Texas attorney general sues second doctor under state's gender-affirming care ban

Texas’s Republican Attorney General Ken Paxton filed a lawsuit Wednesday accusing a second doctor of violating a state law banning gender-affirming care for transgender minors. 

The lawsuit, filed in a Texas district court, accuses Hector M. Granados, an El Paso physician, of prescribing and distributing puberty blockers and hormones to patients as young as 12 to treat gender dysphoria, or the severe emotional distress that stems from a mismatch between a person’s gender identity and sex assigned at birth. 

Texas’s Senate Bill 14, signed into law last year by Republican Gov. Greg Abbott, forbids doctors from administering medical interventions to “transition a child’s biological sex” or affirm a child’s belief that their gender identity is inconsistent with their sex. Texas’s Supreme Court upheld the state’s ban in June. 

Paxton in Wednesday's lawsuit accuses Granados of falsifying medical and billing records to mislead Texas pharmacies and insurance providers into administering the treatments, calling Granados a “scofflaw who is harming the health and safety of Texas children.” 

The attorney general’s office did not contact Granados before filing the lawsuit, according to court documents, because it thought Granados likely “would destroy” or alter “relevant records if prior contact were made.” 

Granados did not immediately return a request for comment. 

“Texas is cracking down on doctors illegally prescribing dangerous ‘gender transition’ drugs to children,” Paxton said in a statement. “State law forbids prescribing these interventions to minors because they have irreversible and damaging effects. Any physician found doing so will be prosecuted to the full extent of the law.” 

Paxton’s office earlier this month sued a Dallas doctor for allegedly prescribing doses of estrogen and testosterone to 21 patients under the age of 18 to help them with their transition. Paxton said the doctor, May Chi Lau, “blatantly” violated Texas law by prescribing the medications. 

Doctors convicted under the state’s ban risk losing their medical licenses or other authorization to practice medicine, as well as financial penalties in the hundreds of thousands of dollars. 

Nearly half the country has passed laws restricting transgender minors’ access to gender-affirming health care, according to the Movement Advancement Project, which tracks LGBTQ laws. Bans passed in six states — Alabama, Florida, Idaho, Oklahoma, North Dakota and South Carolina — include felony penalties for doctors who administer certain treatments to trans youths under 18.

Former President Trump has pledged to enact a nationwide ban on gender-affirming care for minors if he is reelected. 

Major medical organizations have said gender-affirming health care for transgender adults and minors is medically necessary and can be lifesaving. Medical intervention is reserved for older adolescents and adults, and guidelines set by the World Professional Association for Transgender Health do not recommend genital surgery for minors. 

The American Medical Association at its annual meeting in 2023 adopted a resolution formally opposing criminal and other legal penalties against seekers and providers of gender-affirming care.