Attorney General Ken Paxton has filed lawsuits against two UT Southwestern and Children’s Health physicians in the past two months, alleging that the two docs provided illegal “gender transition” treatment to minors.
The first suit was filed against Dr. May Lau, an associate professor in the Department of Pediatrics at UT Southwestern Medical Center who serves as the medical director of the Adolescent and Young Adult clinic at Children’s Medical Center Dallas. The second lawsuit was filed against Dr. Brett Cooper, an assistant professor of pediatrics at UT Southwestern and an adolescent medicine physician at Children’s Medical Center Dallas. The two physicians work in the same clinic.
The suits call the physicians “scofflaws” who violated Senate Bill 14, which took effect in September 2023 and prohibits “gender transition” medical interventions like surgeries, puberty blockers, and cross-sex hormones for minors. The law was upheld by the state’s supreme court in June. The law says that the Texas Medical Board will revoke the medical license for physicians who violate the provisions of SB14.
The First Lawsuit
The suit against Lau says that she misled “pharmacies, insurance providers, and/or patients by falsifying medical records, prescriptions, and billing records” to represent that hormone prescriptions were for something other than transitioning a child’s biological sex or affirming that the child’s gender identity conflicts with their biological sex. The suit says that Lau treated 21 minor patients with “illegal, dangerous, and experimental medical procedures.”
The suit goes on to highlight Lau’s publications in the field and association with the now closed Gender Education and Care Interdisciplinary Support (GENECIS) Clinic, which was unbranded in 2021 by Children’s Health after a protest against gender-affirming care took place outside a Children’s Health’s board member’s house. At the time, the clinic “suspended initiating this treatment for new patients, believing that a failure to act would put the entire program in jeopardy.” The program director, Dr. Ximena Lopez, left Children’s after the passage of SB14 and is in a legal battle with her former employer.
The suit details Lau’s 21 pediatric patients who were given and filled prescriptions for drugs the suit claims were for transitioning from the patients’ biological sex after SB 14 went into effect. It is unclear if these prescriptions were new or refills or if that would matter, given the way the court interprets SB14. The patients ranged from 14 to 17 years old.
The Suit Against Cooper
The filing against Cooper is similar. It claims that he wrote prescriptions as late as September 2024 that were filled in October. Cooper, who ran for Plano City Council in 2023, has been open about his opposition to SB14 and Ken Paxton’s enforcement of it. The lawsuit highlights social media comments expressing as much.
Cooper sent an affidavit in the unsuccessful 2023 lawsuit filed by families and medical providers against the State of Texas to block SB14. He wrote, “SB 14 thus not only endangers the health and wellbeing of my patients but also places me in the unsustainable position of having to choose between providing my patients with the medical care that they need and deserve and having to comply with a discriminatory law like SB 14. I have an ethical duty to provide my patients with the best medical care for their conditions if it is medically indicated for them. I consider the provision of gender-affirming medical care to treat a transgender adolescent’s gender dysphoria to be the best medical care for my patients when medically indicated.”
“Cooper’s practices, publications, and social media presence reveal an entrenched commitment to a gender ideology advocacy that desires to medically transition the biological sex of children or affirm the belief that a child’s gender identity is inconsistent with their biological sex,” the suit says.
The filing details fifteen of Cooper’s minor patients who were prescribed and filled what the suit claims were drugs to transition biological sex or affirm the patient’s belief that their gender conflicts with their biological sex after the law went into effect. The patients ranged from ages 14-17, according to the lawsuit.
The Best Practice Debate
The American Academy of Pediatrics has continually reaffirmed gender-affirming care similar to what the GENECIS clinic provided. This care includes affirming that diverse gender expressions do not constitute mental illness but are a normal part of human diversity. It emphasizes the “integration of medical, mental health, and social services, including specific resources and supports for parents and families” and discourages preventing children from expressing gender-diverse expressions.
In addition to affirming social aspects of the patient’s gender identity, gender-affirming care may include hormones used to suppress or delay puberty in patients. The AAP says normal puberty will resume if the treatment is suspended. Treatment may also include cross-sex hormones, which the AAP says is partially reversible. The development of an Adam’s Apple, breasts, baldness, or voice changes are irreversible once they have developed. There may also be permanent impacts on fertility. The AAP says that gender-affirming surgery is reserved for adults and some adolescents on a case-by-case basis, but Children’s Health and UTSW did not offer surgery to minors.
The lawsuit highlights information from the Mayo Clinic and the Food and Drug Administration, noting that testosterone is not to be prescribed to female patients. It calls the practices unscientific, unproven, and with the potential to do permanent damage. A conservative advocacy group called the American College of Pediatricians, which has less than 1,000 members (compared to 67,000 for the American Academy of Pediatricians), has joined the chorus of voices protesting gender-affirming care for minors.
In an effort to stop promoting gender-affirming care, the group released a statement this year. “We have serious concerns about the physical and mental health effects of the current protocols promoted for the care of children and adolescents in the United States who express discomfort with their biological sex,” it said. “Medical decisions “should not be based upon an individual’s thoughts and feelings,” or “gender identity.” The ACP has supported abstinence-only education and conversion therapy in the past and has advocated against vaccine mandates, abortion rights, and LGBT rights.
Children’s Health, for its part, says the organization is following the law. The bill doesn’t specify whether refill prescriptions would be banned, but the lawsuit makes it clear that the state believes any prescription filled or written after Sept. 1, 2023, violates the law. Children’s Health responded to inquiries by saying, “Our top priority is the health and wellbeing of our patients. Children’s Health follows and adheres to all state health care laws.” UTSW had not responded with a comment as of publication.
What’s Next?
Both pending cases were filed in Collin County and have been assigned to Judge Christine Nowak, who was appointed by Greg Abbott in 2023 and won reelection this fall without an opponent. She is a federal judge from the Eastern District of Texas. According to Collin County, both Lau and Cooper don’t have representation and are listed pro se. The AG also filed a case against a third El Paso physician, who the suit says provided interventions to children as young as 12.
Each case file lists several unsuccessful affidavits of due diligence, which are sworn statements explaining that attempts to serve someone in a legal case were unsuccessful and the defendant could not be found.
It will be interesting to see how the state prosecutes a physician providing care for an entity of the state, such as UT Southwestern, in a state-run medical center. While some UTSW physicians have complex employment agreements and are technically paid by private physician groups rather than directly from the state, both physicians are essentially being sued for providing care representing a state entity that is also the standard of care for the industry.
Attorney General Ken Paxton expressed confidence that the prosecution would be successful. “Texas passed a law to protect children from these dangerous unscientific medical interventions that have irreversible and damaging effects,” he said via statement. “Doctors who continue to provide these harmful ‘gender transition’ drugs and treatments will be prosecuted to the full extent of the law.”
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