On the Texas border, Dr. Hector Granados treats kids with diabetes at his El Paso clinics and makes hospital rounds beneath the shadow of accusations which have thrown his profession into jeopardy: offering care to transgender youth.
In what’s believed to be a U.S. first, Texas is suing Granados and two different physicians over claims that they violated the state’s ban on gender-affirming care for minors, calling the medical doctors “scofflaws” in lawsuits filed final fall that threaten to impose steep fines and revoke their medical licenses. He denies the accusations, and all three medical doctors have requested courts to dismiss the circumstances.
The circumstances are a pivotal check of intensifying Republican efforts to stop such remedies, together with President Donald Trump’s government order that might bar federal assist for gender-affirming take care of youth beneath 19.
Some hospitals have already begun unwinding companies for pediatric sufferers. However, thus far, solely Texas is demonstrating what punishing medical doctors seems to be like when bans are allegedly damaged.
Granados, in an interview with The Related Press, mentioned he was meticulous in halting transgender care earlier than Texas’ ban took impact in 2023. He denied that he continued prescribing puberty blockers and cross-sex hormones to transitioning sufferers and mentioned he was initially unclear which sufferers, who aren’t named within the lawsuit, he’s accused of wrongfully treating.
The opposite accused medical doctors — each in Dallas — are beneath momentary courtroom orders to not see sufferers and solely observe drugs in analysis and tutorial settings.
“Looking at the patients was hard because they were kind of disappointed of what was going on,” Granados mentioned of ending their care. “But it was something that needed to be followed because it’s the law.”
The lawsuits are believed to be the primary time a state has introduced enforcement beneath legal guidelines that ban or limit gender-affirming take care of minors, which Republicans have enacted in 27 states, together with this month in Kansas over the Democratic governor’s veto. Though these accused of violating bans face felony prices in some states, they don’t in Texas.
Nationwide, medical doctors and hospital executives are reevaluating transgender well being packages that carry a widening threat of litigation and shedding federal funding. For transgender Individuals, the local weather has narrowed choices for care and deepened fears.
Trump has launched a broad cost in opposition to transgender rights shortly in his second time period, signing government orders that embrace barring faculties from utilizing federal training {dollars} to assist college students who’re socially transitioning. Supporters say restrictions defend weak kids from what they see as a “radical” ideology about gender and making irreversible medical choices.
The Texas lawsuits have been introduced by Republican Lawyer Normal Ken Paxton, who has beforehand gone past the state’s borders to launch investigations into gender-affirming remedy.
His workplace didn’t reply to requests for an interview. At a courtroom listening to Wednesday involving the Dallas medical doctors, an legal professional in Paxton’s workplace declined to remark and referred inquiries to the company’s press workplace.
“I will enforce the law to the fullest extent to prevent any doctor from providing these dangerous drugs to kids,” Paxton mentioned in an announcement this month.
A observe in El Paso
Granados is considered one of two pediatric endocrinologists in El Paso, a desert metropolis of about 700,000 the place mountains rise within the distance.
Granados, 48, is from Ciudad Juarez, the neighboring Mexican metropolis that sprawls out south of El Paso. He mentioned that after attending medical faculty in Mexico he accomplished further coaching in New York and Connecticut however he needed to return to what he mentioned is an underserved area.
He opened a gender clinic at Texas Tech College Well being Sciences Middle in El Paso earlier than beginning his personal observe in 2019. Earlier than the ban, Granados mentioned, treating transgender youth was simply an extension of his observe that additionally treats youth with diabetes, development issues and early puberty.
He mentioned he accepted transgender sufferers provided that that they had first acquired a prognosis of gender dysphoria from a psychological well being supplier.
“It was not different from doing everything else that a pediatric endocrinologist does,” he mentioned. “It was just taking care of children who required that specific therapy.”
AP Picture/Andres Leighton
AP Picture/Andres Leighton
Emiliana Edwards, 18, former affected person of pediatric endocrinologist Dr. Hector Granados speaks throughout an interview in El Paso, Texas, Tuesday, Jan. 21, 2025.
Emiliana Edwards was amongst them. Now 18, she referred to as Granados an “amazing” caregiver who fastidiously defined her gender-affirming remedy. However at her first appointment after Republican Texas Gov. Greg Abbott signed the ban in 2023, Edwards mentioned the room felt totally different, “like there were wires everywhere.”
“It felt like we couldn’t talk about anything really, even the most simple stuff,” she mentioned.
Her mom, Lorena Edwards, mentioned Granados put a “cold stop” to her daughter’s care.
“It was just: ‘I don’t provide that care anymore.’ And it was done,” she mentioned.
Bringing circumstances to courtroom
On the coronary heart of Texas’ lawsuits in opposition to Granados, Dr. Could Lau and Dr. M. Brett Cooper are allegations of prescribing remedy to transition their sufferers’ intercourse after the ban took impact.
In a single occasion, the state accuses Granados of prescribing testosterone to a 16-year-old, alleging that though the physician’s information establish the affected person as male, {the teenager}’s intercourse assigned at start is feminine. Granados and Lau are additionally accused of getting instructed sufferers to attend till after the ban was in place to fill prescriptions.
Granados doesn’t dispute that he has continued prescribing puberty blockers and hormone substitute remedy. He mentioned these remedies aren’t for gender transition however for youngsters with endocrine problems, which happen when hormone ranges are too excessive or too low.
He mentioned he prescribes testosterone for a lot of causes, together with for sufferers whose testicles don’t work or needed to be eliminated due to most cancers. Others have mind tumors, or surgical procedure or radiation to the mind, that affect puberty. Sufferers with early onset puberty additionally want puberty blockers, he mentioned.
Attorneys for Lau mentioned she has at all times complied with the regulation and the claims haven’t any advantage. Attorneys for Cooper didn’t reply to requests for remark.
“This is really part of a bigger pattern of extremism within the state that even other states have shied away from replicating,” mentioned Sarah Warbelow, vice chairman of authorized for the Human Rights Marketing campaign.
Transgender adults and youth make up lower than 1% of the U.S. inhabitants, in keeping with estimates by the Williams Institute, an LGBTQ+ analysis heart on the UCLA Faculty of Regulation.
Going elsewhere for care
Granados’ trial has been set for late October; trial dates haven’t but been set but for Lau and Cooper. Whereas the circumstances are pending, Lau and Cooper agreed to observe drugs solely in analysis and tutorial settings and never see sufferers.
Neither Lau or Cooper attended the Wednesday listening to of their circumstances by a choose who is about to resolve the place their trials might be held.
Beneath Texas’ ban, the state medical board is instructed to revoke the licenses of medical doctors who’re discovered to have violated the regulation.
Lorena Edwards mentioned she watched her daughter thrive throughout her transition then descend into melancholy as legal guidelines focusing on transgender rights gained steam.
Emiliana Edwards has switched to receiving remedy in neighboring New Mexico — the place gender-affirming care is authorized — however she mentioned assaults on the transgender group have taken a toll on her psychological well being.
“We’re normal people, too, and we’re just trying to live,” she mentioned.
