In El Paso, Texas, Dr. Hector Granados finds himself at the center of a legal battle that could jeopardize his career. Accused of providing care to transgender youth, he faces a lawsuit from the state, alleging violation of Texas’ ban on gender-affirming care for minors. The lawsuit, considered unprecedented in the U.S., involves Granados and two other physicians, and threatens severe penalties, including hefty fines and license revocation. Despite the state’s claims, Granados, alongside the other doctors, maintains his innocence and has sought dismissal of the charges.
This lawsuit represents a critical moment in the escalating dispute over gender-affirming care, as Republican states like Texas push to restrict such treatments. While hospitals are beginning to withdraw these services for young patients, Texas has notably taken a step to actively prosecute doctors alleged to have ignored the prohibition. Dr. Granados claimed he stopped treating transgender patients before the state’s 2023 ban came into effect and denied continuing his services unlawfully. He was initially unsure which patients the lawsuit implicated, given the absence of named individuals.
Two additional doctors in Dallas, similarly charged, face provisional restrictions mandating they only practice medicine within research and academia. Granados expressed that informing patients of cessation of care was challenging, as it disrupted therapeutic relationships fostered over time. Yet, compliance was non-negotiable due to legal obligations.
The litigation marked the first instance where a state indicted healthcare providers under new laws banning or limiting gender-affirming care. In contrast to some states where such violations might result in criminal charges, Texas is pursuing civil penalties. More broadly, the pressure is mounting for doctors and hospital administrators nationwide, as the risk of lawsuits and loss of federal funding for transgender healthcare programs increases. For transgender individuals, the chilling climate restricts healthcare options and intensifies anxiety about the future.
Despite the contentious climate, Trump’s administration promptly enacted executive orders curbing transgender rights further. These measures include prohibiting federal education funds for schools supporting socially transitioning students. Proponents argue these limitations shield children from what they regard as a dramatic gender ideology with potential long-term effects.
Spearheading the Texas lawsuits is Republican Attorney General Ken Paxton, actively extending his pursuit of enforcement beyond state confines. Paxton’s office declined to provide comments on the ongoing cases. However, Paxton has declared his determination to enforce the law comprehensively against any physician giving transgender youth what he describes as hazardous medications.
Granados, an integral part of the medical community in El Paso—a region of approximately 700,000 residents in proximity to the Mexican border—opened a gender clinic at a local university health center before establishing his own practice in 2019. He stated that prior to the ban, treating transgender youth was a natural extension of his work, which primarily involves hormone and growth-related concerns in children. He emphasized that transgender youth were only accepted at his practice if diagnosed with gender dysphoria by a mental health professional.
Emiliana Edwards, a former patient, recalled Granados as an exceptional doctor who explained treatments comprehensively. However, following the enactment of the ban, the atmosphere at his practice shifted dramatically. Her mother, Lorena Edwards, recounted how care ended abruptly for Emiliana.
The core of Texas’ legal action against Granados, Dr. May Lau, and Dr. M. Brett Cooper revolves around alleged violations post-ban, specifically prescribing hormone treatments for gender transition. In one instance, the lawsuit cites the administration of testosterone to a minor identified within records as male, despite being assigned female at birth. Granados insists his prescriptions post-ban have been strictly for endocrine disorders, unrelated to gender transition.
For Lau, her legal team asserts full compliance with the law, dismissing the claims as unfounded. Cooper’s legal representatives did not respond to inquiries regarding the case.
Sarah Warbelow from the Human Rights Campaign criticized the legal actions as part of an extremist trend uncommon even among other states enacting similar bans. Research indicates that transgender individuals, both adults, and minors, constitute less than 1% of the U.S. population.
As Granados anticipates his October trial, his co-defendants’ legal proceedings have yet to be scheduled. During these proceedings, both Lau and Cooper are constrained to non-clinical professional roles per court agreement. The state’s medical board is directed to revoke licenses for confirmed violations.
Emiliana Edwards has since sought care in New Mexico, where such treatments remain legal, but the pervasive hostility towards transgender people continues to affect her mental well-being. “We’re normal people, too, and we’re just trying to live,” she expressed, emphasizing the personal toll of ongoing societal opposition.
