AUSTIN, Texas — On Thursday, Texas Attorney General Ken Paxton initiated legal proceedings against a Dallas doctor, accusing her of administering gender transition therapies to nearly 24 minors, which contravenes a 2023 state law.

The lawsuit asserts that Dr. May Lau, who practices at the University of Texas Southwestern Medical Center, “illegally provided high doses of cross-sex hormones to twenty-one minor patients aimed at ‘transitioning’ their biological sex,” according to a statement from Paxton’s office. This action is the first of its kind against a physician under this law.

The state is pursuing over $1 million in financial compensation and is seeking both temporary and permanent court orders to prevent the doctor from continuing her practices, amid numerous complaints filed by Paxton’s office regarding contentious issues leading to the 2024 presidential election.

Senate Bill 14, upheld by the Texas Supreme Court in June, bans gender modification surgeries for minors and the prescription of “puberty blockers,” which are drugs designed to influence puberty-related development. The state law indicates that physicians who breach SB 14 risk losing their medical licenses, while hospitals can forfeit public funding for infractions.

Although numerous leading medical organizations advocate for youth access to gender-affirming treatments, there has been a growing trend among conservative states to restrict such access in recent years. As of August, 26 states, including Texas, have enacted either partial or complete prohibitions on gender-affirming care, per the LGBTQ advocacy group Human Rights Campaign.

Earlier in the year, a Florida judge overturned the state’s ban on transgender healthcare for minors, declaring it unconstitutional. Additionally, the U.S. Supreme Court announced plans to examine a challenge by the Biden administration against a similar law in Tennessee.

These restrictions are a part of a broader trend of anti-LGBTQ legislation introduced throughout the country. The American Civil Liberties Union reported at least 530 anti-LGBTQ measures proposed during the 2024 legislative period.

Accusations of ‘deceptive trade practices’ against the doctor

In the lawsuit, which does not present any documentation or exhibits, it is claimed that Lau prescribed testosterone to several teenage biological females just before the implementation of the ban on Sept. 1, 2023, and directed them to obtain their prescriptions after that date.

One allegation states that the physician issued a new prescription in October. Additionally, Paxton claims that patients were able to refill their prescriptions multiple times.

While Lau identifies some patients as male, Paxton argues that “according to information available, all these patients are biological females, and Lau is prescribing for the aim of transitioning their biological sex or affirming their belief that their gender identity does not align with their biological sex.”

There are exemptions in the legislation for medical treatment of intersex children and those minors suffering from early-onset puberty or other hormonal disorders, but it’s uncertain if these types of exceptions apply to Lau’s patients.

Paxton’s office also contends that Lau committed a violation by “deceptive trade practices” through falsified diagnoses to conceal gender-transition treatments, although only one instance is cited. In this case, Lau allegedly “falsely” billed a patient for treatment of an endocrine disorder while another medical facility correctly diagnosed the patient with gender dysphoria, according to the lawsuit.

Lau’s employer, UT Southwestern, has not yet responded to an inquiry from the American-Statesman, a part of the YSL News Network.

Lau, who specializes in adolescent medicine, also holds hospital privileges at Children’s Health Medical Center in Dallas and Plano, Texas. The organization has denied any allegations of misconduct.

“The well-being of our patients is our highest priority,” a spokesperson for Children’s Health stated. “Children’s Health complies with all state healthcare regulations.”

Although Paxton is not a prosecutor, SB 14 allows his office to enforce the law by seeking to “restrain or enjoin the person from committing, continuing to commit, or repeating the violation” through civil procedures.

“Healthcare providers who persist in offering these damaging ‘gender transition’ drugs and treatments will face prosecution to the maximum extent of the law,” Paxton stated in a news release on Thursday.

In the announcement, Paxton’s office claimed that “evidence gathered by the Office of the Attorney General” revealed the alleged wrongdoings but provided no further specifics. The attorney general did not answer inquiries from the Statesman regarding the source and nature of the evidence.

‘Healthcare providers should not fear government scrutiny’

Several significant medical organizations, including the American Academy of Pediatrics, the American Medical Association, and the American Psychiatric Association, advocate for providing gender-affirming medical care that is appropriate to individual developmental needs for transgender youth.

Nonetheless, the American Academy of Pediatrics, along with various national health organizations in Europe, has called for further research on the long-term impacts of treatments like hormone therapy, citing insufficient evidence regarding their benefits.

On Thursday, the ACLU criticized Paxton’s recent lawsuit but chose not to discuss the specific details of the case.

Harper Seldin, an attorney for the ACLU’s LGBTQ & HIV project, expressed in an email to the Statesman, “This is the expected and alarming outcome we aimed to prevent with our challenge to SB 14. Healthcare providers should not fear government retaliation when they exercise their professional judgment, and politicians like Ken Paxton should not interfere between families and their doctors.”

This lawsuit is part of an ongoing campaign by Paxton, Governor Greg Abbott, and the Texas GOP to abolish transgender health services for minors in the state. They label these healthcare services as harmful, pointing out that some treatments may lead to irreversible infertility. However, transgender healthcare remains legal for adults in Texas.

Democrats contend that the ban violates parents’ rights and deprives individuals of accepted medical treatment, with some representatives citing letters from transgender children and their parents during Abbott’s signing of the bill in May 2023.