Court Opinion

ID: 9957728
Source: CourtListenerOpinion
Date Created: 2024-04-05 05:04:37.53385+00
Date Added: 2024-06-11T08:18:35.320306
License: Public Domain

If this opinion indicates that it is “FOR PUBLICATION,” it is subject to
                 revision until final publication in the Michigan Appeals Reports.

                          STATE OF MICHIGAN

                            COURT OF APPEALS

MELISSA MARIE RILEY,                                                 UNPUBLISHED
                                                                     April 4, 2024
               Plaintiff-Appellant,

v                                                                    No. 367366
                                                                     Lapeer Circuit Court
RYAN SCOTT GRAVES,                                                   Family Division
                                                                     LC No. 17-050872-DS
               Defendant-Appellee.

Before: CAVANAGH, P.J., and JANSEN and MALDONADO, JJ.

PER CURIAM.

        Plaintiff-mother appeals by right the trial court’s July 28, 2023 order denying her motion
for sole legal custody and to restrict defendant-father’s parenting time. The parties’ minor child
has identified as female since the child was a toddler despite having been born with male anatomy.
This litigation arises entirely from the parties’ inability to agree on how to approach the child’s
gender identity. Plaintiff-mother has always deferred to the child’s desires regarding gender
expression, using the child’s preferred name and pronouns and allowing the use of girls’ clothing.
Defendant-father requires the child to present as masculine during his parenting time and
exclusively uses the child’s birth name and male pronouns. The child has suffered from serious
mental health problems and, despite being only 10 years old at the time the order was entered, the
child had already gone to the hospital multiple times due to suicidal ideations; the parties have
likewise been unable to agree regarding mental health treatment. The trial court elected to maintain
this untenable status quo in the face of a plethora of unrebutted testimony establishing that
defendant-father’s conduct was actively harming the child. The evidence presented to the trial
court in the context of this particular case is clear, and on this record, we can discern no factual
basis supporting the trial court’s decision. Accordingly, we reverse.

                                       I. BACKGROUND

             A. CHILD EXPRESSES FEMALE IDENTITY FROM YOUNG AGE

       The minor child was born on August 13, 2012, and the parties agree that the child began
expressing a female gender identity as a toddler. The parents began taking the child to a therapist

                                                -1-
at the age of four, and the therapist opined that this sort of gender expression at such a young age
was normal. In third grade, the child communicated to the teacher a preference to be referred to
using a chosen, traditionally female name and to use she/her pronouns. After consulting with
plaintiff-mother in a meeting about which defendant-father was unaware, the school decided to
respect the child’s wishes. Defendant-father subsequently met with the school, and believing
plaintiff-mother violated the terms of their joint legal custody arrangement, filed a motion to show
cause why plaintiff-mother should not be held in contempt of court. The court, while
acknowledging that it was the school that ultimately decided to respect the child’s wishes on the
matter, concluded that plaintiff-mother violated the custody order, and it ordered that “[d]ecisions
regarding the minor child’s name and gender are to be discussed with/between both parties.”

       B. PLAINTIFF MOVES FOR SOLE LEGAL CUSTODY AND PARENTING TIME
                                RESTRICTIONS

         In January 2022, less than a month after being held in contempt of court, plaintiff-mother
sought an order granting her sole custody and barring defendant-father from taking actions
contradictory to the child’s gender identity. Plaintiff-mother asserted that, despite the child
adamantly asserting a female identity, defendant father forcibly gave the child a “buzz cut,”
restricted the child’s access to feminine toys and activities, refused to let the child wear feminine
clothing, and accused plaintiff-mother of “making [the child] gay” by allowing feminine toys and
clothing. At the hearing, defendant-father openly used the child’s birth name and referred to the
child using male pronouns. Defendant-father expressed concern regarding allowing a transition at
such a young age and hoped that the child’s counseling with Danielle McIlrath, which began six
weeks prior, would eventually help resolve the issue. The court declined to revisit the custody
arrangement because plaintiff-mother did not meet her burden to show proper cause or change of
circumstances, and the court determined that the parties would decide amongst themselves whether
defendant-father could alter the child’s appearance during his parenting time.

      C. THE CHILD’S MENTAL HEALTH DETERIORATES AND PLAINTIFF-MOTHER
                       AGAIN SEEKS FULL LEGAL CUSTODY

         The child continued to undergo counseling with McIlrath, and while plaintiff-mother
attended each session, defendant-father only attended the first one. McIlrath diagnosed the child
with “Gender Dysphoria,” which she explained in a letter to be correlated with an increased risk
of suicidal behavior, and the risk of such behavior increases with age due to “non-acceptance of
gender-variant behavior by others.” The child went to the hospital for suicidal behavior for the
first time on November 11, 2022, after the child allegedly told plaintiff-mother, “If I have to go to
dad’s, I will kill myself.” The doctor made the following notes:1

                This is a 10-year-old male who identifies himself as female who splits time
         between mother and father. The father is having issues with acceptance of his
         gender identity issues and [the child] states that as her father always cuts her hair

1
    The doctor was inconsistent with usage of gender-specific pronouns.

                                                 -2-
       short and she would like to grow it longer. She had made statements that she would
       rather die than to go to her father’s house who will cut her hair.

              She is not acting suicidal. She has no overt plan. She does have a therapist,
       but needs further intensive treatment. . . .

               They are discharged and spoke to together in the room. [The child] is not
       currently acting suicidal and she does not want to harm herself. She just wants to
       not have her hair cut.

In psychiatric intake notes taken during that visit, Jennifer Edwards, LMSW, indicated that the
child reported to her that defendant-father “doesn’t like” the child’s gender identify and mockingly
refers to the child as “twinkle toes” when the child dances.

        On November 17, 2022, shortly after the first hospital visit, a suicidal behavior reporting
form was filled out by Stacey Stiles-Glowacki, a social worker at the child’s school. The child
reported sadness to Stiles-Glowacki and was “feeling like she wants to hurt herself.” The child
also reported that the negative feelings “are stemming from family dynamic situation outside of
school.” The child did not report having “a specific plan,” but the child did have “thoughts of
what she could do,” such as stabbing herself “with kitchen knives.” Stiles-Glowacki filled out
another form on December 1, 2022. The child had reported “feeling really mad and sad” ever
since the November hospital visit and reported that the “thoughts of suicide started coming back”
that day. While there still was no specific plan, the child reported having “had thoughts of stabbing
her heart with a pencil” and “of cutting herself in the neck with scissors.” On April 19, 2023, a
form was filled out by Briana Overholt after the child reported “having thoughts of committing
suicide.” The child had communicated romantic feelings to a crush, and when the feelings were
not reciprocated, the child “looked at her scissors on her desk and thought ‘what would happen if
I stabbed myself with the scissors.’ ”

        On April 4, 2023, the child underwent a psychotherapy intake session with Alison June
Clinton, MSW, and Clinton completed an intake assessment on April 16. According to Clinton,
the child was “seeking assistance with puberty delay,” and the child’s goal was not to “be as mad
on the inside as much” and for defendant-father to “let me be a girl at his house again.” Defendant-
father said his goal was to “find some mental stability for my son” while plaintiff-mother said, “I
really just want [the child] to live authentically.” The child reported to Clinton having desired to
wear dresses since age three and having come out as transgender a year prior. Regarding puberty,

               [The child] reports that she has started getting zits on her face and has
       started getting more hair on her legs. [The child] reports that she doesn’t want her
       privates to get larger, to have more body hair, and to have a deeper voice. The child
       reports that she would like to have breast development.

