Commissioned Systematic Review of trans phenomena besides transsexualism. These early researchers proposed that the gender identity of these The task force commissioned two systematic reviews to people was located somewhere along a unidimensional support this guideline. The first one aimed to summarize continuum. This continuum ranged from all male the available evidence on the effect of sex steroid use in through “something in between” to all female. Yet such a transgender individuals on lipids and cardiovascular classification does not take into account that people may outcomes. The review identified 29 eligible studies at have gender identities outside this continuum. For in- moderate risk of bias. In transgender males (female to stance, some experience themselves as having both a male male), sex steroid therapy was associated with a statis- and female gender identity, whereas others completely tically significant increase in serum triglycerides and renounce any gender classification (8, 9). There are also low-density lipoprotein cholesterol levels. High-density reports of individuals experiencing a continuous and lipoprotein cholesterol levels decreased significantly rapid involuntary alternation between a male and female across all follow-up time periods. In transgender females identity (10) or men who do not experience themselves as (male to female), serum triglycerides were significantly men but do not want to live as women (11, 12). In some higher without any changes in other parameters. Few countries, (e.g., Nepal, Bangladesh, and Australia), these myocardial infarction, stroke, venous thromboembolism nonmale or nonfemale genders are officially recognized (VTE), and death events were reported. These events were (13). Specific treatment protocols, however, have not yet more frequent in transgender females. However, the been developed for these groups.FILED: NASSAU COUNTY CLERK 07/15/2024 12:48 PM INDEX NO. 612363/2024NYSCEF DOC. NO. 14 RECEIVED NYSCEF: 07/15/2024 3874 Hembree et al Guidelines on Gender-Dysphoric/Gender-Incongruent Persons J Clin Endocrinol Metab, November 2017, 102(11):3869–3903 Instead of the term transsexualism, the current studies across countries that use the same diagnostic and classification system of the American Psychiatric As- inclusion criteria, medications, assay methods, and re- sociation uses the term gender dysphoria in its di- sponse assessment tools (e.g., the European Network for agnosis of persons who are not satisfied with their the Investigation of Gender Incongruence) (17, 18). designated gender (14). The current version of the Terminology and its use vary and continue to evolve. World Health Organization’s ICD-10 still uses the term Table 1 contains the definitions of terms as they are used transsexualism when diagnosing adolescents and throughout this guideline. adults. However, for the ICD-11, the World Health Organization has proposed using the term “gender in- Biological Determinants of Gender congruence” (15). Identity Development Treating persons with GD/gender incongruence (15) Downloaded from https://academic.oup.com/jcem/article/102/11/3869/4157558 by guest on 07 March 2024 was previously limited to relatively ineffective elixirs or One’s self-awareness as male or female changes creams. However, more effective endocrinology-based gradually during infant life and childhood. This pro- treatments became possible with the availability of cess of cognitive and affective learning evolves with testosterone in 1935 and diethylstilbestrol in 1938. interactions with parents, peers, and environment. A Reports of individuals with GD/gender incongruence fairly accurate timetable exists outlining the steps in who were treated with hormones and gender-affirming this process (19). Normative psychological literature, surgery appeared in the press during the second half of however, does not address if and when gender identity the 20th century. The Harry Benjamin International becomes crystallized and what factors contribute to Gender Dysphoria Association was founded in Sep- the development of a gender identity that is not con- tember 1979 and is now called the World Professional gruent with the gender of rearing. Results of studies Association for Transgender Health (WPATH). WPATH from a variety of biomedical disciplines—genetic, published its first Standards of Care in 1979. These endocrine, and neuroanatomic—support the concept standards have since been regularly updated, providing that gender identity and/or gender expression (20) guidance for treating persons with GD/gender in- likely reflect a complex interplay of biological, envi- congruence (16). ronmental, and cultural factors (21, 22). Prior to 1975, few peer-reviewed articles were pub- With respect to endocrine considerations, studies lished concerning endocrine treatment of transgender have failed to find differences in circulating levels of sex persons. Since then, more than two thousand articles steroids between transgender and nontransgender in- about various aspects of transgender care have appeared. dividuals (23). However, studies in individuals with a It is the purpose of this guideline to make detailed disorder/difference of sex development (DSD) have in- recommendations and suggestions, based on existing formed our understanding of the role that hormones medical literature and clinical experience, that will enable may play in gender identity outcome, even though most treating physicians to maximize benefit and minimize risk persons with GD/gender incongruence do not have when caring for individuals diagnosed with GD/gender a DSD. For example, although most 46,XX adult in- incongruence. dividuals with virilizing congenital adrenal hyperplasia In the future, we need more rigorous evaluations of the caused by mutations in CYP21A2 reported a female effectiveness and safety of endocrine and surgical pro- gender identity, the prevalence of GD/gender in- tocols. Specifically, endocrine treatment protocols for congruence was much greater in this group than in the GD/gender incongruence should include the careful as- general population without a DSD. This supports the sessment of the following: (1) the effects of prolonged concept that there is a role for prenatal/postnatal an- delay of puberty in adolescents on bone health, gonadal drogens in gender development (24–26), although some function, and the brain (including effects on cognitive, studies indicate that prenatal androgens are more likely emotional, social, and sexual development); (2) the ef- to affect gender behavior and sexual orientation rather fects of treatment in adults on sex hormone levels; (3) than gender identity per se (27, 28). the requirement for and the effects of progestins and Researchers have made similar observations regarding other agents used to suppress endogenous sex ste- the potential role of androgens in the development of gender roids during treatment; and (4) the risks and benefits identity in other individuals with DSD. For example, a of gender-affirming hormone treatment in older trans- review of two groups of 46,XY persons, each with an- gender people. drogen synthesis deficiencies and female raised, reported To successfully establish and enact these protocols, transgender male (female-to-male) gender role changes in a commitment of mental health and endocrine investi- 56% to 63% and 39% to 64% of patients, respectively gators is required to collaborate in long-term, large-scale (29). Also, in 46,XY female-raised individuals with cloacalFILED: NASSAU COUNTY CLERK 07/15/2024 12:48 PM INDEX NO. 612363/2024NYSCEF DOC. NO. 14 RECEIVED NYSCEF: 07/15/2024 doi: 10.1210/jc.2017-01658 https://academic.oup.com/jcem 3875 Table 1. Definitions of Terms Used in This Guideline Biological sex, biological male or female: These terms refer to physical aspects of maleness and femaleness. As these may not be in line with each other (e.g., a person with XY chromosomes may have female-appearing genitalia), the terms biological sex and biological male or female are imprecise and should be avoided. Cisgender: This means not transgender. An alternative way to describe individuals who are not transgender is “non-transgender people.” Gender-affirming (hormone) treatment: See “gender reassignment” Gender dysphoria: This is the distress and unease experienced if gender identity and designated gender are not completely congruent (see Table 2). In 2013, the American Psychiatric Association released the fifth edition of the DSM-5, which replaced “gender identity disorder” with “gender dysphoria” and changed the criteria for diagnosis. Gender expression: This refers to external manifestations of gender, expressed through one’s name, pronouns, clothing, haircut, behavior, voice, or body characteristics. Typically, transgender people seek to make their gender expression align with their gender identity, rather than their designated gender. Downloaded from https://academic.oup.com/jcem/article/102/11/3869/4157558 by guest on 07 March 2024 Gender identity/experienced gender: This refers to one’s internal, deeply held sense of gender. For transgender people, their gender identity does not match their sex designated at birth. Most people have a gender identity of man or woman (or boy or girl). For some people, their gender identity does not fit neatly into one of those two choices. Unlike gender expression (see below), gender identity is not visible to others. Gender identity disorder: This is the term used for GD/gender incongruence in previous versions of DSM (see “gender dysphoria”). The ICD-10 still uses the term for diagnosing child diagnoses, but the upcoming ICD-11 has proposed using “gender incongruence of childhood.” Gender incongruence: This is an umbrella term used when the gender identity and/or gender expression differs from what is typically associated with the designated gender. Gender incongruence is also the proposed name of the gender identity–related diagnoses in ICD-11. Not all individuals with gender incongruence have gender dysphoria or seek treatment. Gender variance: See “gender incongruence” Gender reassignment: This refers to the treatment procedure for those who want to adapt their bodies to the experienced gender by means of hormones and/or surgery. This is also called gender-confirming or gender-affirming treatment. Gender-reassignment surgery (gender-confirming/gender-affirming surgery): These terms refer only to the surgical part of gender- confirming/gender-affirming treatment. Gender role: This refers to behaviors, attitudes, and pers

