Tishelman, 68, sued Boston Children’s in 2020, alleging that her supervisors had discriminated against her because of her sex and age and that when she complained they warned her to remain silent. The following year, the hospital fired Tishelman for an alleged violation of patient privacy rules related to the Health Insurance Portability and Accountability Act, or HIPAA.

During a trial in Suffolk Superior Court, Tishelman’s attorney, Patrick Hannon, argued that the investigation that led to the firing was “a sham orchestrated by hospital management” to find a way to fire Tishelman. It demonstrated irregularities in the way the hospital investigated the alleged HIPAA violation, including a near complete lack of written reports and notes, in apparent violation of hospital policies requiring documentation of such investigations. It noted that the hospital never informed patients or the federal government about the alleged privacy violation, raising questions about the seriousness of the alleged violation. Additionally, at least two Children’s executives changed or contradicted their own testimony on the stand.

“The evidence presented to the jury demonstrated that this was not about complying with HIPAA or complying with hospital policy. It was about punishing someone for complaining,” Hannon said in an interview Monday. A hospital spokesperson said: “We do not comment on litigation.”

In court, Boston Children’s attorneys argued that anyone would have been fired for the privacy violations Tishelman allegedly committed. At the time of the violations, they argued, Tishelman was under pressure from his bosses because he was months late in submitting patient evaluation reports. She accessed another psychologist’s patient records to show she was not the only one receiving late reports, they said. They said that was an illegitimate reason to access patient records.

But Hannon, Tishelman’s attorney, argued that his client had broad permission to access patient records and that the hospital knew how he accessed the records for a year before launching its investigation following his lawsuit.

The trial attracted public attention last month because of the extraordinary window it provided into the inner workings of perhaps the most influential pediatric gender clinic in the country. Testimony from current and former clinic professionals revealed an internal dispute over how to evaluate patients for medical gender transition.

Since the clinic’s founding in 2007, the psychological evaluation that patients undergo before receiving a recommendation for medical procedures has been reduced. Among the changes is the reduction of the duration of the in-person evaluation carried out by a psychologist from four hours to two.

Kerry McGregor, a psychologist and co-director of the gender clinic, known as the Multispecialty Gender Service, said shortening the assessment was “appropriate,” especially as the clinic’s caseload grew. “We were able to get all the information in much less time,” he said. But he noted that “some were not happy” with the change.

Tishelman testified that the reduction in evaluation time was “reckless” and said more time was needed with the patient and his parents before making recommendations about medical treatments, such as hormones, which can have permanent effects.

Tishelman’s lawsuit originally focused on allegations of discrimination.. she alleged She was paid poorly compared to her male colleagues. Additionally, she said supervisors discouraged her from pursuing opportunities outside of work that would elevate her stature in the field. She described a pattern of derogatory comments and degrading treatment from supervisors and colleagues whenever she received praise, such as being invited to give keynote addresses at conferences or co-writing international standards of care for youth medicine.

In an email that Hannon read aloud during the trial, Francie Mandel, a clinical social worker and former director of mental health at the clinic, wrote that Tishelman’s “outside activities were working to diminish, not enhance, his reputation and, therefore, ours.” He also wrote that “the activities do not accurately correlate with your actual skill level.”

Children’s attorneys denied that Tishelman suffered discrimination. The gender clinic is staffed and run largely by women, they said, although some of Tishelman’s supervisors were men. They argued that tensions between Tishelman and his bosses arose from his late evaluation reports.

Based on the finding that retaliation occurred, the jury awarded Tishelman nearly $1.9 million for back pay, loss of future wages, emotional distress and interest. Tishelman is also entitled to reimbursement of attorney fees pending a judge’s approval. The jury did not find the retaliation “intentional, reckless or careless,” so no punitive damages were awarded.

You can contact Mike Damiano at [email protected].