The child listed the following sources of dysphoria: “being forced to cut her hair, being
misgendered, being deadnamed, the idea of going through a boy puberty.”

        Clinton asked both parents to explain the child’s gender history. Defendant-father reported
that plaintiff-mother began letting the child wear dresses before the age of two, which was
upsetting to him because “a 1.5 year old doesn’t know what they want.” Per the parents’

                                                -3-
agreement, the child wore masculine clothing to school until third grade, at which point the child
expressed a desire to go by a feminine name and use she/her pronouns. Defendant-father did not
want this, but ultimately agreed to allow the child to use “her affirmed name and pronouns at
school as long as it didn’t affect her school work.” Nevertheless, defendant-father believed that
child was too young to choose a different name, he told the child “that it is not ok [sic] for a child
to decide their gender,” and he was “not willing to consent to hormone therapy or puberty
blockers.” Regarding his goals:

               Dad reports that he wants to show [the child] an alternate path. He reports
       that he wants [the child] to wait until she is an adult before making any decision to
       transition and does not support a social transition, and especially does not support
       any medical transition options. When asked if Dad would support [the child] if she
       chose to pursue medical transition options as an adult, he said that he did not know
       and would cross that bridge when he got there.

        The information plaintiff-mother reported to Clinton was starkly different. According to
plaintiff-mother, the child identified as a girl “since she was able to talk.” The child “has always
told kids at school that she was a girl, but” became insistent approximately three years prior.
According to plaintiff-mother, defendant-father did eventually sign the paperwork regarding the
school’s decision to use the child’s preferred name and pronouns, but he “also started forcibly
cutting [the child’s] hair.” Plaintiff-mother was worried about defendant-father’s conduct,
reporting that “he doesn’t realize how rough he is being.” Plaintiff-mother feared that allowing
the child to go through male puberty would cause an increase in suicidal ideation. Regarding her
goals:

              Mom wants [the child] to have the support that she needs to be able to be
       her authentic self. Mom wants [the child] to not be trapped in a body that makes
       her miserable. Mom reports that she wants to speak to a lawyer about options for
       moving toward puberty blockers. Mom reports that she would rather have a living
       daughter than a dead son.

        At the conclusion of the intake, Clinton summarized the child’s sense of gender identity
and strong desire to take puberty blockers. According to Clinton:

       [The child’s] mother fully supports [the child’s] transition and is supportive of [the
       child] initiating puberty blockers. [The child’s] father does not support [the child’s]
       transition and does not use [the child’s] affirmed name or pronouns, does not allow
       [the child] to present as a girl in his household, and does not believe in trans identity.
       Dad is not consenting to any transition options, social or medical.

Clinton recommended

       the initiation of hormone blockers, the use of the affirmed name and pronouns in
       all settings, that the parents affirm and support [the child’s] gender identity and
       expression, that the parent [sic] attend a support group for parents of trans and
       gender nonconforming youth and engaging in psychotherapy with a gender
       affirming therapist.

                                                  -4-
         In May of 2023, the suicidal thoughts escalated, and plaintiff-mother again took the child
to the emergency room. The notes indicated that “she had thoughts about harming herself which
was [sic] worse today,” but as of the hospital visit, the child had no active plans to commit suicide.
The child reported that the suicidal thoughts were “triggered by her father not being supportive.
She noted that her father forcefully cuts her hair and makes her change her clothes to the male
attire and plays music that are [sic] offending to her.” The social worker who spoke with the child
during this visit indicated that defendant-father stopped cutting the child’s hair, but he continued
to make the child wear masculine clothing and practice writing the child’s birth name.

       Pt [patient] admits she feels periods of peace in her father’s care but ultimately
       noted [defendant-father’s] inability to accept her increases her self harming
       thoughts. “I just think sometimes if I died it would be easier for everyone and
       maybe I could come back as a girl.. [sic] you know reincarnation type stuff.”

Ultimately, the child was not hospitalized because “she feels safe to return home in her mother’s
care.” The social worker attempted to call defendant-father, but he did not answer and his
voicemail was full.

       On May 16, 2023, Overholt completed a form indicating active thoughts of suicide:

               Student came to me and shared that she has been having thoughts of killing
       herself. She shared that the thoughts have been stronger and she is afraid that she
       is going to act on it. She shared that she had thoughts of stabbing self with scissors.
       She also shared that she thinks things would be better is she wasn’t alive—spoke
       of stress being gone and wonderings of being reborn as a girl or life being better if
       she were in heaven. After speaking with staff she shared that she does not have a
       plan to kill herself anymore.

        On May 26, 2023, the child again reported to the emergency room due to suicidal ideation
and this time was hospitalized. Dr. Bernard Biermann reported that “she has had increasing
suicidal ideation secondary to conflict with her father” because “father is unaccepting of her gender
identity.” The child reported “that her father makes her visits uncomfortable by not referring to
her by her preferred name, playing ‘transphobic songs’ around her, forcing her to working [sic] in
the garage on cars.” The child admitted having previously self-harmed using writing utensils and
reported being “unsure if she could keep herself safe” with defendant-father the following
weekend. “She states that her thoughts have increased to the point that she has [sic] thinking of
taking a knife and cutting herself in an attempt to end her life. She states that she currently wants
to end her life.” The child wanted to be reincarnated as a girl but if that were not possible, “would
rather just not exist.” Defendant-father reported being unconcerned about the child self-harming,
but he agreed that hospitalization was necessary due to depression and anxiety. The child was
admitted to the hospital on May 27 and discharged on June 2.

        On June 11, 2023, nine days after the child was discharged, plaintiff-mother again moved
for sole legal custody, and she also sought restrictions regarding defendant-father’s parenting time
as well as orders regarding medical care. Plaintiff-mother submitted that the rapid decline in the
child’s mental health constituted proper cause or a change of circumstances warranting revisiting
of custody. Accordingly, plaintiff-mother requested that she be granted full legal custody, that

                                                 -5-
defendant-father’s parenting time be suspended, and that defendant-father be given supervised
parenting time until the child’s mental health is stabilized. On June 20, the court denied plaintiff-
mother’s request to suspend defendant-father’s parenting time pending the court proceedings and
ordered the child to undergo a psychological examination.

        On July 5, 2023, the child underwent a psychiatric evaluation with Dr. Genevieve Davis.
The child reported to Dr. Davis “that this morning she was supposed to go into her father’s care
for the next week and became acutely suicidal due to ongoing conflict with her father.” The child
reported that defendant-father refused the child’s request to go to the hospital as a result of suicidal
ideation, and defendant-father ultimately returned the child to plaintiff-mother’s care, who then
took the child to the hospital. The child had ideas of using a knife to commit suicide at defendant-
father’s house because he continued to leave them accessible; plaintiff-mother had locked away
any sharp objects.

       She denies any concerns related to her mood when she is not at her father’s house.
       She endorses significant anxiety surrounding the potential to go to her father’s
       house as well as anxiety about thinking her father will try to kidnap her one day,
       fear that her mother would die (because then she would have to live with her father),
       and fear that she would try to act on her suicidal thoughts while at his house. She
       denies any anxieties outside of her father and being at his house.

Plaintiff-mother reported to Dr. Davis that the child had been seeing a therapist but that defendant-
father refused to allow the child to see a psychiatrist. Dr. Davis determined that the child “is not
currently required to return to father’s home, and has no acute safety concerns when in mother’s
custody,” inpatient care was unneeded. Instead, Dr. Davis recommended a “partial hospitalization
program” to assist with coping skills and receive medication.

