Coblentz v. United States of America

United 	States 	District 	Court
District 	of 	Massachusetts
)
Katie 	Coblentz 	[FICA Katie 	Anderson],)
)
Plaintiff, 	)
)
V • 	)
)
Civil 	Action No.
25-10435-NMG
United 	States 	of 	America, 	)
)
Defendant. 	)
)
MEMORANDUM & ORDER
GORTON, 	J.
Plaintiff 	Katie 	Coblentz 	("plaintiff" 	or 	"Coblentz") 	has
filed 	a 	complaint 	against 	the 	United 	States 	("defendant" 	or
"Fenway Health") 	pursuant 	to 	the 	Federal 	Tort 	Claims 	Act , 	28
U.S.C. 	§1346 (b) 	("FTCA"), 	alleging 	medical 	malpractice 	and
negligence, 	negligent 	infliction 	of 	emotional 	distress 	and
fraudulent 	misrepresentation. 1 	Defendant 	responds 	that
plaintiff's 	claims 	are 	time-barred 	and moves 	to 	dismiss. 	For
the 	reasons 	that 	follow, 	that 	motion will 	be ALLOWED.
I. Facts
The 	Court 	assumes 	as 	true 	all 	well-pled 	facts 	in 	the
complaint. 	In March, 	2015, 	when 	Coblentz 	was 	19 	years 	old, 	she
visited 	Fenway Health 	for 	"gender-identity 	issues." 	She 	told
1 As a 	federall y 	qualified heath center , 	Fenwa y Health and i ts emplo y ees are
considered to be federal emplo y ees.
1
Case 1:25-cv-10435-NMG Document 23 Filed 03/16/26 Page 1 of 11

providers 	that 	she 	"realized 	she 	was 	not 	a 	boy during 	puberty"
and began 	feeling 	discomfort 	with 	her 	gender 	in 	2014. 	Plaintiff
met 	with various 	Fenway Health providers 	in 	the 	following 	months
before 	beginning 	hormone 	therapy via 	testosterone 	injections 	in
May, 	2015.
In May, 	2016, 	Coblentz 	returned 	to 	Fenway Health 	for 	an
"assessment 	of 	readiness/appropriateness" 	for 	a 	gender-affirming
double 	mastectomy, 	which plaintiff 	ultimately underwent 	in
August, 	2016. 	In January, 	2018, 	during 	a 	routine 	visit
regarding 	the 	testosterone 	injections, 	Coblentz 	complained 	of
pelvic 	pain, 	which 	a 	Fenway Health 	doctor 	believed was 	caused by
the 	testosterone 	injections 	and 	uterine 	atrophy. 	The 	Fenway
Health 	doctor 	referred 	Coblentz 	for 	a 	hysterectomy and
oophorectomy 	at 	a 	Tufts-affiliated medical 	facility. 	At 	about
that 	time, 	Coblentz 	was 	also 	diagnosed with Autism 	Spectrum
Disorder, 	Obsessive-Compulsive 	Disorder 	and Unspecified Anxiety
Disorder by a 	provider 	independent 	of 	Fenway 	Health.
Coblentz 	underwent 	a 	hysterectomy 	and 	oophorectomy 	in
August, 	2020. 	In 	July, 	2021, 	during 	a 	visit 	with 	Fenway Health,
Coblentz 	expressed 	interest 	in 	de-transitioning 	back 	to 	living
as 	a 	female. 	Coblentz 	felt 	that 	her mental 	health 	had 	not
improved 	as 	a 	result 	of 	her 	gender-affirming 	care 	and 	that 	she
would 	be 	able 	"to 	better 	work 	through 	[her] 	emotional 	well 	being
[if 	she 	was] 	less 	focused 	on physical 	changes." 	Accordingly,
2
Case 1:25-cv-10435-NMG Document 23 Filed 03/16/26 Page 2 of 11

