The US state of Texas has filed a lawsuit against a Dallas-based doctor, accusing her of violating the state’s ban on gender-affirming care for transgender youth. This case, among the first of its kind, underscores the severity of draconian restrictions on best practice medical care for transgender youth by state officials.
Currently, 24 US states have imposed bans on medication for transgender youth seeking gender-affirming care, despite opposition from leading medical authorities. Gender-affirming care is a slow, individualized, and iterative process that may involve the use of puberty blockers, menstrual suppressants, and hormone therapy, all tailored to the individual's needs and initiated after the onset of puberty. Organizations such as the American Medical Association, American Academy of Pediatrics, American Psychological Association, and the American Academy of Child and Adolescent Psychiatry uniformly support access to developmentally appropriate care for transgender youth.
The lawsuit alleges that Dr. May Lau provided gender-affirming care to 21 patients ages 14 to 17 in violation of Texas’s ban, which took effect on September 1, 2023. The state contends that Lau sought to circumvent the law by issuing prescriptions to be filled before the ban’s implementation. Texas Attorney General Ken Paxton is seeking $10,000 in penalties per violation, amounting to potential liability of hundreds of thousands of dollars. Additionally, Lau’s medical license is at risk, as the ban mandates the denial, non-renewal, or revocation of licenses for professionals providing gender-affirming care to trans youth.
While this lawsuit is among the first in which a state has taken legal action against a provider for offering gender-affirming care, many clinics and physicians have already preemptively shut down, relocated, or ceased certain services. The now-closed Gender Education and Care, Interdisciplinary Support program at UT Southwestern and Children’s Health, where Lau worked, is one example. Many healthcare facilities “overcomply” with these bans to avoid legal repercussions, hampering access to lifesaving care for transgender youth and their families already facing a hostile political landscape.
This lawsuit is part of Texas’s broader efforts to limit access to gender-affirming care. In February 2022, Governor Greg Abbott ordered state agencies to investigate families supporting their transgender children in accessing such care. Additionally, Paxton has subpoenaed out-of-state medical facilities, such as Seattle Children’s Hospital in Washington State, for records of Texas minors receiving care elsewhere.
Meanwhile, the US Supreme Court is expected to hear a case this term challenging Tennessee’s ban on gender-affirming care, which could set a precedent affecting state-level bans, including the one in Texas.
Data indicate that gender-affirming care can be lifesaving for trans youth and essential for their physical and mental health. Lawmakers should protect trans youth by ensuring access to the medical treatment they need, not criminalizing it.
