1 F.4th 249
4th Cir.2021Background
- Maryland enacted the Youth Mental Health Protection Act (Md. Code Ann., Health Occ. § 1-212.1) banning "conversion therapy" for minors by licensed or certified mental-health or child-care practitioners; violations are "unprofessional conduct" subject to discipline by the practitioner’s licensing board.
- Christopher Doyle is a Maryland-licensed professional counselor who treats minors and uses talk therapy that may seek to reduce unwanted same-sex attractions; he sued in federal court claiming the statute violates his First Amendment rights.
- Doyle sued the Governor (in office at the time) and the Attorney General in their official capacities and sought injunctive relief; the district court found standing and denied sovereign immunity, then dismissed on the merits and Doyle appealed.
- On appeal the Fourth Circuit limited review to whether Doyle could sue the Governor and Attorney General under Ex parte Young (i.e., whether they have the requisite connection to enforcement of the statute); the court declined to reach the constitutional free-speech question because of defective defendants.
- The Fourth Circuit held the Governor lacks a sufficiently specific enforcement connection: the Act vests disciplinary enforcement in the licensing/certifying board, and the Secretary of Health (and thus the Governor) cannot compel the Board to bring charges.
- The Fourth Circuit held the Attorney General lacks the requisite enforcement connection: the AG’s advisory role and permissive ability to represent the Board at its request do not give control to initiate enforcement; Doyle also waived an underdeveloped argument that the AG may have independent statutory authority to seek prospective injunctions.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether Ex parte Young permits suit against Governor and AG | Doyle: Governor’s general duty to enforce laws and supervisory authority, and AG’s advisory role, create enforcement connection | Gov/AG: Only officers with specific authority to enforce the challenged statute are proper defendants | No — general supervisory/advisory authority insufficient |
| Whether Governor can be sued because he can direct Secretary to force Board enforcement | Doyle: Governor supervises Secretary and can thereby cause enforcement | Gov: Secretary cannot override or compel Board; Governor cannot direct actions beyond Secretary’s limited power | No — Secretary lacks authority to force Board; Governor lacks enforcement control |
| Whether Attorney General’s advisory/representation role creates Ex parte Young connection | Doyle: AG’s duty to advise and occasional representation of Board gives practical control over enforcement | AG: Advising or optionally representing the Board does not let AG initiate or compel enforcement | No — advisory/optonal representation is insufficient |
| Availability of Doyle’s damages and injunctive relief claims against these defendants | Doyle sought injunction and damages | Defendants: damages barred by sovereign immunity; injunctive remedy requires proper defendant | Damages barred; injunctive claim against Gov/AG fails for lack of Ex parte Young connection; district court’s contrary ruling reversed and other rulings vacated |
Key Cases Cited
- Ex parte Young, 209 U.S. 123 (establishes narrow exception to state sovereign immunity allowing suits to enjoin state officers enforcing unconstitutional laws)
- Armstrong v. Exceptional Child Ctr., Inc., 575 U.S. 320 (clarifies Ex parte Young’s requirements)
- Waste Mgmt. Holdings, Inc. v. Gilmore, 252 F.3d 316 (requires a specific enforcement connection beyond general authority)
- McBurney v. Cuccinelli, 616 F.3d 393 (threat-of-enforcement requirement for Ex parte Young can be satisfied without imminence)
- Otto v. City of Boca Raton, 981 F.3d 854 (recent circuit decision addressing conversion-therapy restriction under the First Amendment)
- Planned Parenthood of Idaho, Inc. v. Wasden, 376 F.3d 908 (supervisory authority alone does not suffice for Ex parte Young)
- Children’s Healthcare Is a Legal Duty, Inc. v. Deters, 92 F.3d 1412 (distinguishing general enforcement authority from specific statutory enforcement power)
- Sheppard v. Riverview Nursing Ctr., Inc., 88 F.3d 1332 (statutory use of "may" is permissive and does not create compulsion)