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Ruling

NATHAN JACKSON VS PAUL BURKE, ET AL.

Jul 16, 2024 |21STCV08691

Case Number: 21STCV08691 Hearing Date: July 16, 2024 Dept: B NATHAN JACKSON V. PAUL BURKE, ET AL. PETITION TO CONFIRM MINORS COMPROMISE Date of Hearing: July 16, 2024 Trial Date: N/A Department: B Case No.: 21STCV08691 Moving Party: Petitioner Dwain Jackson Responding Party: Unopposed BACKGROUND This action arises from Plaintiff Nathan Jackson, a minor (Plaintiff) sustaining injuries arising from crashing a dirt bike into a walkway railing. On March 5, 2021, Plaintiff filed a Complaint against Defendants Paul Burke (Burke), Yordanose Tesfasilase (Tesfasilase), and Does 1-10, alleging a cause of action for General Negligence. On July 16, 2021, in Nathan Jackson v. Forum Entertainment, LLC, LASC Case No. 21STCV26337 (the 2d Action), Plaintiff filed a Complaint against Defendant Forum Entertainment, LLC (FEL) alleging a single cause of action for General Negligence. On March 18, 2021, in the 2d Action, Dwain Jackson was appointed as guardian ad litem for Plaintiff. On October 26, 2021, the instant action and the 2d Action were deemed related. (10/26/21 Minute Order.) On September 26, 2022, pursuant to stipulation, the Court entered an order consolidating the instant action and the 2d Action. (09/26/22 Order.) The Courts order provided that both cases will be consolidated into case number 21STCV08691. (09/26/22 Order.) On October 19, 2023, Burke and Tesfasilase filed a Cross-Complainant against FEL for: (1) Complete Indemnity; (2) Partial Indemnity; and (3) Declaratory Relief. On February 6, 2024, Plaintiff filed a Notice of Settlement of Entire Case. On June 5, 2024, Parent and Guardian Ad Litem Dwain Jackson (Petitioner) filed the instant Petition to Approve Compromise of Pending Action (the Petition) on behalf of Claimant Nathan Jackson (Claimant). Initially, the Court notes that there is no proof of service pertaining to the Petition. Thus, the Court assumes that no defendant was served with the Petition or its associated papers. [Tentative] Ruling The Petition to Approve Compromise of Pending Action (the Petition) filed on behalf of Claimant Nathan Jackson is DENIED WITHOUT PREJUDICE. DISCUSSION When a minor, a person who lacks legal capacity to make decisions, or a person for whom a conservator has been appointed is a party, that person shall appear either by a guardian or conservator of the estate or by a guardian ad litem appointed by the court in which the action or proceeding is pending, or by a judge thereof, in each case. (Code Civ. Proc., § 372, subd. (a)(1).) The purpose of section 372 is to protect the minor involved in litigation by adding an extra layer of scrutiny to the settlement of the minors claims. (Pearson v. Superior Court (2012) 202 Cal.App.4th 1333, 1339.) Substance of the Petition Claimant, a minor, by and through his Guardian Ad Litem, Petitioner, has agreed to settle his claims against Defendants Burke, Tesfasilase, and FEL for $225,000.00. (Petition, ¶ 10(b)-(c).) The gross amount of settlement is $225,000.00 and attorneys fees in the sum of $56,250.00 are requested to be paid from the gross amount of the settlement. (Petition, ¶¶ 16(a) and 16(e).) Claimants medical expenses to be paid from the proceeds of the settlement amount to $3,320.08. (Petition, ¶ 16(b).) Cost expenses to be paid from the settlement amounts to $2,122.33. (Petition, ¶ 16(d).) The Court finds that the requested attorneys fees, 25% of the total settlement, is fair and reasonable. The declaration of Anthony Willoughby, Esq. complies with Cal. Rules of Court, rule 7.955. However, the Court notes that there is a discrepancy on the Petition as to the net balance of proceeds for Claimant. (See Petition, ¶¶ 15 and 16(f).) Paragraph 15 of the Petition states that Claimant will receive a net balance of $163,234.56 whereas Paragraph 16(f) of the Petition indicates that Claimant will receive a net balance of proceeds of $163,307.59. While the funds are proposed to be deposited in an insured account at one or more financial institutions in this state, Petitioner has not provided any information on the name, branch, or address of such financial institutions. (Petition, ¶ 18(b)(2).) Attachment 18(b)(2) is not attached to the Petition. Additionally, Petitioner has also failed to serve all interested parties with the Petition. As such, the Petition is defective as identified above. CONCLUSION Based on the foregoing, the Petition is DENIED WITHOUT PREJUDICE. Moving party is ordered to give notice.

