DALLAS — Texas Attorney General Ken Paxton is attempting for the second time to intervene in a legal fight over gender-affirming medical care at two Dallas hospitals.
In an appeal filed this month, Paxton said that a lower court judge erred in ruling the state could not intervene in Dr. Ximena Lopez’s lawsuit against Children’s Medical Center of Dallas.
Lopez sued in March to reverse the decision to halt certain treatments for new patients and remove the branding at Genecis, a program for transgender youth that Children’s ran with the University of Texas Southwestern until November. While the program itself remains dismantled, a lower court judge ruled in May that Lopez could treat new patients using puberty blockers and hormone therapy while her case is being litigated.
In his appeal, Paxton said the state has an interest in the case because Lopez is challenging his interpretation of Texas law and has accused the governor of pressuring the hospitals to make changes at Genecis. He added the state acted “through” UT Southwestern, a public university, to discontinue certain treatments for new trans patients at Genecis.
“Lopez intends to obtain a ruling that implicitly challenges the constitutionality of the State’s child abuse laws; consequently, the Attorney General is authorized to intervene to defend the constitutionality of those laws,” Paxton wrote.
Responding this week, Lopez’s lawyers urged the court to throw out the appeal, arguing “this is a private lawsuit between private parties.”
“The State’s involvement is merely a political stunt in an election year, for no apparent purpose other than to allow our disgraced attorney general to show off his allegedly conservative bona fides while he is actually disrupting the ability of some of the most vulnerable members of our society — children — from receiving proper medical care and counseling,” Matthew Kita wrote to the Fifth Court of Appeals in Dallas on Aug. 22.
Spokespeople for the governor and the attorney general did not immediately respond to requests for comment. Children’s and UT Southwestern declined to comment due to the lawsuit.
Playing politics
Paxton lost his first attempt to intervene in June, when Dallas County Judge Melissa Bellan said she was not convinced the state had an interest in the case. Lopez’s lawyers said the attorney general should have stopped there and accused him of playing politics.
“This Attorney General is — and has been for some time — abusing the legal system and exceeding his legal authority so that he can generate Twitter content and play to his base. Worst of all, he does it through the unauthorized use of the name of our great State,” Brent Walker, one of Lopez’s lawyers, told The Dallas Morning News in a statement.
Paxton asserts Lopez has no standing. The doctor cannot show she has been harmed by the changes at Genecis, he wrote in his appeal. He linked the state’s interest to that of UT Southwestern — and to the decisions made at Genecis.
“The State, through UTSW, jointly decided with [Children’s] to discontinue the provision of [puberty blockers/hormone therapy] to new pediatric patients for the treatment of gender dysphoria,” he wrote. “The State is a mandatory party to Lopez’s suit because UTSW is necessarily affected by the outcome.”
While UT Southwestern has acknowledged the political controversy surrounding transgender care for minors, its leaders have said no one forced or directed them to make changes to Genecis.
Lopez has said she was told by hospital leaders that Abbott’s office pressured hospital administrators. Citing this, she has sought to depose UT Southwestern’s president and CEO in order to learn what outside pressure university leaders may have faced to alter the program.
In June, Lopez sought to subpoena communications and other documents from a number of conservative activists, the Texas Republican Party and its chairman. In his appeal, Paxton criticized Lopez for this request and accused her of harassing “political enemies.”
This too, he argued, is grounds for his office to intervene in the suit.
“This Court should permit the State to intervene in Lopez’s suit on public policy grounds so that it may put an end to Lopez’s continued harassment and abuse of those who dare to publicly criticize or disagree with her,” Paxton wrote.
Genecis and transgender care
Last year, Children’s and UT Southwestern removed the Genecis brand and halted certain medical care, like puberty blockers and hormone therapy, for new adolescent patients seeking treatment for gender dysphoria.
They said political controversy and media attention were behind the decision, noting these treatments would continue to be available to current patients.
“UT Southwestern and Children’s Health remain committed to providing care for and a welcoming environment for everyone, regardless of their race, gender, sexual orientation, socioeconomic status, or condition,” the hospitals wrote in an extensive statement released in March. “The safety and privacy of our patients is our top priority.”
The move was applauded by conservative politicians who oppose gender-affirming care for adolescents. It was lambasted by the LGBT and health care communities, including the American and Texas Medical Association, which support age appropriate and individualized medical treatments for transgender youth.
The decision came after Texas GOP politicians took increased interest in transgender youth in recent years. State lawmakers debated bills in 2021 to limit gender-affirming care for minors but failed to pass anything into law.
In February, on the heels of the changes at Genecis, Paxton issued an opinion labeling puberty blockers and hormone therapy used to treat gender dysphoria in minors as child abuse.
Abbott followed the opinion by directing the Department of Family Protective Services to investigate any reports of such treatments. The department has opened 11 cases to date. Four of the families sued to block the investigations and challenge the directive.
In May, the Texas Supreme Court ruled that Abbott had no authority to force DFPS to undertake these investigations. The lawsuits challenging the policy remain active, and Paxton’s office is defending the state in those cases.
All but three of the investigations are closed. No children have been removed from their homes, according to a DFPS spokesperson.