        On July 7, plaintiff-mother filed an emergency motion seeking suspension of defendant-
father’s parenting time and permission to partake in a partial hospitalization program consistent
with Dr. Davis’s recommendations. A hearing was conducted on July 18, and defendant-father
continued to use the child’s birth name as well as male pronouns during the hearing. Defendant-
father informed the court that he would not exercise his parenting time for the upcoming weekend
against the child’s will. Because the custody hearing was scheduled for the following Monday,
the court decided not to suspend defendant-father’s parenting time.

                                  D. EVIDENTIARY HEARING

                            1. PLAINTIFF-MOTHER’S TESTIMONY

        Plaintiff-mother testified that the child began correcting people regarding gender since
approximately age two. For example, “I’d say you’re such a good boy. She’d say no, Mama, I’m
a girl.” Plaintiff-mother disagreed with the notion that she forced a female identity on the child,
describing instances in which the child would “sneak into” her closet to wear adult shirts as dresses,
and when this behavior was corrected, the child would wear child-sized shirts around the waist as
if they were skirts. Plaintiff-mother did not allow the child to decide what to wear until “around
three or four” years old. Plaintiff-mother would get both boy and girl toys, but the child was only

                                                  -6-
interested in the more feminine toys. Plaintiff-mother continued to refer to the child using the
masculine name until the child requested a new name at school.

        Plaintiff-mother testified about the problems stemming from defendant-father’s opposition
to the child having long hair. According to plaintiff-mother, she would give the child a “swoopy
bang” because “if ever the hair went over the ears, when she went to [defendant-father’s] for
parenting time it was like, buzzed off, cut off short.” There were times when the child had “chunks
out of the hair” upon returning to plaintiff-mother, and the child would be “mortified” by and “very
upset” about this. Plaintiff-mother discussed this with defendant-father, who said, “I’ve been
cutting his hair his whole life, um, I don’t agree with long hair. I’m going to keep on cutting it.”
Defendant-father was insistent that the child did not have the right to make decisions regarding
hairstyle. Plaintiff-mother also described an incident in which the child went swimming with
defendant-father, defendant-father insisted that the child wear swim trunks without a shirt, and the
child “felt very embarrassed” because “her breasts were showing.” The child is always required
to change into boys’ clothing when at defendant-father’s house.

        Plaintiff-mother testified in detail about the mental health spiral the child had endured over
the previous year. Plaintiff-mother first took the child to the hospital in November 2022 because
the child said, “I’d rather kill myself than have to go to” defendant-father’s house. Plaintiff-mother
contacted the child’s primary care provider who referred the child to undergo a psychological
evaluation, and this was completed in April 2023. Plaintiff-mother subsequently took the child to
the emergency room again because the child said “that she still would rather kill herself” than see
defendant-father. The child went to the emergency room again prior to Memorial Day weekend
and was hospitalized for six days. Plaintiff-mother then wanted to take the child to a psychiatrist
to discuss antidepressant medication, but defendant-father “said that he would not accept any
referral for a psychiatrist from U of M. Plaintiff-mother eventually made an appointment with Dr.
Schumer to discuss psychiatric medication, defendant-father “did not agree” to this appointment,
and the court ultimately had to order that the appointment take place. The child was taken to the
hospital again on July 5, prior to a five-day stay with defendant-father, because “she was getting
emotional, having a panic attack, feeling suicidal ideation again, saying I can’t do it, I can’t do it.”
When defendant-father came to pick the child up, plaintiff-mother and the child went together to
tell defendant-father that the child did not want to go to his house and needed to go to the
emergency room. The child had “said she was a ten out of ten” which “means that she is at the
epitome of the top where she just wants to die.” Plaintiff-mother took the child to the hospital,
and hospital staff recommended an outpatient treatment plan. Plaintiff-mother attempted to
contact defendant-father for his consent, but she was not able to get in touch until the next day;
defendant-father “said I will not approve unless it’s court ordered.”

        Plaintiff-mother described a school project in which the children were asked to describe
what they would do if they had a time machine. The child’s submission was admitted into
evidence, and the child said that “she wished she could go forward in time so she wouldn’t have
to be around her father so that she could be herself.” Plaintiff-mother was afraid that defendant-
father’s parenting would lead to the child committing suicide. She opined that defendant-father
did not believe anything she told him about the child’s mental health and that defendant-father
believes plaintiff-mother is at fault for the child’s transgender identity. Plaintiff-mother wanted
full legal custody because she did not believe defendant-father was willing to consent to necessary
healthcare. Plaintiff-mother wanted defendant-father’s parenting time to be suspended because

                                                  -7-
defendant-father was putting the wellbeing of the child “in harms way.” If defendant-father’s
parenting time was not suspended, plaintiff-mother believed it should be limited to “a therapeutic
setting” so that the child would feel safe, be referred to with the child’s preferred name and
pronouns, and wear feminine clothing.

                                    2. EXPERT TESTIMONY

a. Alison Clinton

       Alison Clinton, a clinical social worker, testified both generally about transgender children
and specifically regarding this child.2 Clinton explained the meaning of the term “gender identity”:

               So, everyone has an assigned sex at birth. That is when a baby is born, um,
       we look at that baby’s body and make our best guess as to what the baby’s gender
       is going to be and that is the sex assigned at birth. It’s put on the birth certificate.
       But the gender identity is someone’s internal sense of who they are, what their
       gender is. Um, it’s internally experienced rather than externally presumed.

Clinton explained that gender identity can present very young, and there are children “who are
telling us that their gender identity is different from their assigned sex at birth as soon as they can
talk.” Gender identity is distinct from gender expression in that gender identity “is your innate
sense of who you are” whereas gender expression “is how you present to the world.” Clinton
explained that “transgender” refers to anyone “whose gender identity and assigned sex at birth are
not aligned” whereas “cisgender” refers to people for whom these are aligned.

       Clinton agreed that it was common for children to experiment with gender expression
without this being indicative of fluidity with respect to their gender identity. Clinton was asked
how to distinguish between these two classes of children:

              Q. How do you distinguish a child who might be having a phase of gender
       expression from the child’s true gender identity? How do you tell the difference
       when you’re evaluating?

              A. That’s a great question. Um, so we ask the child how they feel about the
       way that other people perceive them, the way that they see themselves. We ask
       about how they feel about their bodies. We ask about how they feel about the way

2
  Clinton was not formally received as an expert during her testimony. However, this appears to
have been an oversight. Clinton detailed her extensive education and training in endocrinology
and childhood gender dysphoria. Clinton has a Master of Social Work (MSW) degree and was
employed “in the Pediatric Endocrinology and Adolescent Gender Services” department for
Michigan medicine. She also described several trainings she went through relating specifically to
transgender children. Moreover, the trial court indicated during opening statements that plaintiff-
mother planned to present testimony from two “experts.” Moreover, during its oral ruling, the trial
court referred to plaintiff-mother’s witnesses as experts. The trial court treated this as expert
testimony, and defendant-father has not disputed her expertise below or on appeal.

                                                 -8-
       their body might develop over time. Oftentimes if someone is experimenting with
       gender expression they will be fine with being seen as their assigned sex at birth,
       being referred to using those pronouns, or their name on their birth certificate. But
       they will want to present in a way that is maybe gender non-conforming, but for a
       child who identifies as a gender that is different from their assigned sex at birth,
       they will consistently want to be seen as that gender, not simply as more masculine
       or feminine version of their assigned sex at birth. They will want often to be
       referred to using different pronouns, using a different name. They will often, you
       know, wish to be treated as their affirmed gender. So that’s generally the big
       difference.

