"A Radical Gender Activist"—Texas Sues Pediatrician, Alleging Violations of Ban On Pediatric Gender-Transition Treatment

Attorney General Ken Paxton has filed suit against UT Southwestern pediatrician Dr. May C. Lau, alleging she violated state law by prescribing at least 21 natal female girls testosterone.

The Texas attorney general has come out swinging against a Dallas pediatrician, alleging in a lawsuit that the physician violated the state’s ban on prescribing pediatric gender-transition drugs to minors.

Attorney General Ken Paxton, who has a long history of aggressive tactics in policing pediatric gender medicine, on Thursday filed suit in the District Court of Collin County, Texas, against UT Southwestern Medical Center pediatrician Dr. May C. Lau.

The suit seeks over $1 million in civil penalties, attorney’s fees, litigation expenses, restitution and costs. It alleges that Dr. Lau prescribed testosterone to at least 21 natal female minors as young as 14 years old after the state’s ban of pediatric gender-transition treatment went into effect in September 2023, or that they filled the prescriptions that she had written after that date.

The suit also alleges that Dr. Lau deceptively prescribed a puberty blocker injection to a minor by entering a billing code of an “endocrine disorder not otherwise specified,” rather than a code for gender dysphoria; records suggest that dysphoria was the actual condition for which the puberty blocker was prescribed.

Dr. Lau is accused of violating both the Texas ban on pediatric gender-transition treatment as well as a statute that prohibits “false, misleading, or deceptive acts of practices in the conduct of any trade or commerce.” Those who violate the former law stand to lose their medical license, although Mr. Paxton has not sought that as a recourse.

The suit does not identify any of the minor patients. But the level of detail it does provide about their cases, including when and where they filled prescriptions, speaks to the aggressive surveillance that Mr. Paxton has wielded or sought to wield in his battle against pediatric medicine. He previously sought—and ultimately failed—to obtain records from Seattle Children’s Hospital of any minors that the Pacific Northwest clinic treated for gender dysphoria who had traveled from Texas to do so. And before the Texas ban on pediatric gender-transition treatment went into effect a year ago, he investigated for child abuse parents who consented to such treatment for their children.

The charges

Mr. Paxton’s suit against Dr. Lau does not mince words. It opens by stating: “The debate in Texas on the legality of dangerous and experimental medical procedures seeking to transition or affirm a child’s belief that their gender identity is inconsistent with their biological sex is over.”

And then it proceeds with an unsparing threat: “Today, enforcement begins against those who have violated the law by providing, prescribing, administering, or dispensing cross-sex hormones to minors for the purposes of transitioning their biological sex or affirming the child’s belief that their gender identity is inconsistent with their biological sex.”

As for Dr. Law, the suit alleges that she “has engaged in deceptive trade practices, including by misleading pharmacies, insurance providers, and/or patients by falsifying medical records, prescriptions, and billing records to represent that her testosterone prescriptions are for something other than transitioning a child’s biological sex or affirming a child’s belief that their gender identity is inconsistent with their biological sex.”

It continues, saying Dr. Lau “is a scofflaw who is putting the health and safety of minors at risk by prescribing testosterone, a controlled substance, to biological female minors 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” the state’s ban on pediatric gender-transition treatment.

Additionally, the state asserts that “by engaging in false, misleading, and deceptive acts and practices to mislead pharmacies, insurance providers, and/or patients by falsifying medical records, prescriptions, and billing records to represent that her testosterone prescriptions are for something other than transitioning a child’s biological sex or affirming a child’s belief that their gender identity is inconsistent with their biological sex.”

The Defendant

Dr. Lau is a pediatrician at the University of Texas Southwestern Medical Center in Dallas. She also has hospital privileges at Children’s Medical Center Dallas and Children’s Medical Center Plano.

Mr. Paxton’s suit brands Dr. Lau as “a radical gender activist,” citing her lengthy academic publishing history about pediatric gender medicine.

