‘I follow the law:’ El Paso physician responds to Ken Paxton’s lawsuit over alleged transgender care

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Dr. Hector Granados felt puzzled when he first heard of the allegations. The El Paso pediatrician had simply completed his hospital rounds early within the morning final fall when he obtained a name from a good friend. The good friend noticed within the information that Texas was suing Granados.

The workplace of Texas Lawyer Common Ken Paxton filed a petition Oct. 29 claiming Granados had prescribed puberty blockers and hormones to minors for gender transition — well being care the state made unlawful starting Sept. 1, 2023. The courtroom submitting accuses Granados of offering gender-affirming care below the false pretense of treating precocious puberty.

Paxton filed the lawsuit in Kaufman County close to Dallas, about 650 miles east of El Paso, the place one of many 21 sufferers within the courtroom submitting is alleged to reside. Granados is considered one of three docs Paxton sued final yr for allegedly offering gender-affirming care to minors.

Granados denied the allegations.

“I was always respectful of the law and I will continue to be because we follow what it specifically mandates,” Granados stated. “You’re not able to provide transgender care to minors. We stopped.”

The AG’s workplace didn’t reply to El Paso Issues’ requests for remark, however known as Granados a “radical gender activist” within the lawsuit.

Granados advised El Paso Issues he stopped offering gender-affirming care after Texas Senate Invoice 14 handed in Might 2023 as a result of he didn’t need to danger getting his medical license revoked. He started informing dad and mom and discharging his transgender sufferers previous to the legislation going into impact. Since then, he’s continued to see youths for different considerations.

Pediatric endocrinologists deal with all kinds of hormonal situations, together with diabetes, thyroid issues, pituitary gland issues and development deficiencies. A few of Granados’ youngest sufferers in El Paso have been preterm newborns with hypothyroidism, which, if not handled instantly, can delay development and mind growth.

Granados is considered one of solely two pediatric endocrinologists in El Paso County, an space that has struggled to draw and retain medical specialists. The opposite, Dr. Sanjeet Sandhu, was a medical resident below Granados and joined his personal observe about 4 years in the past.

Most of Granados’ sufferers have continual situations that require steady monitoring and appointments, based on a response filed by his legal professional. Youngsters with Kind 1 diabetes sometimes see Granados each three months.

A number of moms who take their kids to Granados for Kind 1 diabetes advised El Paso Issues they’re anxious about how this lawsuit might have an effect on their future care — and whether or not they must journey out of city for a physician ought to he be pressured to cease practising.

Jennifer Oguete stated her 8-year-old daughter, who started seeing Granados for hypothyroidism and now Kind 1 diabetes, already travels out of city for varied specialists, together with a rheumatologist in Phoenix.

“The lack of specialties here in El Paso – there’s not very many doctors that will see a child under the age of 12 here,” Oguete stated.

Granados recounts one other mom who advised him her household misplaced a toddler’s treatment whereas on trip.

“She was telling me, ‘If you’re not able to be here in El Paso anymore, what am I going to do?’” he stated. “‘If three days without medicine was a really difficult time, what’s going to happen if there’s not a doctor that is able to take care of my daughter?’”

Granados assured her, ”I comply with the legislation. I didn’t do something mistaken. There’s no cause for me to go away El Paso.”

Why the Texas legal professional basic is suing this El Paso physician

Texas SB 14 prohibits well being care staff from offering sure transition-related medical remedies to folks youthful than 18. Remedies embody puberty blockers, hormone therapies and surgical procedures, although docs hardly ever carry out surgical procedures on kids.

Transgender folks of all ages could also be serious about gender-affirming care, from voice modification to hormone remedy, to deal with gender dysmorphia, a misery triggered when an individual’s gender id differs from their intercourse assigned at beginning.

The state is accusing Granados of prescribing puberty blockers to seven minors and testosterone to 14 minors for the aim of gender transition, based on the submitting. Paxton’s workplace additional accused Granados of “falsifying medical records, prescriptions, and billing records to intentionally conceal the unlawful conduct.”

Paxton stated within the lawsuit that Granados wrote prescriptions as just lately as Aug. 19, 2024, with sufferers filling these prescriptions as just lately as Oct. 12, 2024.

The 21 alleged sufferers, who’re unnamed within the lawsuit, had been ages 12 to 17 on the time of the prescriptions.