        Clinton explained the term “gender dysphoria,” which “is marked by incongruence
between ones [sic] gender identity and one’s sex assigned at birth and then it’s also accompanied
by distress at things that remind that person of their assigned sex at birth.” Sources of distress
include body parts, fears regarding the trajectory of bodily development, and a persistent desire to
be treated as the affirmed gender. Gender dysphoria does not always accompany being
transgender, and it sometimes presents “from a very young age because [the children] recognize
that people are positioning them as a gender that they don’t internally identify with.” It also
commonly presents at puberty because “body changes” cause it to “present really intensely.”

        After this foundation was laid, Clinton was asked to discuss this child. Clinton explained
that she discussed the matter with the child and parents each separately. All three agreed that the
child began to outwardly take on a female gender identity no later than age three, around when the
child began speaking. Clinton was asked about what the child communicated to her when neither
parent was present:

              Q. And so from [the child’s] perspective did she express a preference as to
       her gender?

               A. Yes.

               Q. And what was that preference?

               A. Female.

               Q. And . . . did she express [the female name] as a preference as her name?

               A. Yes.

               Q. All right. In terms of her hopes and wishes for the future, did you get
       into that conversation with her?

               A. Yeah, we did.

               Q. And what are [the child’s] hopes for the future?

              A. Um, she wants to grow up to be a girl, essentially. Essentially. She has
       talked about wanting to go through girl puberty. She was really excited about

                                                -9-
       getting boobs. . . . She wanted to have long hair. She was, ah, just wanted to have
       people be nice to her and you know, just be herself.

               Q. Do you feel that these were authentic expressions of her wishes?

               A. Yes.

        While defendant-father expressed suspicion that plaintiff-mother had been dressing the
child in feminine clothing, Clinton did not discern any reason to suspect that the identity was forced
on the child by either parent. However, the child “expressed a lot of distress at being forced to
wear boy clothes, to have her hair cut short.” Defendant-father reported to Clinton that he did not
allow the child to present as female in any way at his home. Defendant-father wanted the child to
have “an alternate path” and wait until adulthood to transition.

         Clinton recommended “supportive therapy,” which involved “words of affirmation,”
validation, and offering support. Clinton was adamantly opposed to any sort of “conversion
therapy,” which she defined as “the practice of trying to convince a child to identify with their
assigned sex at birth.” She testified that this practice “is generally considered traumatic”; that it
increases the risk of negative mental health outcomes, including suicide; and that it “is considered
to be abusive in many circles.” Another one of Clinton’s recommendations was to use “feminine
names and pronouns in all settings.” Clinton testified that, when parents refuse to use a child’s
preferred name and pronouns, “there is evidence that shows that it increases suicidal ideation.”
Other ways a parent can support a child who is suffering from gender dysphoria include allowing
the child to wear preferred clothing, wear preferred hairstyles, and participate in gender affirming
activities.

        Clinton recommended starting the child on “hormone blockers.” She explained that a type
of hormone blocker is a “puberty blocker,” which “would put a pause on puberty.” Another type
could suppress testosterone. She recommended hormone blockers because “it could potentially
prevent changes that could be very distressing to a child” and “allow a child to have more time to
explore their” gender identity. Clinton was not aware of any permanent effects, and she disagreed
with defendant-father’s contention that such medication would be abusive. Clinton explained that
puberty blockers were a short-term treatment designed to allow a child to decide whether to go
forward with natural puberty or to later begin “hormone replacement therapy.” Clinton
emphasized that there was no evidence that puberty blockers cause long term harm but that there
was evidence of “long term benefit for pubertal suppression in trans youth.” Available research
has concluded that the usage of hormone blockers reduces rates of suicide among transgender
youth. Clinton testified that it would be highly unusual for a child to determine that they actually
are cisgender, but she clarified that help would be available to assist the child with transitioning
back to the gender conforming with their birth-assigned sex.

b. Jane Kessler

       Jane Kessler, who was received as an expert in clinical psychology, had a Master of Arts
degree in clinical psychology, was licensed to practice clinical psychology, was in the process of
obtaining a PhD, had experience as a clinical psychology professor, and had been practicing since
1996. Kessler defined “gender identity” similar to Clinton, but she also explained that gender

                                                -10-
identity is more than just a psychological phenomenon; recent research found that it was also a
“biological phenomenon” with “genetic roots.”

       What current research tells us is that all this time where we thought that gender
       identity was a psychological phenomenon, in fact it’s a biological phenomenon that
       has psychological manifestations. For example, when we do genetic studies
       looking at identical twins reared together, identical twins reared apart, non-identical
       twins, we see a very strong genetic basis for—for gender identity.

Kessler further explained that “the body produces hormones that are consistent with the individuals
[sic] psychological experience of gender.” The research has also identified “shifts” in the brain
structure of transgender individuals. “[I]t is those hormonal differences that in turn produce the
changes in the brain that lead to the experience of self as female.”

        According to Kessler, gender identity “is present very, very early in life.” When asked
about the child’s tendency to wear plaintiff-mother’s clothing as a toddler, Kessler explained that
this age is “typically when expressions of gender identity begin, in toddlerhood with preferences
about clothing as it signals gender.” She opined that a three-year-old child would “[a]bsolutely”
be capable of recognizing “that there’s a difference between their identity and their assigned
gender.” Indeed, the earlier nonconforming gender expression begins, the more likely it is to be
authentic, and consistency of the expression is another indicator of authenticity. Kessler did not
believe it possible to force such a young child to present gender identity a certain way because
“[t]oddlers are known for making themselves known and not going along with the program.” She
noted that children in countries in which a particular gender is considered more desirable are no
more likely to present as the more desirable gender.

        Kessler acknowledged that “the higher order of brain functions” continue developing well
into adulthood, but this is limited to aspects such as reasoning and impulse control; other “aspects
of brain development are completed much earlier.”

               Q. Does what you just explain [sic] to mean that a child wouldn’t know his
       or her true gender identity until they reach that full development?

               A. No.

Kessler testified that “for the vast majority of individuals gender is not fluid and that once the
individual establishes gender identity for themselves psychologically[,] which comes after it’s
established physically, that that [sic] is their status period.”

       Regarding gender dysphoria, Kessler testified that this “is the clinical term when an
individual experiences their biological sex as being the subject of intense unhappiness and upset.”
Kessler was asked about how a parent should support a child suffering from this condition:

             Q. [W]ould you recommend that . . . parents support their child’s preferred
       pronouns?

               A. I would, yes.

                                                -11-
                 Q. What about the an [sic] assumed or chosen name, would you recommend
         that they follow a chosen or assumed name?

                 A. Very important, yes.

                 Q. All right. What about letting the child dress or clothe themselves
         consistent with their preferred gender? Would you recommend that?

                 A. Also very important.

Kessler explained that children learn about “their essential acceptability” from their parents, so
“when a parent rejects some essential part of the child,” the child will “experience this as a global
rejection.”

       Kessler testified that suicidal ideation is “very much” a concern for transgender children.
Research regarding children aged 12 to 183 has found that at least 40% have wanted to die or
engaged in suicidal actions. With respect to adults, that figure rises up to as high as 60%.

                Q. [I]f the defendant were to make an argument well, I don’t want my child
         to have this 40 percent risk of suicide so I just don’t want my child to be
         transgender, how would you respond to that?