Ruling

TAMERA PINELO VS LOS ANGELES COUNTY METROPOLITAN TRANSPORTATION AUTHORITY

Jul 15, 2024 |23STCV11541

Case Number: 23STCV11541 Hearing Date: July 15, 2024 Dept: 32 PLEASE NOTE: Parties are encouraged to meet and confer concerning this tentative ruling to determine if a resolution may be reached. If the parties are unable to reach a resolution and a party intends to submit on this tentative ruling, the party must send an email to the Court at sscdept32@lacourt.org indicating that partys intention to submit. The email shall include the case number, date and time of the hearing, counsels contact information (if applicable), and the identity of the party submitting on this tentative ruling. If the Court does not receive an email indicating the parties are submitting on this tentative ruling and there are no appearances at the hearing, the Court may place the motion off calendar or adopt the tentative ruling as the order of the Court. If all parties do not submit on this tentative ruling, they should arrange to appear in-person or remotely. Further, after the Court has posted/issued a tentative ruling, the Court has the inherent authority to prohibit the withdrawal of the subject motion and adopt the tentative ruling as the order of the Court. TENTATIVE RULING DEPT: 32 HEARING DATE: July 15, 2024 CASE NUMBER: 23STCV11541 MOTIONS: Motion to Compel Defendants Deposition MOVING PARTY: Plaintiff Tamera Pinelo OPPOSING PARTY: Defendant Jorge Carlos Castro BACKGROUND Plaintiff Tamera Pinelo (Plaintiff) moves to compel Defendant Jorge Carlos Castros (Defendant) deposition. Plaintiff also seeks monetary sanctions. Defendant opposes. No reply has been filed. LEGAL STANDARD If, after service of a deposition notice, a party to the action . . . , without having served a valid objection under Section 2025.410, fails to appear for examination, or to proceed with it, or to produce for inspection any document . . . described in the deposition notice, the party giving the notice may move for an order compelling the deponents attendance and testimony, and the production for inspection of any document . . . described in the deposition notice. (Code Civ. Proc., § 2025.450, subd. (a).) A motion under subdivision (a) [above] shall comply with both of the following: 1. The motion shall set forth specific facts showing good cause justifying the production for inspection of any document, electronically stored information, or tangible thing described in the deposition notice. 2. The motion shall be accompanied by a meet and confer declaration under Section 2016.040, or, when the deponent fails to attend the deposition and produce the documents, electronically stored information, or things described in the deposition notice, by a declaration stating that the petitioner has contacted the deponent to inquire about the nonappearance. (Code Civ. Proc., § 2025.450, subd. (b).) If a motion is granted, the court shall impose a monetary sanction in favor of that party unless the court finds that the one subject to the sanction acted with substantial justification or that other circ*mstances make the sanction unjust. (Code Civ. Proc. § 2025.450 (g).) MEET AND CONFER The Declaration of Sayeh M. Dayen, Plaintiffs counsel, shows an effort to coordinate Defendants deposition with Defendants counsel since November 2023. DISCUSSION On November 21, 2023, Plaintiff asked for available dates for Defendants deposition but received no response. (Dayen Decl. ¶ 34.) On December 15, 2023, Plaintiff served a deposition notice set for January 8, 2024. (Id. ¶ 4, Exh. C.) Defendant objected on December 29, 2023 because the date was unilaterally set. (Id., Exh. D.) On February 23, 2024, Plaintiff served a second deposition notice set for March 4, 2024. (Id. ¶ 4, Exh. E.) On February 26, 2024, Defendant objected to the second deposition notice and informed Plaintiff he was available for various dates in March via teleconference. Plaintiff then asked for the basis for the teleconference deposition but received no response. (Id. ¶ 7, Exh. G.) In opposition, Defendant contends that the motion is moot since he has agreed to appear for an in-person deposition on August 13, 2024. (Renaud Decl. ¶ 15, Exh. K.) Defendant also seeks monetary sanctions. No reply has been filed. Based on the information above, because Defendant served timely objections, and has now agreed to appear at a noticed deposition, the motion to compel is denied. The Court declines to award monetary sanctions to Defendant since he has not shown a statutory basis under section 2025.450. CONCLUSION AND ORDER Accordingly, Plaintiffs motion to compel Defendants deposition is DENIED. Plaintiff shall provide notice of the Courts ruling and file a proof of service of such.