The suit cites a presentation Dr. Lau and her assistant, Patti Pagels, gave on transgender care for adolescents and adults on January 8, 2020. (See the video below.)

During the presentation they stated:

• That “adolescents’ gender identity is fluid. So from one day or one point in time, they say, ‘No, I’m this, I’m female.” But then realize later that on that, ‘I’m male.’”

• “We’re not sure about the safety and long-term effects of puberty suppression in youth with gender dysphoria. We do know that this is safe to use in youth with precocious puberty. But we don’t know if we can translate those side effects and the long-term effects to those with gender dysphoria.”

• That testosterone treatment in natal females will cause “some atrophy of the vagina.”

The suit states: “Lau’s practices, publications, and presentations betrays an entrenched commitment to a gender ideology that desires to medically transition the biological sex of children or affirm the belief that a child’s gender identity is inconsistent with their biological sex.”

I reached out to UT Southwestern seeking comment, but have not heard back.

The State’s Ban

The Texas legislature passed a ban on pediatric gender-transition treatment and surgeries on May 17, 2023. Governor Greg Abbott then signed it June 2. The law was set to go into effect the following September 1.

There was a narrow grandfather clause that permitted physicians to prescribe gender-transition treatment to patients already on such medications prior to June 1, 2023, who had had at least 12 mental health counseling sessions over a period of at least six months before starting treatment. But the purpose of the prescription could only be to wean the minor off the medication.

On August 25, 2023, the Travis County District Court issued a temporary injunction that blocked the law’s enforcement. But the state supreme court then allowed the ban to go into effect on September 1 of that year during the appeal. The plaintiffs ultimately lost that appeal on June 28.

The Allegations

The suit against Dr. Lau lays out in exacting detail cases of 21 minor natal girls to whom she allegedly prescribed testosterone for the purpose of treating gender dysphoria and engaging in a medical gender transition. The state asserts that she prescribed these drugs after the ban went into effect on September 1, 2023.

This included cases of Dr. Lau providing multiple refills before the ban went into effect that would last the minor for a period following the ban’s start date. Not only do prescriptions written after that date violate the law, the suit asserts; so do any prescription fills, even if the prescription was written before the ban went into effect.

The minors ranged in age between 14 and 17 years old. They filled prescriptions as late as July 26, 2024.

Details about the first 10 patients

Dr. Lau’s records for some of these minors indicate that their sex is male. But the state asserts that they are all biological females. It notes that Dr. Lau has previously asserted that she, the suit states, “commonly changes the biological sex of her patients in her medical records.”

The suit asserts that Dr. Lau “deceptively misleads pharmacies, insurance providers, and/or the patients by falsifying patient medical records, prescriptions, and billing records to indicate that the use of puberty blockers for minor patients are for something other than transitioning their biological sex or affirming their belief that their gender identity is inconsistent with their biological sex.”

The suit also provides an example of a 22nd patient, a 15 year old minor, whom Dr. Lau first saw in January 2023 and allegedly treated for gender dysphoria while billing insurance under a diagnostic code for an endocrine disorder, unspecified. On August 18, 2023, Dr. Lau saw the child for the purpose of swapping out a puberty blocker implant.

“Gender dysphoria is not an endocrine disorder,” the suit asserts.

What the suit seeks

The suit seeks to prevent Dr. Lau from prescribing any further gender-transition drugs to children, and from: “Deceptively misleading pharmacies, insurance providers, and/or the patients as to the correct medical diagnosis by writing prescriptions and billing for treatments to transition a child’s biological sex under false diagnoses, such as endocrine disorder, unspecified, rather than gender dysphoria (or other similarly related diagnosis).”

The suit seeks penalties of no more than $10,000 per violation of the state law barring “false, misleading, or deceptive acts or practices in the conduct of any trade or commerce.”

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I am an independent journalist, specializing in science and health care coverage. I contribute to The New York Times, The Guardian, NBC News and The New York Sun.  I have also written for the Washington Post, The Atlantic and The Nation.  Follow me on Twitter: @benryanwriter. Visit my website: benryan.net