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- Dr. Orenstein must follow up and keep updated with Amala's case and the outcome of it. If necessary Dr. Orenstein must appropriately intervene with services and modifications.

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- It is important that Dr. Orenstein evaluate and measure the best possible routes to solutions and dealing with Amala's case from most helpful to least helpful for all considered parties. It might also help to consult outside sources such as colleagues.

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- Dr. Orenstein should make a thorough effort to evaluate and understand completely all outcomes of the situation, whom will be affected both positively and negatively , and how will all involved be affected both positively and negatively.

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- The major legal issue concerns the ACA (Affordable Care Act) which requires Dr. Orenstein to include an explanation of benefits since Amala is under her parents insurance.
- Another major legal issue is the protection of Amala's confidentiality, which can be dealt with by Dr. Orenstein appropriately limiting nay information included in the records; more precisely the explanation of benefits.

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Principle A&B - Safe guarding the welfare and rights of Amala, also while the parents have the right to be informed of the treatment they are paying for.
Principle C - Dr. Orenstein has an ethical responsibility to be honest with Amala concerning the complications and limitations of her particular case.

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- Dr. Orenstein must thoroughly evaluate and keep track of all of the details of Amala's case to ensure no conflicts of interest and all possible issues are considered and looked into carefully. The details known are as follows ...
Amala
- 24 yr. old born male being treated for Gender Dysphoria as she has always felt she was a female.
- Has health coverage under her parents.
- Fears parents will find out what her treatments are for and may remove her from their coverage upon finding out about Amala's gender identity.