In late October, Texas Attorney General Ken Paxton sued a second doctor for providing gender-affirming medical care to minors in the state, where Senate Bill 14 prohibits the prescribing of treatments like puberty blockers and hormones. It’s the latest punitive action taken to restrict access to trans health care in Texas, which has become a battleground for LGBTQ rights. As such, many are concerned about the message Paxton’s lawsuits sends to health care providers and trans people in the state and across the country.
Any form of restricting access to gender-affirming care will have a “chilling” effect on health care for transgender and gender-diverse people, said Dr. Alex Keuroghlian, the director of the Division of Public and Community Psychiatry at Massachusetts General Hospital.
“It’s a violation of people’s right to autonomy and is an example of the government interfering in careful discussions and decisions made involving patients, their families, and their clinicians,” Keuroghlian told Salon in a phone interview.
Just before Senate Bill 14 took effect in September 2023, Paxton opened an investigation into a prominent children’s hospital to probe around for “potentially illegal” activity that was happening there. Afterward, the center stopped providing gender-affirming care. In February, Paxton also ordered the LGBTQ nonprofit PFLAG National to hand over any records of Texas youth who were receiving gender-affirming care, although his request was blocked by a judge and the organization also sued to object against his request.
The lawsuits, filed against Dr. Hector Granados and Dr. May Lau, call both doctors “radical gender activists,” and seek to revoke their medical licenses. Neither Granados or Lau responded to a request for comment before this story's publication. Paxton didn't either, though he has been criticized for having an evasive relationship with the press.
“Texas is cracking down on doctors illegally prescribing dangerous ‘gender transition’ drugs to children,” Paxton said in a statement. “Any physician found doing so will be prosecuted to the full extent of the law.”
As a result of punitive policies like Senate Bill 14, doctors providing gender-affirming care are leaving Texas in droves, not unlike the exodus of reproductive health care workers leaving Texas because of abortion bans. One report issued by the Campaign for Southern Equality estimated families in Houston, Texas, would have to drive over 1,000 miles to access care due to various bans passed in Southern states. Some patients have even reported struggling to access routine healthcare from doctors who are afraid that treating trans patients could lead to consequences, said Andrea Segovia, the policy director of Transgender Education Network of Texas.
“Transgender youth who deserve access to care cannot receive it,” Segovia told Salon in a phone interview. “Trans people are left with nowhere to go.”
Research shows gender-affirming care improves the mental health and well-being of youth who are transgender, gender diverse, or nonbinary. This treatment through social transitioning, puberty blockers, or hormone therapy can be lifesaving for children, and more than 30 medical associations have issued policy statements that support its use.
With the second-largest transgender population in the country, Texas often leads the way in passing or reversing anti-trans initiatives. Many states also blocked bills restricting transgender individuals’ right to use bathrooms that match their gender identity around the time advocates in Texas were fighting to kill the bathroom bill in 2017. A similar story played out when Texas lawmakers killed a bill intended to restrict transgender athletes’ participation in sports in 2021. (However, a more recent wave of anti-trans legislation has reenacted bathroom bills and legislation restricting transgender people’s access to sports in several states.)
“When we have something that stops in Texas, it stops in the country,” Segovia said. “When we can’t stop it in Texas, then it kind of spreads like wildfire.”
Restrictions on access to gender-affirming care fall under a larger movement to limit transgender rights, with more than 400 anti-LGBTQ bills launched in state legislatures in 2023. This election, Donald Trump spent $38 million on anti-trans campaign ads and promised to ban transgender women from sports and minors from having gender-affirming surgeries on his first day of office should he win the election.
As of this writing, Texas was one of 26 states to have enacted partial or total bans on youth gender-transition care, according to the Human Rights Campaign. Moreover, half of states do not have any safeguards in place to protect transgender patients’ health data from probes by law enforcement, according to a study published last month in JAMA. This essentially makes it legal for authorities in states with gender-affirming care bans to investigate medical records for things like testosterone use without the need for a warrant.
“We talk a lot in Texas about how we care about … the government not interfering with your everyday life,” Segovia said. “But how much more big government can you be that your government is suing doctors and telling them to not provide care to their patients?”