Ruling

JOHN VU VS JEFFREY GEGIELSKI

Jul 17, 2024 |22STCV20052

Case Number: 22STCV20052 Hearing Date: July 17, 2024 Dept: 74 McDaniel v. Colaianni et al. Defendants Motion to Correct and Confirm Arbitration Award BACKGROUND Plaintiff April McDaniel sued defendants Rodrigue Colaianni and Lisa Colaianni aka Lisa Leroy on September 14, 2022 for (1) breach of contract, (2) negligence, (3) fraud, (4) negligent misrepresentation, and (5) concealment. Plaintiff alleged Defendants knowingly sold her a home replete with construction defects after Defendants negligently remodeled it. On October 31, 2022, the parties stipulated to arbitrate their claims and stay court proceedings in the interim. The arbitrator, Ernest C. Brown, issued a twenty-six-page Final Award on April 19, 2024, awarding Plaintiff $391,114.50, accruing simple interest at 10% annually from the date of the award. (D.Ex. 10, 26:2-7 (Award).) On May 28, 2024, Defendants filed the instant Motion to Confirm the Arbitration Award With Corrections by Striking the Award of Attorneys fees and Pre-Judgment Interest. On July 3, 2024, Plaintiff opposed. On July 10, 2024, Defendants replied. LEGAL STANDARD ¿¿ Any party to an arbitration in which an award has been made may petition the court to confirm, correct or vacate the award. (Code Civ. Proc., § 1285.) If a petition or response under [section 1285] is duly served and filed, the court shall confirm the award as made ... , unless in accordance with this chapter it corrects the award and confirms it as corrected, vacates the award or dismisses the proceeding. (Id., § 1286.) [T]he court ... shall correct the award and confirm it as corrected if the court determines that: (a) There was an evident miscalculation of figures or an evident mistake in the description of any person, thing or property referred to in the award; (b) The arbitrators exceeded their powers but the award may be corrected without affecting the merits of the decision upon the controversy submitted; or (c) The award is imperfect in a matter of form, not affecting the merits of the controversy. (Id., ¶ 1286.6.) [A]n arbitrator's decision is not generally reviewable for errors of fact or law, whether or not such error appears on the face of the award and causes substantial injustice to the parties. (Moncharsh v. Heily & Blase¿(1992) 3 Cal.4th 1, 6.) An arbitrator does not exceed their powers by assigning an erroneous reason for their decision. (Id. at 28.) Arbitrators do not exceed their statutory powers merely by rendering an erroneous decision on a legal or factual issue, so long as the issue was within the scope of the controversy submitted to the arbitrators. (Roehl v. Ritchie (2007) 147 Cal.App.4th 338, 348.) DISCUSSION 1. Attorneys Fees Defendants move the Court to strike the arbitrators $87,320.00 attorneys fees award. Defendants mistakenly suggest that the award of attorneys fees and the award of interest [by the arbitrator] are reviewed de novo but the authorities they cite refer to the standard a higher court applies when reviewing a lower courts fees determination. (Mot., 3:27-28.) When a trial court reviews an arbitrators decision, the standard is more deferential, as described above. (See Moncharsh, supra, 3 Cal.4th at p. 6.) Defendants argue Plaintiff is not entitled to fees because she did not attempt to mediate with them before resorting to legal action. The arbitrator found differently. The Final Award includes findings that on May 25, 2022, Plaintiffs counsel demanded prompt mediation, and between June and August 2022, Plaintiff requested that Respondents participate in an early mediation and Respondents and its [sic] counsel did nothing and refused to agree to mediate. (Award, 14:20-26, 15:7-14.) Defendants ask the Court to reverse the arbitrators factual determinations, not to correct them. The Court cannot do so. [P]arties who enter into arbitration agreements are presumed to know the arbitrators decision will be final and binding; arbitral finality is a core component of the parties agreement to submit to arbitration. (SingerLewak LLP v. Gantman (2015) 241 Cal.App.4th 610, 616, quoting Moncharsh, supra, at pp. 6, 10.) The Court defers to the arbitrators finding of fact that Plaintiff tried to mediate and Defendants refused. The arbitrator was thus empowered to award fees. 2. Prejudgment Interest Defendants contend the arbitrators award is not clear and unequivocal as to the scope of interest awarded. (Mot., 10:23-25 [heading].) The contention is unavailing because the award is straightforward. The arbitrator awarded Plaintiff 10% simple annual interest beginning on the date of the award. That rate will continue after judgment. The arbitrator simply formalized the date on which damages were capable of being ascertained for purposes of post-award, prejudgment interest. 3. Attorneys Fees for This Motion A party entitled to attorneys fees in an arbitration award is similarly entitled to fees incurred to confirm it, where fees are otherwise authorized by the parties contract. (See Carole Ring & Associates v. Nicastro (2001) 87 Cal.App.4th 253, 260-261.) The prevailing partys right to fees extends from Code of Civil Procedure section 1293.2, entitling a party to costs after a successful petition to confirm, and Code of Civil Procedure section 1033.5(a)(10), incorporating attorneys fees within costs when authorized by contract. Here, the parties contract authorized a fees award. (See Mot. Ex. 1, ¶ 25 [reasonable fees to prevailing party [i]n any action, proceeding, or arbitration between the parties arising out of [their] Agreement].) The arbitrator determined Plaintiff to be the prevailing party and awarded fees. The Court awards Plaintiff the costs of litigating this petition based on section 1293.2, and per section 1033.5, those costs include Plaintiffs fees. Plaintiffs two attorneys charge a reasonable hourly rate of $400.00 based on their experience and qualifications. (Markow Dec., ¶¶ 17-19.) Counsel Ari Markow estimates his colleague spent 15.4 hours reading and analyzing Defendants motion, conducting legal research, and writing the opposition, and Markow himself spent 2.2 hours discussing the motion, case status, and strategy with Plaintiff, and reviewing and finalizing [counsels] declaration and related exhibits. (Id., ¶ 21 [typo omitted].) Markow estimated 3.5 hours reviewing a reply brief and appearing at the hearing. Plaintiffs counsels billing is slightly excessive. 2.2 hours spent meeting with the client about a single law and motion matter is unnecessary, as is 3.5 hours to review the reply and prepare for the hearing on a straightforward legal issue. The Court will award 15.0 hours, in total, to review the motion and reply and prepare the opposition, and 1.0 hours to prepare for and attend the hearing, which can be accomplished remotely. The Court awards $6,400.00 in attorneys fees. 4. Prejudgment Interest The Court also calculates interest from April 19, 2024, through date of judgment as follows: ten percent, divided by three-hundred sixty five, multiplied by the total award of $391,114.50, results in a $107.15 per diem accrual. Eighty-nine (89) days passed between the award on April 19, 2024 and the judgment on July 17, 2024; $107.15 multiplied by 89 is $9,536.35. CONCLUSION The Court denies Defendants petition to correct the arbitration award. The Court confirms the award as rendered and enters judgment for Plaintiff against Defendants, jointly and severally, in the amount of $413,450.85, inclusive of attorneys fees and interest accrued to the date of judgment.