Two of the sufferers who allegedly obtained testosterone for transition are described as biologically male within the lawsuit. SB 14 doesn’t ban the prescription of testosterone doses for males youthful than 18.

“Texas is cracking down on doctors illegally prescribing dangerous ‘gender transition’ drugs to children,” Paxton stated in an Oct. 30 information launch. “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.”

Paxton seeks each non permanent and everlasting injunctions towards Granados, in addition to greater than $1 million together with civil penalties and litigation bills.

A reality sheet from the Pediatric Endocrine Society describes puberty blockers as reversible. The group additionally describes puberty blockers as a drugs that has been used to deal with precocious puberty with “few side effects identified,” although considerations exist about bone growth. The U.S. Meals and Drug Administration authorized the primary puberty blocker treatment in 1993.

Precocious puberty, also called early puberty, happens when a toddler begins sexually maturing at a younger age, earlier than 8 for ladies and earlier than 9 for boys. Together with fast development, ladies could begin experiencing menstruation and breast growth, whereas boys could begin experiencing deepened voices and testicular enlargement.

Puberty blockers are supposed to be non permanent, delaying puberty till a youth is prepared, however usually are not a one-off treatment. Granados stated he sometimes sees sufferers for precocious puberty at a younger age and follows them into their teenage years to ensure they’re creating appropriately.

The state’s lawsuit cites Granados’ medical data in its claims. Mark Bracken, the El Paso legal professional representing Granados, stated the Texas Lawyer Common’s Workplace by no means requested the physician flip over his medical data previous to the lawsuit.

Bracken stated he’s working with the Lawyer Common’s Workplace to attempt to acquire a protecting order from the courtroom that may permit the state to establish the alleged sufferers with provisions to guard their private info from the general public.

Lawyer information movement to maneuver case to El Paso County

In a response filed Nov. 25, Bracken filed a movement to maneuver the case from Kaufman to El Paso, and a movement to dismiss the case.

The entire prescriptions cited within the lawsuit had been crammed in El Paso, based on the state’s courtroom submitting. Granados resides and works in El Paso, splitting his time between his three clinics, in addition to El Paso Youngsters’s Hospital and the Hospitals of Windfall.

Scheduling out-of-town courtroom appearances could be tough when Granados is on name three weeks each month for neonatal, emergency and pediatric intensive care, Bracken stated. Granados must make a number of two-day journeys to Kaufman to seem in courtroom, taking time away from the sufferers who depend upon him, he stated.

On a current late afternoon in his Downtown workplace, Granados pulled out his cellphone to scan his variety of sufferers. The physician started making his hospital rounds at 6:30 a.m. that day. He sees anyplace from 22 to twenty-eight sufferers a day and the observe receives an estimated common of 200 referrals for brand spanking new sufferers each month.

Granados typically opens the clinic on Saturdays to get via the backlog of recent referrals, he stated.

Weight problems is changing into extra prevalent amongst kids in El Paso, which might result in metabolic points, he stated. After the beginning of the pandemic he started seeing extra new sufferers with Kind 2 diabetes, in addition to Kind 1, which is an autoimmune situation.

Granados started working and educating at Texas Tech College Well being Sciences Middle El Paso in 2014, the place he opened El Paso’s first transgender well being clinic, earlier than leaving in 2017 to enter personal observe.

After him and Sandhu, the subsequent closest pediatric endocrinologist is in Ciudad Juárez, a four-drive to Albuquerque, New Mexico, or farther to Tucson, Arizona. Through the years, Granados has seen kids and adolescents from Las Cruces, New Mexico, to Fort Hancock in West Texas, in addition to households from Juárez in search of a second opinion.

Any of Granados’ sufferers, their dad and mom and workers known as to be witnesses must take break day to make the journey to Kaufman and pay for their very own journey bills simply to testify, Bracken stated.

“The law is clear with these types of claims, if it’s filed, it has to be where the health care was provided and all the health care was provided here,” Bracken stated.

This article first appeared on El Paso Issues and is republished right here below a Artistic Commons license.

Disclosure: Texas Tech College, Texas Tech College Well being Sciences Middle, Texas Tech College Well being Sciences Middle El Paso and Hospitals of Windfall have been monetary supporters of The Texas Tribune, a nonprofit, nonpartisan information group that’s funded partially by donations from members, foundations and company sponsors. Monetary supporters play no position within the Tribune’s journalism. Discover a full listing of them right here.