Texas Attorney General Ken Paxton has filed a lawsuit against Dr. Hector M. Granados, a Dallas-area pediatric endocrinologist, accusing him of providing hormones and puberty blockers to 21 minors in violation of Texas law.
This legal action follows the passage of Senate Bill 14 (SB14) in 2023, which prohibits any form of “sex-change” treatment, including hormone therapy and puberty blockers, for individuals under 18. The lawsuit alleges that Granados falsified records and used incorrect billing codes to evade legal restrictions.
In a statement about the lawsuit, Paxton pointed to Texas’s strict regulations regarding medical treatments for minors, especially those involving hormonal or other interventions aimed at transitioning gender. He also highlighted the potential consequences for doctors who defy these rules. “Texas passed a law to protect children from these dangerous unscientific medical interventions that have irreversible and damaging effects,” Paxton said. “Doctors who continue to provide these harmful ‘gender transition’ drugs and treatments will be prosecuted to the full extent of the law.”
Dr. Granados is accused of using deceptive practices to continue prescribing cross-sex hormones to minors, despite SB14’s ban. According to the Attorney General’s Office, he allegedly manipulated medical records, billing, and diagnostic codes to disguise these prescriptions. This would mark him as the second doctor Paxton has targeted within weeks for allegedly providing such treatments to minors.
Two weeks earlier, Paxton filed a similar lawsuit against Dr. May Chi Lau, an adolescent medicine specialist based in Dallas, who also allegedly provided gender-affirming care to minors. Both lawsuits are unique on a national level, as Texas is the first state where an attorney general has taken individual doctors to court over providing gender-transition-related care to minors.
Other states have enacted similar laws, but legal enforcement remains less direct. Currently, 26 states have enacted various restrictions on transition-related care for minors, according to the Movement Advancement Project, an LGBTQ think tank.
If found in violation of SB14, Dr. Granados could face severe penalties, including the loss of his medical license and substantial financial fines. Texas law mandates that any physician found violating this ban should have their medical license revoked, with the Texas Medical Board responsible for enforcing these penalties.
The Texas Attorney General’s Office claims to have gathered evidence showing that Dr. Granados prescribed high doses of cross-sex hormones specifically intended for minors’ gender transition. By using misleading diagnostic codes and medical records, Dr. Granados is alleged to have concealed these prescriptions from regulatory authorities.
The lawsuits represent a new chapter in the national debate surrounding gender-affirming care for minors. States with laws similar to Texas’s SB14 cite concerns over the potential for permanent changes resulting from hormonal interventions in adolescents. Proponents of these laws argue that minors are too young to make decisions with lasting effects on their bodies. However, advocates for LGBTQ rights and many medical professionals contend that gender-affirming care is crucial for the well-being of transgender minors, citing mental health and quality-of-life benefits.
Texas lawmakers passed SB14 to ensure that no minor can access transition-related treatments, a decision they argue is based on concerns about the potential for physical and psychological harm. However, medical organizations, including the American Academy of Pediatrics and the American Medical Association, have defended gender-affirming care when administered with a careful, individualized approach.
They argue that such treatments can be life-saving for young people experiencing gender dysphoria, potentially alleviating severe mental health challenges. Yet, for lawmakers in Texas and other states, the risk of harm is viewed as outweighing any potential benefit.
These lawsuits also come amid a wave of similar legislation being debated and enacted across the country. In states such as Arkansas, Tennessee, and Alabama, laws restricting access to gender-affirming care for minors have faced both support and backlash. The nationwide discourse includes a mix of legislative actions, court challenges, and debates over parental rights versus government oversight. In Texas, SB14 passed with strong support among conservative lawmakers, who argue the law aligns with protecting children from irreversible medical interventions.
The lawsuits filed by Paxton’s office are not just legally unprecedented but also set the stage for future legal battles between individual states and medical professionals over the extent of medical care for transgender minors. This action by Texas stands as the first instance where individual doctors have been legally pursued under laws restricting transition-related care. The outcome of these cases may serve as a bellwether, influencing similar legislation and legal actions in other states.
While Paxton’s lawsuits progress, Dr. Granados and Dr. Lau have yet to make public statements regarding the accusations, and Dr. Lau’s employer, the University of Texas Southwestern Medical Center, has also declined to comment. Should they be found in violation, both doctors could lose their medical licenses and face financial penalties amounting to hundreds of thousands of dollars.
The impact of these lawsuits on the broader medical and LGBTQ communities remains to be seen, as Texas forges ahead with a controversial approach to enforcing its restrictions on gender-affirming care for minors. Whether these cases will inspire similar actions in other states or lead to challenges on constitutional or medical ethics grounds will depend on the outcomes in Texas courts.