                 A. The—the risk of suicide does not necessarily accompany an individual
         being transgender. It doesn’t have to accompany an individual being transgender.
         It accompanies an individual being transgender because of the way they are treated
         by those around them, and in particular by family members. So, that risk is very
         modifiable, can be lowered quite dramatically when the family members and others
         close to the child, and later the young adult, accept them for their experience of
         themselves.

                 Q. Would it be fair to say that a parent’s rejection of a child’s gender
         identity poses a risk of safety to that child?

                 A. A tremendous risk.

Kessler opined that a child should be “very quickly” evaluated at a hospital if the child expresses
an intent to self-harm.

        Kessler was asked to respond to some of the arguments that defendant-father had raised
during the proceedings:

                Q. [A] statement was made that gender forming care as to age of 10 is
         tantamount to child abuse. What would your response to that be?

3
    No research was available for younger children.

                                                -12-
               A. There is an enormous weight of evidence collected all over the world
       that that is not correct.

              Q. What about the statement that administering any sort of hormone
       blockers or puberty blockers is child abuse?

               A. Um, there is an enormous weight of evidence collected at medical
       centers all over the world that that is not correct.

                           3. DEFENDANT-FATHER’S TESTIMONY

        Following the close of plaintiff-mother’s proofs, defendant-father testified. He was
examined by the court and then cross-examined by plaintiff-mother’s attorney. During his
testimony, defendant-father continued using he/him pronouns and the child’s male name.
Defendant-father noted that the child’s “downward spiral” correlated with the decision to
recognize the child’s transition at school, and he testified that he wanted the child to have “multiple
pathways” in life. He wanted the child to present as male at his home and believed that it would
be better if a final decision were made when the child is “old enough to understand.” The court
noted that the experts testified that defendant-father’s approach was detrimental to the child’s
wellbeing, but defendant-father indicated that he disagreed. Defendant-father described three
incidents, apart from the aforementioned hospital trips, in which the child expressed suicidal
ideations at school, and plaintiff-mother did not take the child to the hospital. Defendant-father
acknowledged that, each time plaintiff-mother did take the child to the hospital, the child reported
fear of committing suicide at defendant-father’s house, but defendant-father continued to maintain
that there were no such issues at his home.

        Defendant-father testified that mental health crises never occurred with the child at his
home. He explained that the child never corrected him when he used the male name and pronouns
and that the child would change into male clothes upon arrival without direction. However,
defendant-father acknowledged that he previously had a conversation with the child, shortly after
the in-school transition, in which he explained that he did not want the child to present as female
at his home. “I’m like we’re not wearing girls’ clothes here, we’re not calling you [your female
name] here. And he said that’s fine, and we’ve had that understanding since the name change at
school began to happen.” Defendant-father was uncertain if he would ever soften this rule, but
was adamant that the child was too young. Defendant-father acknowledged that the child was
bothered by his refusal to use the female name and pronouns.

        The court pressed defendant-father regarding his approach to the child’s gender dysphoria,
noting that he seemed to be “trying to ignore it.” Defendant-father again stated that the child’s
mental health had deteriorated since the child’s name and pronouns were changed at school.
Therefore, he believed it would be beneficial “to show him a separate path” when at defendant-
father’s house. Defendant-father suspected that additional underlying problems were present
because the child never expressed a desire to engage in self-harm at defendant-father’s home, and
he believed the mental health issues were “facilitated at his mother’s house.” Defendant-father
did note that he would not force the child to see him if the child did not want to. Defendant-father
did not believe hormone treatments would be helpful, and he opined that it would be “morally

                                                 -13-
wrong” to allow a child to use hormonal medication at such a young age because the child was too
young to “understand the ramifications” of the medication.

        Defendant-father explained that such a young child lacked “the cognitive reasoning” to
make such a decision, and his opinion was informed by “common sense.” He acknowledged that
Kessler disagreed with him, but he wrote this off as “a subjective opinion” and believed his opinion
was also valid. Defendant-father was unmoved the clinical recommendations for the child made
the previous April because they were made “[b]y a social worker,” but he admitted that he had not
contacted a psychologist for an evaluation and that he did not consent to evaluations with
psychological experts at the University of Michigan. He was concerned that “the affiliations with
U of M” evidenced “an agenda” to bring the child to a doctor whom he did not support. He also
did not consent to “in-depth outpatient therapy” at the New Oakland facility. Defendant-father
indicated that he wanted the depression and anxiety medications to be reviewed by the child’s
primary care provider rather than a psychiatrist. Defendant-father testified that he had not cut the
child’s hair since the previous October, but he acknowledged that the previous two haircuts he
gave were against the child’s will because, “I’m not going to have [the child] look like a slob.”
Defendant-father testified that it was not possible for he and plaintiff-mother to agree on how to
approach the child’s gender dysphoria.

                                 4. THE COURT’S DECISION

        The court began by providing an in-depth summary of the evidence. The court, noting that
it met with the child in chambers, decided that it would refer to the child using the feminine name
and she/her pronouns. The court determined that plaintiff-mother had not met the threshold burden
to establish proper cause or change of circumstances because the child’s gender dysphoria “is not
a new issue.” The court acknowledged that the child reported becoming suicidal when faced with
the notion of seeing defendant-father, but it reasoned that this was an issue the parties had “been
dealing with for years.” The court, despite describing itself as “not convinced there’s a proper
cause, change of circumstances at this point,” decided to perform a full best-interests analysis
anyway—presumably to facilitate appellate review.

        The court found an established custodial environment with both parents then made findings
regarding each best interest factor. Regarding the specifically delineated factors, the court’s
findings fell pretty evenly without any factor strongly favoring either party. The catchall factor
proved to be the focal point of the court’s analysis, and it used that factor to address the child’s
gender dysphoria. The court found that defendant-father was not understanding “the big picture”
and seemed to be blaming plaintiff-mother for the problems. The court stated that the parents
needed “to get closer to a middle ground” and suggested that defendant-father should be a little bit
more accepting and work on using she/her pronouns. In general, the court essentially nudged the
parties toward figuring out how to work together. The court decided that the parties could hold
off on hormonal medication and try to reach an agreement in the future. The court concluded that
plaintiff-mother failed to meet her burden and ordered that custody and parenting time remain
unchanged. The court then entered a handwritten order providing that the parties would attend a
consultation with Dr. Shumer at the University of Michigan; that both parties still need to consent
to any medication; that the parties would need to attend six sessions with a psychologist; and that
both parties need to continue individual therapy.

                                               -14-
       This appeal followed.

                                         II. DISCUSSION

        We conclude that the trial court erred by electing to maintain what the evidence clearly
established to be an untenable status quo.

                                 A. STANDARDS OF REVIEW

        MCL 722.28 provides that when reviewing a lower court order in a custody dispute, “all
orders and judgments of the circuit court shall be affirmed on appeal unless the trial judge made
findings of fact against the great weight of evidence or committed a palpable abuse of discretion
or a clear legal error on a major issue.” This statute “distinguishes among three types of findings
and assigns standards of review to each.” Dailey v Kloenhamer, 291 Mich App 660, 664; 811
NW2d 501 (2011) (quotation marks and citation omitted). Factual findings “are reviewed under
the ‘great weight of the evidence’ standard.” Id. “A finding of fact is against the great weight of
the evidence if the evidence clearly preponderates in the opposite direction.” Pennington v
Pennington, 329 Mich App 562, 570; 944 NW2d 131 (2019). “Questions of law are reviewed for
clear legal error. A trial court commits clear legal error when it incorrectly chooses, interprets, or
applies the law.” Id. (quotation marks and citation omitted). “Discretionary rulings, such as to
whom custody is awarded, are reviewed for an abuse of discretion. An abuse of discretion exists
when the trial court's decision is palpably and grossly violative of fact and logic.” Dailey, 291
Mich App at 664-665 (quotation marks, citations, and alteration omitted).

