In a significant move in the debate over gender-affirming healthcare, Texas Attorney General Ken Paxton has initiated a lawsuit against Dr. Hector Granados, an El Paso pediatric endocrinologist, accusing him of unlawfully prescribing puberty blockers and hormone therapy to minors.

Paxton’s case argues that Granados’s practices violate Texas Senate Bill 14 (SB14), a 2023 law that bans certain types of gender-affirming medical care for individuals under 18. This lawsuit follows Paxton’s broader legal campaign against medical providers offering gender-affirming care, as he recently sued Dr. May Lau, a physician in Dallas, for similar reasons.

According to Paxton’s lawsuit, Granados allegedly provided hormone treatments and puberty blockers to more than 20 minors aged 12 to 17, even after SB14 took effect. The lawsuit claims that Granados disguised these treatments by recording them as necessary for precocious puberty management instead of gender dysphoria, which Paxton characterizes as an act of fraud.

Paxton’s office has labeled Granados and others providing gender-affirming care as “radical gender activists,” alleging that they seek to “medically transition the biological sex of children or affirm the belief that a child’s gender identity is inconsistent with their biological sex,”​ according to the lawsuit documents.

 Granados, who worked at Texas Tech University Health Sciences Center in El Paso until 2019 and now operates a private practice, has long advocated for trans-inclusive healthcare. He opened a clinic in El Paso specifically to treat transgender youths, emphasizing the regional lack of trained professionals for such care.

“There’s a huge need for the care of trans youths; there’s very little physicians or few who have been trained to do so,” said Granados in a 2015 interview from The Daily Toreador, Texas Tech’s newspaper.

However, the recent lawsuit reflects Texas’s shifting stance on transgender healthcare and growing state intervention in medical practices involving gender dysphoria.

Paxton’s lawsuit seeks not only financial penalties but also aims to revoke Dr. Granados’s medical license. Components of SB14 and similar legislation argue that such treatments are experimental and harmful, particularly for young people, and contend that minors cannot fully understand the long-term consequences of these treatments. However, opponents, including numerous medical associations, argue that gender-affirming care is evidence-based and vital for the mental health and well-being of transgender youths.

As the case progresses, it is likely to add fuel to the intense legal and cultural battle over transgender healthcare. Paxton’s focus on high-profile lawsuits against gender-affirming care providers underscore the polarized views within Texas and across the United States on how—or if—medical care should address gender identity in minors​.

Adam Regalado is the multimedia editor at The Prospector and may be reached at [email protected]