she 	was 	prescribed 	estradiol, 	a 	form 	of 	estrogen, 	by 	Fenway
Health.
During 	subsequent 	visits 	in 	2021, 	Coblentz 	expressed
confusion 	and 	uncertainty 	about 	her 	gender 	identity, 	her
decision 	to 	de-transition and 	the 	course 	of 	treatment 	she 	had
received 	at 	Fenway 	Health. 	By December, 	2021, 	Fenway Health had
stopped prescribing 	testosterone 	to 	Coblentz. 	In March, 	2022,
plaintiff 	visited a 	healthcare 	provider 	unrelated 	to 	Fenway
Health 	to 	continue 	hormone 	therapy 	for 	de-transitioning.
Coblentz 	was 	again prescribed 	estradiol.
In October, 	2023, 	Coblentz 	met 	with 	legal 	counsel 	who
informed 	her 	that 	Fenway Health had misled 	her 	into 	undergoing
the 	testosterone 	injections, 	double 	mastectomy and
hysterectomy/oophorectomy 	surgeries 	by 	"misrepresenting 	to 	her
[that 	those 	treatments 	were] 	medically 	necessary 	and would 	cure
her 	mental 	health 	issues 	and 	not 	harm 	her." 	Plaintiff 	alleges
that 	the 	providers 	at 	Fenway Health 	concealed 	the 	fact 	that
gender 	affirming 	care 	is 	not 	supported by adequate 	scientific
evidence. 	Coblentz 	and 	her 	legal 	counsel 	submitted 	an
administrative 	claim 	to 	the 	Department 	of 	Health 	and Human
Services 	("HHS") 	on March 	1, 	2024. 	HHS 	denied 	that 	claim 	in
September, 	2024, 	and 	plaintiff 	then 	commenced 	the 	instant 	suit
on 	February 	21, 	2025.
3
Case 1:25-cv-10435-NMG Document 23 Filed 03/16/26 Page 3 of 11

II. 	Legal 	Standard
To 	survive 	a 	motion 	to 	dismiss 	under 	Fed. 	R. 	Civ. 	P.
12(b) (6), 	the 	subject 	pleading must 	contain 	sufficient 	factual
matter 	to 	state 	a 	claim 	for 	relief 	that 	is 	actionable 	as 	a
matter 	of 	law and 	"plausible 	on 	its 	face." 	Ashcroft 	v. 	Iqbal,
556 	U.S. 	662, 	678 	(2009) 	(quoting 	Bell 	Atl. 	Corp. 	v. 	Twombly,
550 	U.S. 	544, 	570 	(2007)) 	A claim 	is 	facially 	plausible 	if,
after 	accepting 	as 	true 	all 	non-conclusory 	factual 	allegations,
the 	court 	can 	draw 	the 	reasonable 	inference 	that 	the 	defendant
is 	liable 	for 	the 	misconduct 	alleged . 	Ocasio-Hernandez 	v.
Fortuno-Burset, 	640 	F.3d 	1, 	12 	(1st 	Cir. 	2011) . 2
III. 	Statute 	of 	Limitations
Under 	the 	FTCA, 	a 	tort 	claim 	against 	the 	United 	States 	is
"forever 	barred" 	unless 	it 	is 	presented 	in 	writing 	to 	the
relevant 	administrative 	agency 	within 	two 	years 	after 	the 	claim
accrues. 	Gonzalez 	v. 	United 	States, 	284 	F.3d 	281, 	288 	(1st 	Cir.
2002).
A. Accrual 	and 	the 	Discovery Rule
i. 	Legal 	Standard
Although a 	tort 	claim generally 	accrues 	at 	the 	time 	of
plaintiff's 	injury, 	under 	the 	so-called 	"discovery 	rule" 	the
2 Although defendant brings its motion under both Fed. 	R. 	Civ . 	P . 	12(b) (1) 	and
12(b) (6), 	motions to dismiss based on the FTCA's statute of limitations
should be brought under Rule 12(b) (6) 	onl y or considered pursuant to Rule 56
(summary judgment). 	Morales-Melecio v. 	United States , 	890 F.3d 361, 	367 	( 1st
Cir . 	2018). 	Accordingly, 	the Court will proceed under Rule 12(b) (6).
4
Case 1:25-cv-10435-NMG Document 23 Filed 03/16/26 Page 4 of 11