Ruling

JOSHUA LOMBARDO, ET AL. VS ELDEN ELMS, LP, A CALIFORNIA LIMITED PARTNERSHIP

Jul 17, 2024 |24CHCV00725

Case Number: 24CHCV00725 Hearing Date: July 17, 2024 Dept: F51 JULY 16, 2024 DEMURRER WITH MOTION TO STRIKE Los Angeles Superior Court Case # 24CHCV00725 Demurrer and Motion to Strike Filed: 4/18/24 MOVING PARTY: Defendant Elden Elms, LP, a California Limited Partnership (Defendant) RESPONDING PARTY: Plaintiffs Joshua Lombardo, an individual; and Michael D. Everett, an individual (collectively, Plaintiffs) NOTICE: OK RELIEF REQUESTED: Defendant demurs against the sixth, eighth, and ninth causes of action in Plaintiffs complaint. Defendant also moves to strike references to punitive damages from Plaintiffs complaint. TENTATIVE RULING: The unopposed demurrer is sustained, with 30 days leave to amend. The unopposed motion to strike is granted with 30 days leave to amend. ANALYSIS This is a landlord-tenant action in which Plaintiffs are tenants in a rental unit located at 1255 Elden Avenue, Los Angeles CA 90006, in a residential property owned and operated by Defendant. (Compl. ¶ 1.) Plaintiffs allege that the subject property holds numerous habitability violations, and resulting in ongoing bed bug infestations at the Subject Property, Plaintiffs endured slum-type living conditions resulting in financial loss, property loss, personal injury and presently ongoing emotional distress. (Id. at ¶ 3.) On 3/7/23, Plaintiffs filed their complaint against Defendant, alleging the following causes of action: (1) Breach of Warranty of Habitability (Civil Code § 1941.1); (2) Breach of Warranty of Habitability (Health & Safety § 17920.3); (3) Breach of Warranty of Habitability (Civil Code § 1942.4); (4) Negligence; (5) Nuisance; (6) Intentional Infliction of Emotional Distress; (7) Breach of Contract; (8) Unfair Business Practices; and (9) Fraudulent Concealment. On 4/18/24, Defendants filed the instant demurrer and motion to strike. No opposition has been filed to date. ANALYSIS As a general matter, a party may respond to a pleading against it by demurrer on the basis of any single or combination of eight enumerated grounds, including that the pleading does not state facts sufficient to constitute a cause of action and is uncertain, meaning ambiguous and unintelligible. (Code Civ. Proc., § 430.10, subds. (e) and (f).) In a demurrer proceeding, the defects must be apparent on the face of the pleading or via proper judicial notice.¿(Donabedian v. Mercury Ins. Co. (2004) 116 Cal.App.4th 968, 994.)¿ A demurrer tests the pleading alone, and not the evidence or facts alleged. (E-Fab, Inc. v. Accountants, Inc. Servs. (2007) 153 Cal.App.4th 1308, 1315.) As such, the court assumes the truth of the complaints properly pleaded or implied factual allegations. (Ibid.) The only issue a demurrer is concerned with is whether the complaint, as it stands, states a cause of action. (Hahn v. Mirda (2007) 147 Cal.App.4th 740, 747.) Here, Defendants demur to the sixth, eighth, and ninth causes of action in Plaintiffs complaint on the bases that Plaintiffs fail¿to allege facts sufficient to¿constitute those causes of action, thereby rendering them fatally uncertain. A. Meet and Confer Defendants counsel declares that on 4/4/24, she sent Plaintiffs counsel a letter in an attempt to resolve the issues raised in the instant demurrer and motion to strike. (Decl. of Rochelle M. McKenzie ¶ 2.) On 4/16/24, counsel for the parties met and conferred telephonically, but were unable to come to a resolution. (Id. at ¶ 3.) Accordingly, the Court finds that counsel has satisfied the preliminary meet and confer requirements of Code of Civil Procedure section 430.41, subdivision (a). B. Intentional Infliction of Emotional Distress Plaintiffs sixth cause of action alleges Intentional Infliction of Emotional Distress against Defendant. The elements of a prima facie case for the tort of intentional infliction of emotional distress are: (1) extreme and outrageous conduct by the defendant with the intention of causing, or reckless disregard of the probability of causing, emotional distress; (2) the plaintiffs suffering severe or extreme emotional distress; and (3) actual and proximate causation of the emotional distress by the defendants outrageous conduct. Conduct to be outrageous must be so extreme as to exceed all bounds of that usually tolerated in a civilized community. (Wilson v. Hynek (2012) 207 Cal.App.4th 999, 1009.) A mere allegation that a plaintiff suffered severe emotional distress, without facts indicating the nature or extent of any mental suffering incurred as a result of the defendants alleged outrageous conduct, does not state a cause of action for intentional infliction of emotional distress. (Pitman v. City of Oakland (1988) 197 Cal.App.3d 1037, 10471048.) Here, Plaintiffs allege that although they notified Defendants of the bed bug infestations, Defendants knowingly, intentionally and willfully failed to abate the uninhabitable conditions (bed bug infestations), maintaining a company policy of apathy and/or denial. As such Plaintiffs were forced to live in uninhabitable conditions (bed bug infestations) for an extended period as a result of Defendants incessant failure to abide by their statutory duties to abate known uninhabitable conditions. (Compl. ¶ 139.) As a direct and proximate result thereof, Plaintiffs have endured and presently continue to endure many sleepless nights and much emotional and mental distress, coupled with other physical conditions associated with severe presently ongoing mental and emotional distress. (Id. at ¶ 143.) Defendant argues that Plaintiffs allegations do not rise to the requisite level of outrageousness to support a cause of action for intentional infliction of emotional distress because Plaintiffs do not reference any specific practices or maintenance by Defendant that led to the habitability issues with the unit. In fact, the Plaintiffs resided in the unit for over 2 years without any bed bug complaints from March 2021 until April 2023 until the first issue arose. (Dem. 4:69.) Defendant further argues that Plaintiffs have not sufficiently alleged severe emotional distress resulting from Defendants conduct. (Id. at 4:1328, citing Wong v. Jing (2010) 189 Cal.App.4th 1354.) The Court agrees and notes the Plaintiffs have failed to oppose this demurrer. Based on the foregoing, the demurrer against Plaintiffs sixth cause of action is sustained. C. Unfair Business Practices Plaintiffs eighth cause of action alleges that Defendant violated Business and Professions Code section 17200 et seq. (the UCL). To set forth a claim for unfair business practices in violation of the UCL, a plaintiff must establish that the defendant was engaged in an unlawful, unfair or fraudulent business act or practice and unfair, deceptive, untrue or misleading advertising and certain specific acts. (Bus. & Prof. Code, § 17200.) In essence, an action based on Business and Professions Code section 17200 to redress an unlawful business practice borrows violations of other laws and treats these violations, when committed pursuant to business activity, as unlawful practices independently actionable under section 17200 et seq. and subject to the distinct remedies provided thereunder. (People ex rel. Bill Lockyer v. Fremont Life Ins. Co. (2002) 104 Cal.App.4th 508, 515.) A plaintiff alleging an unfair business practice under the UCL must show that the defendant's conduct is tethered to an underlying constitutional, statutory or regulatory provision, or that it threatens an incipient violation of an antitrust law, or violates the policy or spirit of an