High school student Ashton Whitaker (Ash) identified as a transgender boy. He was diagnosed with Gender Dysphoria, which the American Psychiatric Association recognizes as experiencing a gender opposite from that assigned at birth. School administrators said Ash could use only the girls’ or a gender-neutral office bathroom. Worried that would stigmatize him and undermine his transition, Ash developed stress-related migraines, depression, anxiety, and suicidal thoughts. During his junior year, Ash used the boys’ bathroom for nearly six months without incident until a teacher reported him. The administration told Ash that changing school records to identify him as male and allow him to use the boys’ bathroom would require proof of a surgical transition—a surgery prohibited before age 18. Ash had security guards monitor him and meetings with school officials for using the boys’ room. The school gave him a key to two additional gender-neutral bathrooms far from the classrooms, but other students questioned him about it. Ash’s mother (plaintiff) sued the school board and its superintendent (defendants) on Ash’s behalf, claiming that the school’s unwritten policy violated Title IX and equal protection. Experts testified that using the boys’ bathroom was integral to Ash’s transition and emotional health. His doctor reported that the meetings with school officials caused psychological distress that could permanently injure his well-being. The court granted preliminary injunction allowing Ash to use the boys’ room. The school board appealed.