limitations 	clock 	does 	not 	begin 	to 	run 	until 	the 	plaintiff
"knows, 	or 	reasonably 	should 	know, 	both 	that 	he 	is 	injured 	and
what 	caused 	the 	injury." 	Sanchez 	v. 	United 	States, 	740 	F . 3d 47,
52 	(1st 	Cir. 	2014).
A plaintiff 	need not 	know 	every 	detail 	about 	his 	injury 	and
its 	cause, 	including whether 	it 	was 	negligently 	inflicted, 	for
the 	limitations 	period 	to 	begin. 	See 	Morales-Melecio, 	890 	F.3d
at 	369. 	Actual 	knowledge 	is 	also 	not 	necessary 	for 	a 	claim 	to
accrue. 	The 	standard 	is 	whether 	a 	reasonable 	plaintiff
objectively 	should have 	known 	or 	discovered both 	the 	injury 	and
the 	government's 	causal 	connection 	to 	it. 	Donahue 	v. 	United
States, 	634 	F.3d 	615, 	623-24 	(1st 	Cir. 	2011). 	Thus, 	the 	accrual
of 	the 	limitations 	period 	will 	be 	delayed only when 	that
information 	is 	incapable 	of 	"detection 	through 	the 	exercise 	of
reasonable 	diligence." 	Sanchez, 	740 	F.3d at 	52.
ii. 	Analysis
In 	the 	instant 	case, 	plaintiff 	alleges 	she 	was 	injured by
"undergoing 	unnecessary, 	and 	thus 	harmful, 	testosterone
injections 	and 	surgeries" 	and 	that 	her 	injury was 	caused by
Fenway 	clinicians 	misleading 	her 	into 	believing 	the
testosterone 	and 	surgeries 	were 	medically 	necessary,
beneficial, 	and 	scientifically proven.
Plaintiff 	contends 	that 	she 	could not 	have 	discovered 	Fenway
Health's 	"misrepresentations, 	omissions, 	negligence, 	and
5
Case 1:25-cv-10435-NMG Document 23 Filed 03/16/26 Page 5 of 11

wantonness" 	until 	she 	received a 	second medical 	opinion on March
16, 	2022. 	The 	Court 	disagrees.
Plaintiff 	began 	the 	process 	of 	de-transitioning 	in 	July,
2021. 	By 	then, 	Coblentz 	was 	aware 	she 	wanted 	to 	live 	as 	a
female 	but 	no 	longer 	had 	certain 	female 	anatomy. 	"Her 	injury
was 	then, 	by 	its 	nature, 	complete 	and 	obvious." 	See 	Sanchez, 	740
F.3d 	at 	52. 	The 	cause 	(the 	preceding 	six years 	of 	gender-
affirming 	care) 	was 	also 	known 	and obvious. 	At 	that 	point, 	a
reasonable 	person would question whether 	it 	had 	been appropriate
for 	doctors 	to 	prescribe 	testosterone 	and perform a 	double
mastectomy, 	hysterectomy and oophorectomy, 	given 	the 	rarity 	of
de-transitioning. 	See 	id. 	at 	52 	("The 	death of 	a 	generally
healthy woman 	in 	childbirth 	is 	sufficiently 	rare
make 	most 	reasonable 	people 	ask 	why 	it 	happened.").
. 	so 	as 	to
Armed 	with 	that 	information 	(with 	respect 	to 	her 	knowledge
of 	a 	claim),
it 	[was] 	incumbent 	upon 	[Coblentz] 	to 	bear 	the 	burden 	of
seeking 	further 	advice 	from 	the 	medical 	and 	legal
communities 	to 	decide 	whether 	[she] 	has 	a 	viable 	cause 	of
action.
Rold6n-Barrios 	v. 	United 	States, 	2025 	WL 	2954921, 	at 	*2 	(1st
Cir. 	Oct. 	20, 	2025). 	Coblentz 	retorts 	that 	her
confusion and uncertainty about 	whether 	transitioning 	was
right 	for 	her 	says 	nothing 	about 	her 	eventual 	discovery
that 	Fenway had 	actively misled her[.]
6
Case 1:25-cv-10435-NMG Document 23 Filed 03/16/26 Page 6 of 11

That 	argument 	overlooks 	the 	fact 	that 	her 	confusion and
uncertainty manifested 	her 	burden 	to 	investigate 	whether 	she 	had
been misled. 	The 	caselaw makes 	clear 	that 	Coblentz 	did 	not 	need
to 	"know 	that 	the 	acts 	legally 	constitute[d] 	medical
malpractice" 	in 	order 	for 	the 	statute 	of 	limitations 	to 	run.
Cascone 	v. 	United 	States, 	370 	F.3d 	95, 	104 	(1st 	Cir. 	2004).
Even 	if 	Coblentz 	needed 	to 	know 	of 	the 	misrepresentation
and 	a 	second 	opinion was 	needed 	to 	discover 	the
misrepresentation, 	she 	should have 	sought 	such 	an 	opinion well
before 	March, 	2022. 	Coblentz 	avers 	that 	she 	was 	"under 	the
influence" 	of 	Fenway Health 	until 	March, 	2022, 	and was 	therefore
"forced 	to 	rely 	upon 	what 	she 	was 	told" 	until 	that 	time,
preventing 	her 	from 	discovering 	her 	injury and 	its 	cause. 	The
Court 	is 	unpersuaded . 	As 	soon as 	Coblentz 	expressed a 	desire 	to
de-transition, 	Fenway Health 	immediately prescribed 	estradiol.
Fenway Health 	allegedly 	continued 	to 	prescribe 	testosterone
until 	December, 	2021, 	but 	in any 	event, 	by 	January, 	2022, 	Fenway
Health was 	no 	longer 	providing 	any male-gender-affirming 	care 	to
Coblentz. 	Thus, 	to 	the 	extent 	Fenway Health 	ever misled 	or
influenced plaintiff, 	such 	conduct 	had 	ceased by 	January, 	2022.
Finally, 	plaintiff 	contends 	that 	the 	objective 	standard on
which 	the 	discovery 	rule 	depends 	is 	actually 	context-specific
and 	thus 	her mental 	illness 	prevents 	accrual 	of 	the 	claim. 	The
caselaw Coblentz 	proffers 	in 	support 	of 	that 	contention 	is
7
Case 1:25-cv-10435-NMG Document 23 Filed 03/16/26 Page 7 of 11