antitrust law. (Graham v. Bank of America, N.A. (2014) 226 Cal.App.4th 594, 613.) Fraudulent, as used in the statute, does not refer to the common law tort of fraud but only requires a showing members of the public are likely to be deceived. (Olsen v. Breeze, Inc. (1996) 48 Cal.App.4th 608, 618.) Here, Plaintiffs allege that Defendants failure to maintain the Subject Property and failure to abate known habitability violations while demanding rent constitutes an unlawful business practice. & Moreover, & the unlawful practices of the Defendants violated California Civil Code §§ 1941, 1941.1, 1942.4. (Compl. ¶¶ 157158.) Defendant argues that the allegations that Defendant failed to maintain the property and abate the habitability violations while demanding rent are insufficient to support a cause of action for unfair business practices. There are no specific allegations that this was a practice of the Defendant. (Dem. 5:276:1.) The Court once again, agrees and notes Plaintiff failed to oppose this demurrer. Accordingly, the demurrer against Plaintiffs eighth cause of action is overruled. D. Fraudulent Concealment Plaintiffs ninth cause of action alleges Fraudulent Concealment against Defendant. The required elements for fraudulent concealment are (1) concealment or suppression of a material fact; (2) by a defendant with a duty to disclose the fact to the plaintiff; (3) the defendant intended to defraud the plaintiff by intentionally concealing or suppressing the fact; (4) the plaintiff was unaware of the fact and would not have acted as he or she did if he or she had known of the concealed or suppressed fact; and (5) plaintiff sustained damage as a result of the concealment or suppression of the fact. (Hambrick v. Healthcare Partners Medical Group, Inc. (2015) 238 Cal.App.4th 124, 162.) Fairness requires that allegations of fraud be pled with particularity so that the court can weed out nonmeritorious actions before a defendant is required to answer. (Small v. Fritz Companies, Inc. (2003) 30 Cal.4th 167, 184.) The particularity requirement typically necessitates pleading facts that show how, when, where, to whom, and by what means the representations were tendered. (Lazar v. Superior Court (1996) 12 Cal.4th 631, 645.) Here, Plaintiffs allege that prior to their April 2023 discovery of the bedbug infestation in their apartment, Defendants knew of widespread bed bug infestations at the Subject Property and Plaintiffs Unit. However, Defendants intentionally withheld this information from Plaintiffs. (Compl. ¶ 163.) Specifically, Plaintiffs allege that Defendants knew that the Subject Property and Subject Unit was infested with bedbugs and that prospective tenants would incur significant physical injuries and severe emotional distress, along with property damage and economic losses, and therefore intentionally did not notify Plaintiffs so that they could ensure that the unit would be leased out by them. (Id. at ¶ 168.) Such knowledge was materially relevant to Plaintiffs and Defendants, as, had Plaintiffs known of the bedbugs within the unit, Plaintiffs would not have leased the Subject Property. (Id. at ¶ 165.) Defendant argues that Plaintiff fails to allege that Defendant owed them a duty to disclose the presence of bed bugs in other units that are not leased to Plaintiffs. (Dem. 7:1415.) Defendant further argues that this cause of action is not pled with the requisite specificity because Plaintiffs have failed to include any such facts about the specific representations made and at what point in time in the Complaint. (Id. at 7:2223.) The Court agrees, and again notes that Plaintiffs have failed to oppose the instant motion. Based on the foregoing, the Court finds that Plaintiffs have failed to allege facts sufficient to constitute a cause of action for fraudulent concealment. Accordingly, the demurrer is sustained as to Plaintiffs ninth cause of action. MOTION TO STRIKE The court may, upon a motion, or at any time in its discretion, and upon terms it deems proper, strike any irrelevant, false, or improper matter inserted in any pleading. (Code Civ. Proc., § 436, subd. (a).) The court may also strike all or any part of any pleading not drawn or filed in conformity with the laws of this state, a court rule, or an order of the court. (Id., § 436, subd. (b).) The grounds for moving to strike must appear on the face of the pleading or by way of judicial notice. (Id., § 437.) A. Punitive Damages Punitive damages may be recovered upon a proper showing of malice, fraud, or oppression by clear and convincing evidence. (Civ. Code § 3294, subd. (a).) Malice is defined as conduct intended to cause injury to a person or despicable conduct carried on with a willful and conscious disregard for the rights or safety of others. (Id. at subd. (c); Turman v. Turning Point of Cent. Cal., Inc. (2010) 191 Cal.App.4th 53, 63.) Oppression means despicable conduct subjecting a person to cruel and unjust hardship, in conscious disregard of the persons rights. (Ibid.) Fraud is an intentional misrepresentation, deceit, or concealment of a material fact known by defendant, with intent to deprive a person of property, rights or otherwise cause injury. (Ibid.) Punitive damages must be supported by factual allegations. Conclusory allegations, devoid of any factual assertions, are insufficient to support a conclusion that parties acted with oppression, fraud or malice. (Smith v. Superior Court (1992) 10 Cal.App.4th 1033, 1042; Anschutz Entertainment Group, Inc. v. Snepp (2009) 171 Cal.App.4th 598, 643.) Here, Defendant argues that punitive damages are not warranted because Plaintiffs only claim inaction in the form of failing to abate bed bugs, which is not enough to support punitive damages. (MTS 2:2021.) Defendant contends that Plaintiffs[] Complaint merely alleges that Defendant failed to abate bed bugs. Nothing about the facts in the Complaint suggest any intentional let alone malicious behavior other than Plaintiffs[] conclusory allegation, absent of specific notifications made, that Defendant failed to address the alleged bed bugs. (Id. at 4:1619.) Once again, the Court notes Plaintiffs have failed to oppose the instant motion and grants the Motion to Strike. LEAVE TO AMEND Where a demurrer is sustained, leave to amend must be allowed where there is a reasonable possibility of successful amendment. (Goodman v. Kennedy (1976) 18 Cal.3d 335, 348.) The burden is on the plaintiff to show the court that a pleading can be amended successfully. (Id.; Lewis v. YouTube, LLC (2015) 244 Cal.App.4th 118, 226.) However, [i]f there is any reasonable possibility that the plaintiff can state a good cause of action, it is error to sustain a demurrer without leave to amend. (Youngman v. Nevada Irrigation Dist. (1969) 70 Cal.2d 240, 245). Here, the Court notes that this is the first demurrer brought against Plaintiffs original complaint. Therefore, under the Courts liberal policy of granting leave to amend, Plaintiff is granted 30 days leave to amend the complaint to cure the defects set forth above. Plaintiff is cautioned that following an order sustaining a demurrer & with leave to amend, the plaintiff may amend his or her complaint only as authorized by the court's order. & The plaintiff may not amend the complaint to add a new cause of action without having obtained permission to do so, unless the new cause of action is within the scope of the order granting leave to amend. (Zakk v. Diesel (2019) 33 Cal.App.5th 431, 456.) CONCLUSION The unopposed demurrer is sustained with 30 days leave to amend. The unopposed motion to strike is granted with 30 days leave to amend.