                                          B. CUSTODY

                  1. PROPER CAUSE OR CHANGE OF CIRCUMSTANCES

       To the extent that the trial court found that there was not proper cause or a change of
circumstances necessitating a review of the custody arrangement, this finding was against the great
weight of the evidence.

       Pursuant to MCL 722.27(1)(c), a court may only modify prior custody orders “for proper
cause shown or because of change of circumstances . . . .” This requirement “imposes a
gatekeeping function” designed to maintain stability in the child’s life. Kuebler v Kuebler, ___
Mich App ___, ___; ___ NW3d ___ (2023) (Docket No. 362488); slip op at 16.

       [T]o establish “proper cause” necessary to revisit a custody order, a movant must
       prove by a preponderance of the evidence the existence of an appropriate ground
       for legal action to be taken by the trial court. The appropriate ground(s) should be
       relevant to at least one of the twelve statutory best interest factors, and must be of
       such magnitude to have a significant effect on the child's well-being.

                                               * * *

       [I]n order to establish a “change of circumstances,” a movant must prove that, since
       the entry of the last custody order, the conditions surrounding custody of the child,

                                                -15-
       which have or could have a significant effect on the child's well-being, have
       materially changed. . . . [T[he evidence must demonstrate something more than the
       normal life changes (both good and bad) that occur during the life of a child, and
       there must be at least some evidence that the material changes have had or will
       almost certainly have an effect on the child. This too will be a determination made
       on the basis of the facts of each case, with the relevance of the facts presented being
       gauged by the statutory best interest factors. [Vodvarka v Grasmeyer, 259 Mich
       App 499, 512-514; 675 NW2d 499 (2003).]

        The record is unclear regarding the trial court’s position on whether proper cause or change
of circumstances necessitating a custody review was established. The court indicated at the close
of the evidentiary hearing that it was “not convinced” plaintiff-mother had met her burden.
However, this comment notwithstanding, plaintiff-mother maintains that the trial court actually
did find that the burden was met because (1) the trial court purportedly did find the burden met at
a prior hearing and (2) the trial court proceeded to perform a best-interests analysis anyway.
Regardless, the court’s statement that it was not convinced plaintiff-mother met this threshold
burden was against the great weight of the evidence.

        The trial court’s finding was premised on its belief that the child’s gender dysphoria was
not a new issue. The child began expressing a female gender identity at a very young age, and the
parties have never agreed regarding how to approach this issue. The trial court’s finding that there
had not been a material change in circumstances did have support in the record, but it erred by
ending the analysis there. A full custody evaluation can also be started with a finding of “proper
cause,” and the evidence in this case overwhelmingly established that the present arrangement is
not working. The child had been taken to the emergency room three times due to suicidal ideation,
and suicidal ideation was regularly documented at school. The child’s thoughts continued to
escalate, and the child was eventually hospitalized for six days. The parents were perpetually
unable to agree on how to proceed, with plaintiff-mother advocating for gender-affirming care
while defendant-father insisted on providing an “alternate path.” It is undeniable from the record
that the current arrangement is not working, and this is proper cause.

                      2. ESTABLISHED CUSTODIAL ENVIRONMENT

       Plaintiff-mother’s contention that the trial court erred by finding an established custodial
environment is without merit.

        “When resolving important decisions that affect the welfare of the child, the court must
first consider whether the proposed change would modify the established custodial environment.”
Pierron v Pierron, 486 Mich 81, 85; 782 NW2d 480 (2010).

       The custodial environment of a child is established if over an appreciable time the
       child naturally looks to the custodian in that environment for guidance, discipline,
       the necessities of life, and parental comfort. The age of the child, the physical
       environment, and the inclination of the custodian and the child as to permanency of
       the relationship shall also be considered. [MCL 722.27(1)(c).]

                                                -16-
“[A] custodial environment can be established in more than one home.” Ritterhaus v Ritterhaus,
273 Mich App 462, 471; 730 NW2d 262 (2007). “If the proposed change alters the established
custodial environment, the party seeking the change must demonstrate by clear and convincing
evidence that the change is in the child's best interests.” Marik v Marik, 325 Mich App 353, 361;
925 NW2d 885 (2018). If an order does not change an established custodial environment, then the
applicable standard of proof is a preponderance of the evidence. Id.

        Plaintiff-mother argues that the court erred by holding her to the clear and convincing
evidence standard because there was no established custodial environment with defendant-father.
Plaintiff-mother maintains that defendant-father’s unwillingness to allow the child to be feminine
in his home, taken together with the child’s proclivity for vocalizing a desire to self-harm before
defendant-father’s parenting time, forecloses a finding of an established custodial environment.
We conclude that the court’s finding had substantial support in the record. Defendant-father had
been exercising parenting time every other weekend for the child’s entire life. While defendant-
father was not supportive of the child’s transition, he consistently met other needs when the child
was in his care, and the child looked to him for guidance in other facets of life. Therefore, the
court’s finding was not against the great weight of the evidence.

                        3. BEST INTERESTS AND LEGAL CUSTODY

        The trial court made numerous best interest findings that were against the great weight of
the evidence, and it abused its discretion by not granting plaintiff-mother sole legal custody of the
child.

       “A trial court must consider the factors outlined in MCL 722.23 in determining a custody
arrangement in the best interests of the children involved.” Bofysil v Bofysil, 332 Mich App 232,
244; 956 NW2d 544 (2020), lv den 507 Mich 1020 (2021). MCL 722.23 provides:

              As used in this act, "best interests of the child" means the sum total of the
       following factors to be considered, evaluated, and determined by the court:

              (a) The love, affection, and other emotional ties existing between the parties
       involved and the child.

               (b) The capacity and disposition of the parties involved to give the child
       love, affection, and guidance and to continue the education and raising of the child
       in his or her religion or creed, if any.

              (c) The capacity and disposition of the parties involved to provide the child
       with food, clothing, medical care or other remedial care recognized and permitted
       under the laws of this state in place of medical care, and other material needs.

              (d) The length of time the child has lived in a stable, satisfactory
       environment, and the desirability of maintaining continuity.

             (e) The permanence, as a family unit, of the existing or proposed custodial
       home or homes.

                                                -17-
               (f) The moral fitness of the parties involved.

               (g) The mental and physical health of the parties involved.

               (h) The home, school, and community record of the child.

               (i) The reasonable preference of the child, if the court considers the child to
       be of sufficient age to express preference.

               (j) The willingness and ability of each of the parties to facilitate and
       encourage a close and continuing parent-child relationship between the child and
       the other parent or the child and the parents. A court may not consider negatively
       for the purposes of this factor any reasonable action taken by a parent to protect a
       child or that parent from sexual assault or domestic violence by the child's other
       parent.

               (k) Domestic violence, regardless of whether the violence was directed
       against or witnessed by the child.

               (l) Any other factor considered by the court to be relevant to a particular
       child custody dispute.