inapposite. 	In 	Patterson v. 	United 	States, 	the 	First 	Circuit
explicitly 	declines 	to 	decide 	whether 	mental 	incapacity 	tolls
the 	accrual 	of 	an 	FTCA claim. 	451 	F.3d 	268, 	272 	(1st 	Cir. 	2006)
("Thus, 	even 	assuming 	arguendo 	that 	mental 	incapacity 	could 	toll
the 	accrual 	of 	an 	FTCA claim 	. 	."). 	Mel~ndez 	Col6n v.
Rosado 	Sanchez 	is 	similarly unhelpful 	for 	plaintiff 	because 	the
quoted passage 	concerns 	actual 	knowledge 	of 	the 	injury, 	which 	is
not 	required 	to 	initiate 	the 	limitations 	period. 	995 	F.3d 	262,
267 	(1st 	Cir . 	2021).
In 	sum, 	the 	statute 	of 	limitations 	began 	to 	toll 	before
March, 	2022, 	and 	thus 	Coblentz's 	filing 	of 	her 	claim with HHS
was 	not 	at 	all 	timely.
B. Equitable 	Tolling
Plaintiff 	argues, 	in 	the 	alternative, 	that 	even 	if 	her
claim 	accrued 	before 	March, 	2022, 	the 	statute 	of 	limitations
should be 	equitably 	tolled until 	that 	time 	because: 	1) 	her
mental 	health 	issues 	were 	exacerbated by 	her 	course 	of 	treatment
at 	Fenway Health 	and 	2) 	Fenway Health 	fraudulently 	concealed her
injury. 	Coblentz 	must 	establish 	that 	she 	has 	pursued 	her 	rights
diligently 	and 	that 	some 	extraordinary 	circumstance 	stood 	in 	the
way 	of 	timely 	filing. 	Duke 	v. 	Cmty. 	Health 	Connections, 	Inc.,
355 	F. 	Supp. 	3d 49, 	56 	(D. 	Mass. 	2019). 	The 	First 	Circuit 	uses
a 	five-factor 	test 	when 	assessing 	a 	party's 	entitlement 	to
equitable 	tolling:
8
Case 1:25-cv-10435-NMG Document 23 Filed 03/16/26 Page 8 of 11

a 	lack 	of 	actual 	notice 	of 	a 	time 	limit, 	a 	lack 	of
constructive 	notice 	of 	a 	time 	limit, 	diligence 	in 	the
pursuit 	of 	one's 	rights, 	an 	absence 	of 	prejudice 	to 	the
opponent 	party 	and 	the 	claimant's 	reasonableness 	in
remaining 	ignorant 	of 	the 	time 	limit.
Id. 	at 	57. 	In 	the 	instant 	case, 	the 	parties 	have 	concentrated
primarily on plaintiff's 	diligence 	and 	reasonableness 	in
remaining 	ignorant 	of 	the 	time 	limit.
i. 	Mental 	Illness
A mental 	illness 	may 	toll 	the 	time 	to 	file 	an
administrative 	claim 	only 	if 	the 	plaintiff 	has 	demonstrated 	that
it 	was 	so 	severe 	that 	the 	plaintiff 	was
unable 	to 	engage 	in 	rational 	thought 	and 	deliberate
decision making 	sufficient 	to 	pursue 	[their] 	claim 	alone 	or
through 	counsel.
Bartlett 	v. 	Dep't 	of 	the 	Treasury, 	749 	F.3d 1, 	12 	(1st 	Cir.
2014). 	Evidence 	of 	a 	diagnosis 	is 	not 	sufficient, 	standing
alone, 	to 	make 	such a 	showing. 	Melendez 	v. 	Cutler-Hammer 	de 	P.R.
Co., 	Inc., 	273 	F.3d 	30, 	38 	(1st 	Cir. 	2001).
In 	the 	instant 	case, 	Coblentz 	has 	provided nothing more
than 	her 	diagnoses 	and 	conclusory allegations 	that 	they 	rendered
her 	"unable 	to 	meaningfully 	assess 	her 	condition 	or 	connect 	it
to 	any potential 	wrongdoing." 	Such evidence 	is 	insufficient 	to
meet 	plaintiff's 	heavy burden of 	proving 	entitlement 	to
equitable 	tolling 	and 	is 	inconsistent 	with 	the 	factual 	record.
As 	noted 	earlier, 	Coblentz 	engaged 	in 	rational 	thought 	and
deliberate 	decision making 	in 	July, 	2021, 	when 	she 	chose 	to 	de-
9
Case 1:25-cv-10435-NMG Document 23 Filed 03/16/26 Page 9 of 11

