Mariah L. is a 20-year-old man who identifies as a woman who was in foster care in New York City. Mariah’s doctors said that sex reassignment surgery was medically necessary for him. The Administration for Children’s Services (ACS) refused to provide Mariah with the procedure. Mariah obtained a court order requiring ACS to pay for the surgery, which ACS appealed. The National Center for Lesbian Rights filed an amicus brief on behalf of a group of doctors and health clinics in support of Mariah. The appellate court ruled in favor of ACS, holding that the family court does not have the authority to order ACS to provide and pay for any type of medical care.