A Texas woman who wants to transition her 7-year-old son into a girl has been defeated in a second court hearing.
Dr Anne Georgulas, a pediatrician, believes her son, James, has gender dysphoria and wants to be a girl named Luna.
Last October, a jury awarded Dr Georgulas sole managing guardianship of James, making it possible for her to oversee his medical transition.
But the judge hearing the case, Judge Kim Cooks, ignored the jury verdict and awarded co-conservatorship with the child's father, Jeff Younger.
Younger maintains that his child shows "no signs of wanting to be a girl when given the choice" and strongly objects to any medical transition for James, including the taking of puberty blockers.
The case returned to court in Dallas on Wednesday after Dr Georgulas requested that the original jury verdict be upheld.
Presiding over the hearing on Wednesday, Judge Mary Brown ruled against the request.
Dr Georgulas' attorney has said that this decision will be appealed.