Ruling

JONATHAN VARGAS, ET AL. VS LENA MEYER, ET AL.

Jul 17, 2024 |22STCV26120

Case Number: 22STCV26120 Hearing Date: July 17, 2024 Dept: 28 Having considered the moving papers, the Court rules as follows. BACKGROUND On August 12, 2022, Plaintiffs Jonathan Vargas and Ivan Vargas filed this action against Defendants Lena Meyer, Mimi Meyer, and Does 1-50 for motor vehicle tort. On December 18, 2023, the Court granted Plaintiffs counsels motion to be relieved as counsel. On January 18, 2024, Plaintiffs substituted new counsel to represent them. On January 26, 2024, no parties or counsel appeared at the scheduled final status conference or contacted the Court. On February 9, 2024, no parties or counsel appeared for the scheduled trial or contacted the Court. The Court dismissed the case without prejudice. On June 12, 2024, Plaintiffs filed a motion for relief from dismissal. The motion was set to be heard on July 17, 2024. No trial date is currently scheduled. PARTIES REQUEST Plaintiffs ask the Court to vacate the dismissal. LEGAL STANDARD Code of Civil Procedure section 473, subdivision (b), provides in part: Notwithstanding any other requirements of this section, the court shall, whenever an application for relief is made no more than six months after entry of judgment, is in proper form, and is accompanied by an attorneys sworn affidavit attesting to his or her mistake, inadvertence, surprise, or neglect, vacate any (1) resulting default entered by the clerk against his or her client, and which will result in entry of a default judgment, or (2) resulting default judgment or dismissal entered against his or her client, unless the court finds that the default or dismissal was not in fact caused by the attorneys mistake, inadvertence, surprise, or neglect. The court shall, whenever relief is granted based on an attorneys affidavit of fault, direct the attorney to pay reasonable compensatory legal fees and costs to opposing counsel or parties. However, this section shall not lengthen the time within which an action shall be brought to trial pursuant to Section 583.310. (Code Civ. Proc., § 473, subd. (b).) DISCUSSION Plaintiffs argue the dismissal resulted from their counsels inadvertent failure to calendar the January 26, 2024 final status conference and the February 9, 2024 trial. Plaintiffs counsel has submitted an attorney affidavit of fault. The Court grants the motion and vacates the default. CONCLUSION The Court GRANTS the motion for relief from dismissal filed by Plaintiffs Jonathan Vargas and Ivan Vargas. The Court vacates the dismissal entered on February 9, 2024. The Court sets an OSC re: dismissal for failure to file proof of service of the summons and complaint on August 20, 2024 at 8:30 a.m. in Department 28 of the Spring Street Courthouse. Moving parties are ordered to give notice of this ruling. Moving parties are ordered to file the proof of service of this ruling with the Court within five days.

Ruling

BAYRON ENRIQUEZ VASQUEZ VS RICHARD CARTIER

Jul 18, 2024 |21STCV44649

Case Number: 21STCV44649 Hearing Date: July 18, 2024 Dept: T Motion to Reclassify to Limited Jurisdiction Moving Party: Richard Cartier (Defendant) Responding Party: N/A Tentative Ruling: Deny BACKGROUND Plaintiff Bayron Enriquez Vazquez (Plaintiff) filed this action on December 8, 2021, for personal injuries arising out of a motor vehicle accident on July 28, 2020, alleging negligence. Plaintiff seeks special damages for the medical treatment he received as a result, amounting to a $8,525.00, in addition to $3,500 in damages his vehicle sustained. Plaintiff also estimates he will incur between $1,500 to $3,000 in medical costs for future treatment. (Motion to Reclassify, Exh. A Response to Interrogatory Form 1.1.) MOVING PARTY POSITION Defendant Richard Cartier (Defendant) filed this motion to reclassify the action as a limited jurisdiction action, arguing that Plaintiff does not seek relief for costs above the $35,000.00 threshold for unlimited jurisdiction. Plaintiff has not filed an opposition to this motion. ANALYSIS I. Defects As a preliminary matter, the court notes Defendants notice was untimely. Defendants notice (p. 7) to Plaintiff reflects that service was provided to Plaintiff via email on June 2516 court days before the July 18 hearing. Because service made via email extends the notice period by 2 court days, Defendant was untimely. ((Code Civ. Proc., § 1010.6(a)(3)(B).) II. Motion to Reclassify this Action as a Limited Jurisdiction Action CCP § 403.040 governs reclassification of civil cases. The court shall grant the motion and enter an order for reclassification, regardless of any fault or lack of fault, if the case has been classified in an incorrect jurisdictional classification. (Code Civ. Proc.,, § 403.040(a).) A case should only be reclassified from unlimited to limited if the jurisdictional amount necessarily cannot be reached. (See Walker v. Superior Court (1991) 53 Cal.3d 257, 270-71.) This is a high standard that amounts to a legal certainty. (Id. at 270) The court may believe it highly unlikely that plaintiff will recover the amount demanded, but this is not enough to defeat jurisdiction, unless it appears to a legal certainty that plaintiff cannot recover the amount which he has demanded. (Id.) CCP § 86(a)(1) classifies civil cases as limited when the demand, exclusive of interest, or the value of the property in controversy amounts to thirty-five thousand ($35,000) or less. A. Amount in controversy The court initially notes the jurisdictional amount increased to $35,000 at the beginning of this year, but it does not appear the new statute is retroactive. (See Civ. Code §§ 85-86.) Thus, the central issue to determine whether to reclassify this action as limited jurisdiction is whether it is a legal certainty that Plaintiff cannot recover over $25,000.00 from this case. (Walker v. Superior Court (1991) 53 Cal.3d 257, 270.) Whether the new jurisdictional amount is retroactive and applicable to this case is immaterial, as Defendant still would not meet their burden for the reasons discussed below. Defendant points to Plaintiffs responses to form 1.1 interrogatories to assert that the total relief sought does not reach the jurisdictional amount required. Namely, Defendant indicates that Plaintiff incurred $12,025.00 in medical expenses and vehicle damage so far, and estimates up to $3,000.00 in additional costs for future medical expenses. (Motion to Reclassify, Exh. A Response to Interrogatory Form 1.1.) Defendant argues that because these total costsamounting to $15,025.00fall below the minimum requirement for unlimited jurisdiction, this action should be reclassified. (Memorandum of Points and Authorities in Support of Reclassification p. 3.) Here, it is not a legal certainty that Plaintiff will not recover over the jurisdictional minimum. Plaintiffs response to interrogatory no. 6.7 indicates that a healthcare provider advised Plaintiff that they will have between $1,500 to $3,000 in future medical costs attributable to Defendant, it does not speak directly to the issue of damages Plaintiff is seeking in this action. More specifically, Plaintiffs response to interrogatory no. 9.1 lists that he requests recovery for general damages, pain and suffering, and future medical expenses, all of which in the amount to be determined. Defendant has not addressed the potential for Plaintiff to recover for pain and suffering, nor the possibility that Plaintiffs future medical expenses will exceed the estimate his healthcare provider provided. Because of the especially uncertain nature of personal injury cases, failing to address all of Plaintiffs bases for recovery is especially problematicas Defendant did not conclusively show Plaintiff cannot receive above threshold required for unlimited jurisdiction. In turn, Defendant has not met the burden of showing the legal certainty required to reclassify the case to limited jurisdiction. RULING Based on the foregoing, the Motion to Reclassify is denied.

