Texas Attorney General Ken Paxton (R) has filed suit against El Paso doctor Hector Granados for prescribing puberty blockers and cross-sex hormones to children as young as 12 in violation of state law. “Granados unlawfully treated 21 patients with testosterone or puberty blockers for the purposes of transitioning their biological sex or affirming their belief that their gender identity is inconsistent with their biological sex in violation of SB 14,” the lawsuit alleged.

“Puberty blockers and cross-sex hormones, when used for the purpose of transitioning a child’s biological sex or affirming their belief that their gender identity or sex is inconsistent with their biological sex, interfere with a child’s normal physical development and result in long-term harm to the child,” explained the October 29 lawsuit, including “sterilization, loss of bone density, and the development of irreversible secondary opposite sex characteristics. Children, by definition, lack the cognitive maturity to provide informed consent/assent to these harmful and irreversible, life-altering decisions.”

In recognition of these facts, the Texas legislature in June 2023 enacted SB 14, which protects minors from these harmful, life-altering procedures.

Left-wing activists sued the state over its law, as they have done elsewhere, but the Texas Supreme Court allowed the law to take effect on September 1, 2023. On June 28, 2024, the Texas Supreme Court rejected the constitutional challenges brought against the law. Thus, the Texas law has now been in effect for just over 14 months.

When the Supreme Court upheld the constitutionality of Texas’s law, that should have been the end of the story. Even Vice President Kamala Harris, when asked about her 2019 support for taxpayer-funded gender transition procedures for inmates — a distinct but closely related issue — replied, “I will follow the law.”

Yet it seems that medical profiteers in Texas would not sacrifice their golden goose so readily. After Texas Children’s Hospital in Houston publicly discontinued its gender transition program in 2023, it continued to secretly provide gender transition procedures to minors, according to the testimony of two independent whistleblowers. The first whistleblower now faces a politicized federal indictment, while the second was abruptly fired in August.

However, the pro-transgender ideologues running the Biden-Harris administration’s Department of Justice are not the only ones with prosecutorial powers. One provision the Texas legislature enacted in SB 14 empowered the state attorney general to file lawsuits to enforce the law’s prohibitions on gender transition procedures for minors, which is how Paxton was able to bring a suit against Granados. On October 17, Paxton filed a similar lawsuit against Dallas doctor May Lau.

“Texas is cracking down on doctors illegally prescribing dangerous ‘gender transition’ drugs to children,” Paxton announced. “State law forbids prescribing these interventions to minors because they have irreversible and damaging effects. Any physician found doing so will be prosecuted to the full extent of the law.”

The Texas lawsuit against Granados detailed how, after SB 14 took effect, he “falsely diagnosed” seven minors — as young as 12 years old — “with precocious puberty,” then “falsely billed insurance” as if he was treating precocious puberty, “when, in fact, he was treating” the patients “for gender dysphoria and transitioning their biological sex or affirming their belief that their gender identity is inconsistent with their biological sex.”

But precocious puberty is “the early onset” of puberty before the age of eight in girls and nine in boys, the state countered. “Treatment of precious puberty with puberty blockers is normally stopped before ages 11 for biological females and 12 for biological males. … Contrary to the treatment goals of precocious puberty, the goal in transgender treatments is to disrupt the normal functioning of the body to produce an unnatural developmental response.” Insurance companies will pay for precocious puberty treatments, but many will not pay for gender transition treatments.

Therefore, the state concluded, “Granados deceptively misleads pharmacies, insurance providers, and/or the patients by falsifying patient medical records, prescriptions, and billing records to indicate that office visits and prescriptions written to minor patients are for precocious puberty when, in fact, they are for the purpose of transitioning their biological sex.”

The lawsuit likewise detailed how Granados had prescribed the cross-sex hormone testosterone to 14 biological females, ages 14 to 17, “for the purpose of transitioning the minor’s biological sex or affirming their belief that their gender identity is inconsistent with their biological sex.” Again, the state argued, “Granados is engaging in false, misleading, or deceptive practices, by falsely diagnosing and billing patients using endocrine disorder, unspecified, billing codes instead of gender related diagnoses codes to conceal that he is prescribing testosterone to biological female minors for the purposes of transitioning their biological sex.”

In some cases, Granados issued the testosterone prescription after the effective date of the law. In other cases, he issued the prescription before the effective date, but the minor patients filled the prescription after the effective date of the law. “Granados cannot circumvent SB 14 by writing puberty blocker or testosterone prescriptions to his patients prior to the SB 14 taking effect with orders to fill or refill the prescriptions after it takes effect,” the state protested.

The state contended that “each and every prescription for puberty blockers or testosterone” Granados wrote — or ordered patients to fill — after September 1, 2023 violates the law and “serves as an independent ground for revocation of Granados’s medical license.” Additionally, Attorney General Paxton asked the court for an injunction against Granados and “monetary relief in an amount greater than $1,000,000.”

Cases like this underscore the importance of enforcement provisions in state laws addressing gender transition procedures for minors. Although 26 states have passed legislation that aims to protect minors from gender transition procedures, only 10 states — less than half — allow the attorney general to enforce the law through civil litigation, as Paxton did here (four more allow criminal litigation). Empowering the state attorney general to enforce these laws is important because their offices have the investigative power often required to uncover secret violations, such as those committed by falsifying medical codes on insurance claims.

This means that state legislatures in places like Georgia, Indiana, Kentucky, South Dakota, and West Virginia can and should do more to empower their state attorneys general to protect children from gender transition procedures.

Cases like this also underscore the importance of down-ballot races like state attorney general. They may not receive the same publicity or funding as races for president, U.S. Congress, or even governor, but these offices can still play a significant role on important cultural issues.

In the 2024 election, 10 states will elect their attorney general, according to Ballotpedia. These states include the key presidential swing states of North Carolina and Pennsylvania, states with important Senate races such as Montana and West Virginia, as well as Indiana, Missouri, Oregon, Utah, Vermont, and Washington. If you live in one of those 10 states and are entitled to vote in U.S. elections, be sure to cast a ballot by Election Day, November 5, to take part in the important civic process that can help protect America’s children from harmful transgender experimentation.