       The dispute in this case is about legal custody rather than physical custody. Legal custody
is governed by MCL 722.26a, which provides in relevant part:

               (1) In custody disputes between parents, the parents shall be advised of joint
       custody. At the request of either parent, the court shall consider an award of joint
       custody, and shall state on the record the reasons for granting or denying a request.
       In other cases joint custody may be considered by the court. The court shall
       determine whether joint custody is in the best interest of the child by considering
       the following factors:

               (a) The factors enumerated in section 3.

              (b) Whether the parents will be able to cooperate and generally agree
       concerning important decisions affecting the welfare of the child.

“If two equally capable parents . . . are unable to cooperate and to agree generally concerning
important decisions affecting the welfare of their children, the court has no alternative but to
determine which parent shall have sole custody of the children.” Bofysil, 332 Mich App at 249
(quotation marks and citation omitted).

       Plaintiff-mother challenges the trial court’s findings regarding factors (c), (i), (l), and MCL
722.26a(1)(b). With the exception of factor (i), we agree with plaintiff-mother.

        Factor (c) is “[t]he capacity and disposition of the parties involved to provide the child with
food, clothing, medical care or other remedial care recognized and permitted under the laws of this
state in place of medical care, and other material needs.” MCL 722.23(c). This factor is not

                                                 -18-
determined solely by who makes more money as long as each party has enough money to meet the
child’s needs. See Berger v Berger, 277 Mich App 700, 711; 747 NW2d 336 (2008). Regarding
this factor, the trial court said that “both have the capacity and disposition to provide that, they
both have good, stable jobs; PNC and GM. They both have good jobs. They’re able to provide
the food and clothing, medical care and things of that, so I would find this to be equal.”

        The court’s finding was against the great weight of the evidence because the record
overwhelmingly established that plaintiff-mother had a significantly greater disposition to provide
the child with medical care. Multiple experts testified that it was important for a child to be
promptly taken to the hospital upon expressing suicidal intent, but plaintiff-mother was the only
person who ever took the child to the hospital. There were multiple instances in which medical
providers were unable to get in touch with defendant-father while the child was receiving
emergency care. Defendant-father refused to consent to plaintiff-mother’s efforts to have a
psychiatrist assess the child’s need for depression and anxiety medication, insisting instead that
this should be done by a general practitioner. Defendant-father also refused to consent to an
intensive outpatient psychiatric program at the New Oakland facility that was recommended for
the child. Defendant-father dismissed medical advice that came from clinical social workers,
seemingly viewing them as unqualified, and insisted on only listening to clinical psychologists.
Despite this insistence, defendant-father vetoed any consultation with practitioners employed by
the University of Michigan, citing fears that they would have an “agenda.” However, defendant-
father failed to seek care from alternative practitioners. Regarding puberty blockers, defendant-
father was dug-in on his opposition to it and was unwilling to view the evidence through an
objective lens. The court was presented with unrebutted expert testimony that there was no
evidence of long-term harm from puberty blockers, that they simply delayed puberty, and that
natural puberty would progress normally if the child was taken off the puberty blockers.
Defendant-father simply “disagreed” with these expert opinions, citing “common sense” as the
basis for his belief that the child was too young to undergo any sort of a medical transition.
Moreover, the evidence suggested that defendant-father lacked insight into the sources of the
child’s mental illness. As detailed above, the child repeatedly cited defendant-father’s lack of
acceptance as the root of the suicidal ideation, and the mental health crises routinely correlated
with the child’s impending departure for defendant-father’s parenting time. Despite this,
defendant-father was unwilling to concede the possibility that his actions contributed to the child’s
mental illness and insisted that something else must be underlying the problems. The only rational
view of the evidence mandates a conclusion that this factor should weigh heavily in plaintiff-
mother’s favor.

       Factor (i) is the reasonable preference of the child. Regarding this factor, the court said the
following:

       I met [the child] in Chambers, and talked to her briefly. I can’t share that with you.
       I’ll tell you it was a little—I was a little surprised how that went down, but the
       reasonable preference of [the child] will be taken into consideration. But that is
       confidential and I won’t share that with you, but I can take that into consideration.

               But I will tell you, Mom and Dad, I don’t give that factor a huge preference
       there because it just doesn’t seem fair that we don’t put it on the record, but that’s

                                                -19-
       how the law works, but the Court will consider that and give it the weight that I
       consider necessary.

Plaintiff-mother argues that the trial court erred by declining to give this factor greater weight due
to fairness concerns.

        It is true that the court is required to consider the child’s preference if the child is old
enough to express one. Kubicki v Sharpe, 306 Mich App 525, 545; 858 NW2d 57 (2014).
However, the record suggests that the court satisfied this obligation, its comments regarding the
fairness of this factor notwithstanding. The court explicitly stated that the child’s preference would
be taken into consideration and that it would be given as much weight as the court determined
necessary. Therefore, we discern no error regarding factor (i).

        “Factor l is a ‘catch-all’ provision.” McIntosh v McIntosh, 282 Mich App 471, 482; 768
NW2d 325 (2009). The trial court correctly chose to consider the child’s gender dysphoria, but
this factor should have weighed heavily in favor of plaintiff-mother. Testimony from multiple
experts established the most effective approaches that parents should take when raising
transgender children in order to facilitate positive mental health outcomes. Defendant-father’s
own testimony, in conjunction with the documentation from the child’s numerous hospitalizations,
established that defendant-father was unwilling to approach the child’s welfare in conformance
with expert advice. Clinton and Kessler each testified that it was in the best interests of the child
to use the child’s preferred name and pronouns and, more generally, to affirm the child’s gender
identity. Indeed, Kessler described a parent’s failure to accept a transgender child as “a global
rejection” that causes the child to feel entirely unworthy. This testimony was unrebutted. Despite
this, defendant-father was unwilling to use the child’s female name and pronouns. Indeed, even
the court decided to respect the child’s wishes in this regard, but defendant-father made it clear
that he was not willing to budge. He suggested that he might reconsider at an undefined point in
the future, but he was noncommittal about this as well. Defendant-father likewise had a rule that
the child needed to wear masculine clothes when at defendant-father’s house. The court asked
defendant-father about his unwillingness to affirm the child’s gender identity, and he suggested
that it was best that the child be given an “alternate path.” Defendant acknowledged that this
approach was contrary to the recommendations of the experts, but he disagreed with their opinions,
describing them as “subjective.”

        Defendant-father made numerous assertions that were directly contrary to the expert
testimony. Defendant-father insisted that the child was too young to decide to wear feminine
clothing, choose a different name, and use she/her pronouns. Defendant-father, a layperson in
these matters, offered opinions regarding the cognitive abilities of young children to support his
approach. However, this testimony came immediately after multiple experts extensively addressed
the child’s age. Both experts explained that it was very common for a nonconforming gender
identity to manifest at a very young age, perhaps as young as when the child first becomes verbal.
Kessler specifically testified regarding brain development, stating that certain facets of brain
development are completed at a very young age and that components involving critical thinking
and impulse control develop later in life. Defendant-father expressed concern regarding
irreversible damage that was not founded in expert opinions. The evidence suggested it was very
unlikely that the child would later come to identify as male and that, if this did happen, support
could be offered to help transition back. There also was no evidence of long-term harm arising

                                                -20-
from puberty blockers. Rather, the evidence presented suggests that puberty blockers would afford
the child an additional one to three years to determine the child’s preferred path regarding puberty,
and this would align with defendant-father’s preference to wait until the child is older to allow
such changes to take place. Finally, defendant-father’s insistence on treating the child as a boy
was directly against all expert advice offered at any point in this proceeding, and defendant-father
has not offered any support for this approach aside from his own opinion.

