Tishelman, 68, filed a lawsuit against Boston Children’s in 2020, claiming that her supervisors discriminated against her because of her gender and age and that she was warned to remain silent when she complained. The following year, the hospital fired Tishelman for allegedly violating patient privacy rules related to the Health Insurance Portability and Accountability Act (HIPAA).

During the hearing 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 cited irregularities in the hospital’s investigation of the alleged HIPAA violation, including a near-total absence of written reports and notes, a clear violation of hospital policies requiring documentation of such investigations. He noted that the hospital never notified patients or the federal government of the alleged privacy breach, raising questions about the severity of the alleged breach. Additionally, at least two Children’s administrators changed or contradicted their own statements on the witness stand.

“The evidence presented to the jury showed that this wasn’t about complying with HIPAA or complying with hospital policy. This was about punishing someone for complaining,” Hannon said in an interview Monday. “We do not comment on litigation,” a hospital spokesman said.

In court, attorneys for Boston Children’s Hospital argued that everyone would be fired for the privacy violations Tishelman allegedly committed. They alleged that Tishelman was under pressure from his bosses for months of delays in submitting patient evaluation reports at the time of the violations. They said another psychologist had accessed patient records to show that he wasn’t the only one receiving a late report. They said this was an illegitimate reason to access patient records.

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

The trial came to public attention last month for the extraordinary window it provided into the inner workings of perhaps the nation’s most influential pediatric gender clinic. Testimony from current and former practitioners at the clinic revealed an internal disagreement over how to screen patients for medical gender transition.

Since the clinic’s establishment in 2007, the psychological evaluation of patients before receiving medical procedure advice scaled back. Among the changes was a reduction in the duration of a face-to-face assessment conducted by a psychologist from four hours to two.

Kerry McGregor, a psychologist and co-director of the gender clinic known as the Gender Multispecialty Service, said it was “appropriate” to shorten the assessment, especially as the clinic’s caseload increases. “We were able to access all the information in a much shorter time,” he said. However, he noted that “some people were not happy” with the change.

Tishelman called the shortened evaluation period “reckless” and said more time was needed with patients and their parents before making recommendations about medical treatments that could have lasting effects, such as hormones.

Tishelman’s lawsuit initially focused on allegations of discrimination. claimed She was paid less than her male counterparts. Additionally, he said supervisors discouraged him from pursuing opportunities outside of work that would enhance his reputation in the field. She described a pattern of derogatory comments and degrading treatment from superiors and colleagues when she received accolades such as giving keynote speeches at conferences or being invited to co-write international standards of care for youth gender medicine.

In an email that Hannon read aloud at the hearing, Francie Mandel, a clinical social worker and the clinic’s former director of mental health, wrote that Tishelman’s “outside activities seek to diminish, not enhance, his reputation, and by extension ours.” He also wrote that “the activities did not fully correlate with his actual skill level.”

Child Advocates denied that Tishelman was discriminated against. Although some of Tishelman’s managers are men, the gender clinic is largely staffed and led by women, they said. They argued that tensions between Tishelman and his bosses stemmed from late evaluation reports.

Based on the finding of retaliation, the jury awarded Tishelman approximately $1.9 million in back pay, lost future wages, emotional distress and interest. Tishelman also has the right to seek reimbursement of attorney fees, subject to the judge’s approval. The jury did not find that the retaliation was “intentional, reckless, or indifferent,” and so no punitive damages were awarded.

Mike Damiano can be reached at [email protected].