Introduction to the Controversy
In the city of El Paso, located on the Texas border, Dr. Hector Granados treats children with diabetes at his clinics and makes hospital rounds. However, his career is now under threat due to accusations that he provided care to transgender youth. Texas is suing Granados and two other physicians, alleging that they violated the state’s ban on gender-affirming care for minors. The state is calling the doctors “scofflaws” in lawsuits filed last fall, which could result in steep fines and the revocation of their medical licenses.
The cases are a significant test of the intensifying Republican efforts to prevent such treatments, including President Donald Trump’s executive order that would bar federal support for gender-affirming care for youth under 19. Granados denies the accusations, and all three doctors have asked the courts to dismiss the cases.
The Lawsuits and Their Implications
The lawsuits against Granados and the other two doctors are believed to be the first time a state has brought enforcement under laws that ban or restrict gender-affirming care for minors. Although those accused of violating bans face criminal charges in some states, they do not in Texas. The Texas lawsuits were brought by Republican Attorney General Ken Paxton, who has previously launched investigations into gender-affirming treatment beyond the state’s borders.
Granados said he was meticulous in halting transgender care before Texas’ ban took effect in 2023. He denied that he continued prescribing puberty blockers and cross-sex hormones to transitioning patients and said he was initially unclear which patients he is accused of wrongfully treating.
Dr. Hector Granados said he was meticulous in halting transgender care before Texas’ ban took effect in 2023.(Andres Leighton / AP)
A Practice in El Paso
Granados is one of two pediatric endocrinologists in El Paso, a desert city of about 700,000 people. He is from Ciudad Juarez, the neighboring Mexican city, and returned to the area after completing medical school in Mexico and additional training in New York and Connecticut. Granados opened a gender clinic at Texas Tech University Health Sciences Center in El Paso before starting his own practice in 2019.
Before the ban, Granados said treating transgender youth was just an extension of his practice that also treats youth with diabetes, growth problems, and early puberty. He accepted transgender patients only if they had first received a diagnosis of gender dysphoria from a mental health provider.
Bringing Cases to Court
At the heart of Texas’ lawsuits against Granados, Dr. May Lau, and Dr. M. Brett Cooper are allegations of prescribing treatment to transition their patients’ sex after the ban took effect. In one instance, the state accuses Granados of prescribing testosterone to a 16-year-old, alleging that although the doctor’s records identify the patient as male, the teenager’s sex assigned at birth is female.
Granados does not dispute that he has continued prescribing puberty blockers and hormone replacement therapy. However, he said those treatments are not for gender transition but for children with endocrine disorders, which occur when hormone levels are too high or too low.
Emiliana Edwards, 18, former patient of pediatric endocrinologist Dr. Hector Granados speaks during an interview in El Paso.(Andres Leighton / AP)
Going Elsewhere for Care
Granados’ trial has been set for late October, while trial dates have not yet been set for Lau and Cooper. Under Texas’ ban, the state medical board is instructed to revoke the licenses of doctors who are found to have violated the law.
Emiliana Edwards, a former patient of Granados, has switched to receiving treatment in neighboring New Mexico, where gender-affirming care is legal. However, she said attacks on the transgender community have taken a toll on her mental health.