        Legal custody disputes require the added consideration of the ability of the parents to agree
regarding “important decisions affecting the welfare of the child.” MCL 722.26a(1)(b). The
evidence irrefutably established that the parties were incapable of agreeing with respect to
hormonal medicate and psychiatric care. Indeed, defendant-father expressly admitted that it was
impossible for him and plaintiff-mother to agree regarding the approach to the child’s gender
dysphoria. Thus far, the parties have not been able to agree with respect to puberty blockers,
psychiatric medication, and psychological care providers. The record makes clear that issues such
as these will inevitably arise on a regular basis until the child attains the age of majority. On this
record, the court’s instruction that the parties must simply attempt to find “a middle ground” was
indefensible. The court had no choice but to grant sole legal custody to one of the parties and to
do so in the best interests of the child. See Bofysil, 332 Mich App at 249. The only conclusion
supported by the evidence is that plaintiff-mother was substantially better equipped to make
important decisions in the best interests of the child.

       Therefore, we conclude that the trial court abused its discretion by denying plaintiff-
mother’s motion for sole legal custody.

                                      C. PARENTING TIME

         The trial court abused its discretion by denying plaintiff-mother’s request to place
restrictions on defendant-father’s parenting time.

       Parenting time in Michigan is governed by MCL 722.27a, which provides in relevant part:

               (1) Parenting time shall be granted in accordance with the best interests of
       the child. It is presumed to be in the best interests of a child for the child to have a
       strong relationship with both of his or her parents. Except as otherwise provided in
       this section, parenting time shall be granted to a parent in a frequency, duration,
       and type reasonably calculated to promote a strong relationship between the child
       and the parent granted parenting time.

                                               * * *

              (7) The court may consider the following factors when determining the
       frequency, duration, and type of parenting time to be granted:

               (a) The existence of any special circumstances or needs of the child.

               (b) Whether the child is a nursing child less than 6 months of age, or less
       than 1 year of age if the child receives substantial nutrition through nursing.

                                                -21-
              (c) The reasonable likelihood of abuse or neglect of the child during
       parenting time.

              (d) The reasonable likelihood of abuse of a parent resulting from the
       exercise of parenting time.

               (e) The inconvenience to, and burdensome impact or effect on, the child of
       traveling for purposes of parenting time.

              (f) Whether a parent can reasonably be expected to exercise parenting time
       in accordance with the court order.

               (g) Whether a parent has frequently failed to exercise reasonable parenting
       time.

               (h) The threatened or actual detention of the child with the intent to retain
       or conceal the child from the other parent or from a third person who has legal
       custody. A custodial parent's temporary residence with the child in a domestic
       violence shelter shall not be construed as evidence of the custodial parent's intent
       to retain or conceal the child from the other parent.

               (i) Any other relevant factors.

The trial court did not explicitly address the parenting time factors laid out in MCL 722.27a(7),
but it was not required to do so as long as its decision was guided by the child’s best interests. See
Shade v Wright, 291 Mich App 17, 32; 805 NW2d 1 (2010). Regardless, the parties and court
agreed that the dispute in this matter revolved entirely around management of the child’s gender
dysphoria.

         The only conclusion that can be reasonably supported by this record is that parenting time
with defendant-father was actively harming the child. Both expert witnesses testified that it was
harmful to the child when defendant-father refused to respect the child’s female identify. Clinton
testified that the child “expressed a lot of distress” when defendant-father required the use of
masculine clothing and that a parent’s refusal to use a child’s preferred name and pronouns
increased the risk of suicidal ideation. Kessler described it as “very important” that parents use
the child’s chosen name, use the child’s preferred pronouns, and allow the child to wear clothing
and partake in activities that affirm the child’s gender identity. During the progression of the
child’s mental illness, each set of prospective recommendations endorsed steps to affirm the
child’s gender identity. Defendant-father unequivocally and unapologetically refused to do any of
this during his parenting time, explaining that he crafted a rule that the child must dress and act as
a boy when at his house and expressing no openness to easing this rule. The court seemingly
endorsed the approach advocated for by these experts by using the child’s female name and
pronouns and by suggesting, but not ordering, that defendant-father should open his mind and
recognize “the big picture.”

       The evidence also makes clear that defendant-father’s approach to his parenting time has
already caused the mental anguish of which Clinton and Kessler warned. Each of the child’s
emergency room visits came on the eve of defendant-father’s parenting time, and the child

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repeatedly expressed a preference for death over participating in defendant-father’s parenting time.
At one point, the child expressed fear that it would be impossible to remain safe from suicidal
actions during an impending weekend stay with defendant-father. The evidence that each
hospitalization came with reports of fears of committing suicide at defendant-father’s home was
unrebutted and even acknowledged by defendant-father. There was no evidence suggesting that
the child was being inauthentic, and the trial court’s finding that plaintiff-mother was not
facilitating these problems was supported by the evidence. What was not supported by the
evidence was its decision to maintain the status quo.

         While the trial court erred by leaving defendant-father’s parenting time without any
restrictions, the evidence did support its decision to deny plaintiff-mother’s request to outright
suspend his parenting time. The evidence suggested that defendant-father loved the child dearly.
There was no indication that defendant-father was physically abusing the child or failing to meet
the child’s physical needs. There likewise was no indication that defendant-father had a habit of
explicitly disparaging the child’s feminine inclinations.4 Moreover, defendant-father indicated
that he would not exercise parenting time against the child’s will.5 However, as an alternative to
outright suspension, plaintiff-mother advocated for restrictions on defendant-father’s parenting
time.

        Simply put, the trial court’s decision to allow defendant-father’s parenting time to remain
wholly unchanged, on this record, was indefensible. Unless defendant-father brings a new motion
supported by expert testimony that it is in the child’s best interests, defendant-father must be barred
from ignoring the advice of medical professionals outlined on the record which include using the
child’s masculine name, referring to the child using male pronouns, forcing the child to wear
masculine clothes, and cutting the child’s hair.
                                         III. CONCLUSION

        The trial court’s July 28, 2023 order is reversed. Plaintiff-mother shall have full legal
custody of the minor child. Plaintiff-father shall not refer to the child using a masculine name and
masculine pronouns while in the child’s presence. Plaintiff-father likewise shall not require that
the child wear masculine clothing, cut the child’s hair, or restrict the child’s access to activities
based only on his perception of the activities as feminine. These provisions of this opinion shall
have immediate effect pursuant to MCR 7.215(F)(2). The methods employed to ensure defendant-
father’s compliance with the parenting time restrictions as well as any corresponding changes to
the frequency and duration of defendant-father’s parenting time shall be left to the trial court’s
discretion.

4
  There was evidence that at some point in time defendant-father referred to the child as “twinkle
toes” while dancing at defendant-father’s house. There likewise were concerns at times that
defendant-father would play transphobic music at his house. However, on balance, the evidence
supported a finding that this was not an ongoing source of concern.
5
  We note that defendant-father at one point suggested an arrangement that he exercise parenting
time at the discretion of the child, but it clearly is not in the best interests of an 11-year-old child
to be charged with constructing and enforcing a parenting time schedule.

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        We reverse. This case is remanded for additional proceedings consistent with this opinion.
Plaintiff-mother, being the prevailing party, may tax costs. See MCR 7.219(A). We do not retain
jurisdiction.

                                                            /s/ Mark J. Cavanagh
                                                            /s/ Allie Greenleaf Maldonado

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