Ruling

ORTEGA vs MILLER

Jul 15, 2024 |CVPS2305851

Motion to Compel: Answer/Response toCVPS2305851 ORTEGA vs MILLERSpecial Interrogatories by THERESA MILLERTentative Ruling: No tentative ruling. A hearing will be conducted. Trial counsel are ordered to appearin person in Department PS1. No telephonic or video appearances will be permitted. Counsel shouldbe prepared to address in detail whether verified discovery responses were served in May 2024, priorto the time this motion was filed.Based on its review of the pleadings, the Court finds it is necessary to remind all counsel that civilityand professionalism among counsel should be the norm and not the exception. Counsel need notalways agree, but their disagreements, especially when relayed to the Court, should be free of rancorunbecoming of legal professionals.No further briefing of any kind may be filed.

Ruling

FCS055719 - PINEDO, CRISTOBAL VS. VALLEY FARM TRANSPORT, INC.,

Jul 18, 2024 |FCS055719

FCS055719Motion for Summary JudgmentTENTATIVE RULINGThe motion for summary judgment by Defendant Valley Farm Transport, Inc. is denied.Plaintiff has met his burden of establishing that there is a triable issue of material fact asto whether Defendant Martinez-Solis was an employee of Defendant Valley Farm at thetime of the incident.“The principal test of an employment relationship is whether the person to whom serviceis rendered has the right to control the manner and means of accomplishing the resultdesired.” (Tieberg v. Unemployment Ins. App. Bd. (1970) 2 Cal.3d 943, 946; Baco*ka v.Best Buy Stores, LP (2021) 71 Cal.App.5th 126, 133.) While the right to control workdetails is the “most important” consideration, “no rigid test governs whether someone isan employee” and the court may consider “secondary” indicia of an employmentrelationship, such as whether the person performing services is engaged in a distinctoccupation or business and whether the work is a part of the regular business of theprincipal. (Baco*ka, 71 Cal.App.5th at 133.)Plaintiff presents evidence that Defendant Valley Farm was in the business oftransporting goods as a licensed motor carrier (Depo. of David Nickum, pp. 69:24-70:4,16-18; Decl. of Miller, ¶ 6) and that Defendant Valley Farm was the primary carrier forthe load Defendant Martinez-Solis was transporting pursuant to a “sub-haul” contract atthe time of the incident (Depo. of Martinez-Solis, pp. 33:18-21, 69:21-70:6).Additionally, Plaintiff presents evidence that Delta Valley Logistics, LLC was “an entitycreated to ‘handle the sub-hauler trucks’” of Defendant Valley Farm in an attempt toshield Defendant Valley Farm from liability for any accidents or misdeeds of the sub-haulers (Decl. of Miller, ¶¶ 4-5, 7), that Defendant Valley Farm “was in complete controlof Delta Valley” (id. at ¶ 8), that sub-haulers, including Defendant Martinez-Solis, “werenot free to take on additional freight or do other loads” while under dispatch from DeltaValley (id. at ¶ 9), and that Delta Valley exercised “total control” over the use of its sub-haulers (id. at ¶ 10). These factors can support a determination that DefendantMartinez-Solis was an employee of Defendant Valley Farm.Department 7 is inviting you to a scheduled ZoomGov meeting.Join ZoomGov Meetinghttps://solano-courts-ca-gov.zoomgov.com/j/1611554664?pwd=T3U4QlBGWWNWaGlieXJTcGxIVHRXZz09Meeting ID: 161 155 4664Passcode: 818575One tap mobile+16692545252,,1611554664#,,,,*818575# US (San Jose)+14154494000,,1611554664#,,,,*818575# US (US Spanish Line)

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Nov 24, 2018 |Thomas Rademaker |Torts - Medical, Dental, or Podiatrist Malpractice |Torts - Medical, Dental, or Podiatrist Malpractice |601080/2021

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Alyson Walker v. The City Of Long Beach, National Grid Usa Service Company, Inc, Keyspan Gas East Corporation D/B/A NATIONAL GRID

Aug 09, 2022 |Randy Sue Marber |Torts - Other Negligence (Slip & Fall) |Torts - Other Negligence (Slip & Fall) |610472/2022

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Justin Forman v. King David Of New Rochelle Management Inc., Jesse Cole Muller

May 04, 2024 |Torts - Motor Vehicle |Torts - Motor Vehicle |607827/2024

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Stacy Lane As Executrix Of The Estate Of Peter J. Navarra, deceased v. Lawrence P. Horl D.P.M., Lawrence P. Horl, D.P.M., P.C., Robert H. Clark M.D., Robert H. Clark, M.D., P.L.L.C., H. Bianca Japal M.D., H. Bianca Japal, M.D., P.C., Alvin D Holcomb M.D.,, Alvin D. Holcomb, M.D., P.C.,, South Nassau Communities Hospital, Mount Sinai South Nassau Hospital

Apr 11, 2018 |Rhonda E. Fischer |Torts - Medical, Dental, or Podiatrist Malpractice |Torts - Medical, Dental, or Podiatrist Malpractice |606872/2020

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Dawn Marie Nicoletti v. Joseph E. Garber M.D., Syosset Hospital, Northwell Health, Inc. f/k/a NORTH SHORE-LIJ HEALTH SYSTEM

Jun 14, 2017 |JOHN MICHAEL |Torts - Medical, Dental, or Podiatrist Malpractice |Torts - Medical, Dental, or Podiatrist Malpractice |605626/2017

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Nov 24, 2018 |Thomas Rademaker |Torts - Medical, Dental, or Podiatrist Malpractice |Torts - Medical, Dental, or Podiatrist Malpractice |601080/2021

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Scott D. Mantel as Administrator for the Estate of Deborah Bucko v. South Nassau Communities Hospital d/b/a Mount Sinai South Nassau

May 11, 2023 |Randy Sue Marber |Torts - Medical, Dental, or Podiatrist Malpractice |Torts - Medical, Dental, or Podiatrist Malpractice |607604/2023

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David Mcneary v. Lawrence Woodmere Academy, Richard Briglio Phd

Mar 01, 2021 |Leonard D. Steinman |Torts - Child Victims Act |Torts - Child Victims Act |900014/2021

EXHIBIT(S) - 10 - Wylie C. Hembree, et al.s article, Endocrine Treatment of Gender-Dysphoria/Gender Incongruent Persons: An Endocrine Society Clinical Practice Guideline July 15, 2024 (2024)

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