Executive Summary: Key Legal and Evidentiary Issues

• Judicial review examined whether the Health Professions Review Board reasonably upheld the College’s summary dismissal of a complaint against a physician.

• Allegations involved professional misconduct regarding the prescription of testosterone to a minor and compliance with clinical standards for gender-affirming care.

• The College’s authority to summarily dismiss complaints as vexatious, frivolous, or not raising a “serious matter” under the Health Professions Act was central.

• Adequacy of the College’s investigation and sufficiency of evidence provided by the complainant were key issues.

• The petitioner’s refusal to provide further particulars and reliance on unsupported allegations influenced the outcome.

• The court considered whether the administrative decisions were patently unreasonable or demonstrated bias.

Facts of the case

The petitioner, Karin Litzcke, filed a complaint with the College of Physicians and Surgeons of British Columbia regarding the conduct of a physician, anonymized as Dr. G.H., who provided treatment to a transgender child, A.B., in the context of the A.B. v. C.D. and E.F. proceedings. The complaint was based on Litzcke’s observations of a two-day hearing in February 2019 and her belief that the prescription of testosterone to teenaged patients is presumptively harmful. She alleged that Dr. G.H. acted inappropriately, manipulated A.B., failed to follow professional standards, and was motivated by financial and career interests. The complaint was divided into three parts: Dr. G.H.’s anonymity, the clinical care provided to A.B., and Dr. G.H.’s role in the court proceedings. Litzcke requested that the College investigate Dr. G.H., restrict his medical licence regarding gender-affirming care, refer youth patients with gender dysphoria to another practitioner, and halt all administration of testosterone or puberty blockers by Dr. G.H.

The complaints process and regulatory framework

The College of Physicians and Surgeons of British Columbia is responsible for superintending the practice of medicine in the province under the Health Professions Act, R.S.B.C. 1996, c. 183 (HPA). The HPA establishes a three-stage process for dealing with complaints about registrants. The Registrar may summarily dispose of a complaint at the initial intake stage if it is determined to be trivial, frivolous, vexatious, made in bad faith, outside the College’s jurisdiction, or not a “serious matter” as defined in the HPA. A “serious matter” is one that would ordinarily result in an order suspending or cancelling the respondent’s registration or imposing limits or conditions on the respondent’s practice. If not summarily dismissed, the complaint is referred to the Inquiry Committee for investigation. The Health Professions Review Board (HPRB) is a specialized decision-making body with jurisdiction to review dispositions of the College’s Inquiry Committee, including summary dispositions by the Registrar.

Summary dismissal and review

On January 10, 2023, the College dismissed Litzcke’s complaint pursuant to s. 32(3) of the HPA. The Registrar concluded that certain allegations were vexatious and an abuse of process because they challenged determinations made by the courts in A.B. v. C.D. and E.F. Other allegations were dismissed as frivolous because they were speculative and unsupported by evidence. The Registrar also found that allegations of professional misconduct by prescribing testosterone, not following WPATH standards, or not following the College’s Practice Standards or Code of Ethics did not constitute a “serious matter” as defined in the HPA. The Registrar noted that the trial decision in A.B. v. C.D. and E.F. found compelling evidence to the contrary regarding the harmfulness of testosterone treatment and that the petitioner declined to provide additional information when requested.

Litzcke applied to the HPRB for review of the College’s decision. On November 21, 2023, the HPRB dismissed the application, finding that the College’s investigation was adequate and that the summary dismissal was reasonable. The HPRB noted that the complaint offered no evidentiary basis other than bare assertions and speculation, and that the Registrar was justified in concluding that the complaint was based on speculation and inferences unsupported by any substantial evidence. The HPRB also found that the College’s treatment of the evidence enclosed with the complaint, such as a podcast transcript and a presentation, was reasonable because these materials did not provide particulars of the allegations or indicate the standards to which Dr. G.H. must adhere.

Judicial review and legal analysis

Litzcke sought judicial review of the HPRB’s decision in the Supreme Court of British Columbia. The hearing took place on May 30, 2025, and judgment was delivered on October 17, 2025. The Court’s role was to review the HPRB Decision against the relevant standards of review, focusing on whether the HPRB’s decision was patently unreasonable. The Court found that the College and HPRB had acted within their statutory mandates and properly applied the relevant provisions of the HPA. The Court rejected arguments that the HPRB demonstrated bias or relied on patently unreasonable findings of fact. It also found that the College’s and HPRB’s reliance on the evidentiary record from the related court proceedings was appropriate and that the petitioner’s refusal to provide further evidence undermined her claims.

Outcome and ruling

The Supreme Court dismissed the petition for judicial review, upholding the HPRB’s decision and the College’s summary dismissal of the complaint. The Court concluded that the determinations of the College and HPRB were based on intelligible and transparent justifications and were reasonable. The successful parties were the Health Professions Review Board and the College of Physicians and Surgeons of British Columbia. Neither the College nor the HPRB sought costs, and each party was ordered to bear their own costs. No monetary award was determined.