transition. 	Her 	decision 	to 	reverse 	the 	course 	of 	treatment 	she
had pursued 	for 	the 	preceding 	six years 	demonstrates 	that 	she
had 	the 	mental 	acuity 	necessary 	to 	pursue 	her 	claim.
ii. 	Fraudulent 	Concealment
For 	plaintiff 	to 	succeed 	in 	equitably 	tolling 	the 	statute
of 	limitations 	on 	the 	basis 	of 	fraudulent 	concealment , 	she 	must
demonstrate 	that 	the 	defendant
engaged 	in 	fraud 	or 	deliberate 	concealment 	of 	material
facts 	relating 	to 	his 	wrongdoing 	and 	the 	plaintiff 	must
have 	failed 	to 	discover 	these 	facts 	within 	the 	normal
limitations 	period despite 	his 	exercise 	of 	due 	diligence.
Callahan v. 	United 	States , 	426 	F . 3d 444, 	454 	(1st 	Cir . 	2005).
Here, 	Coblentz 	contends 	that 	Fenway Health 	fraudulently
concealed 	information 	"about 	the 	efficacy of 	the 	testosterone
and 	surgeries" 	and 	thus 	she 	could not 	realize 	she 	had been
injured and misled 	until 	she met 	with an 	independent 	provider 	in
March, 	2022 . 	That 	argument 	is 	unavailing. 	There 	is 	no 	evidence
of 	actual 	concealment ; 	p l aintiff 	does 	not 	a ll ege 	that 	Fenwa y
Health providers 	ever withheld 	information when 	asked 	nor 	that
the 	information was 	"inaccessible 	or 	inherently unknowable."
Camerano 	v. 	United 	States, 	196 	F. 	Supp. 	3d 	172 , 	179 	(D. 	Mass.
2016). 	Indeed, 	plaintiff's 	opposition 	cites 	a 	"systematic
review 	[that] 	found 	considerable 	uncertainty 	about 	the 	effects"
of 	hormone 	therapy based on 	research 	studies 	published between
1996 	and 	2023,
10
Case 1:25-cv-10435-NMG Document 23 Filed 03/16/26 Page 10 of 11

confirming 	that 	evidence 	of 	the 	type 	[plaintiff] 	contend[s]
was 	fraudulently 	concealed by 	the 	government 	was 	available
in 	the 	timeframe 	when 	[plaintiff's 	claim] 	would 	have 	been
timely.
W.J. 	v. 	Sec'y of 	Health 	& Hum. 	Servs., 	93 	F.4th 	1228, 	1242 	(Fed.
Cir. 	2024) 	(declining 	to 	toll 	statute 	of 	limitations 	where
plaintiff 	alleged 	the 	government 	fraudulently 	concealed 	evidence
of 	a 	connection between vaccinations 	and autism).
Because 	there 	is 	no 	evidence 	that 	Fenway Health
deliberately 	concealed 	information nor 	that 	such 	information was
undiscoverable 	in 	the 	exercise 	of 	ordinary due 	diligence,
fraudulent 	concealment 	cannot 	serve 	as 	a 	basis 	for 	equitable
tolling 	in 	this 	case.
ORDER
For 	the 	foregoing 	reasons, 	defendant's 	Motion 	to 	Dismiss
(Docket 	No. 	13) 	is 	ALLOWED.
So 	ordered.
Nathaniel 	M. 	Gorton
Senior 	United 	States 	District 	Judge
Dated: 	March /6 , 2026
11
Case 1:25-cv-10435-NMG Document 23 Filed 03/16/26 Page 11 of 11