Texas Attorney General Expands Lawsuits Targeting Doctors Over Gender-Affirming Care for Youth

Texas Attorney General Ken Paxton has expanded civil lawsuits against two physicians, Dr. May Lau and Dr. M. Brett Cooper, accusing them of providing gender-affirming medical care to transgender minors in violation of the state’s 2023 ban on such treatments. The cases are among the highest-profile enforcement actions brought under Texas Senate Bill 14, which prohibits physicians and other health care professionals from prescribing puberty blockers and hormone therapies to minors for gender transition.

According to reporting by The Advocate, Paxton’s office announced on 2025-12-11 that it is expanding the scope of its civil claims against Lau and Cooper, after dropping a related lawsuit against El Paso-based endocrinologist Dr. Hector Granados earlier this year. The expanded suits seek financial penalties and professional sanctions, asserting that the doctors prescribed gender-affirming hormones to adolescents in defiance of SB 14.

Senate Bill 14, which took effect in 2023, directs the Texas Medical Board to revoke the licenses or authorizations to practice of physicians found to have violated the statute’s restrictions on gender-affirming care for minors. Following the law’s passage, Paxton’s office filed one of its first SB 14 enforcement cases against Dr. May Lau, a Dallas adolescent medicine specialist known for treating young people with a range of sexual and reproductive health needs, including gender dysphoria.

In that lawsuit, Paxton alleged that Lau prescribed testosterone to at least 21 patients ages 14 to 17 for the purpose of gender transition, and accused her of falsifying medical and billing records in connection with a puberty-blocking device placed for a 15-year-old patient. The attorney general’s office sought up to $1 million in penalties and costs.

A separate case was filed against Dallas pediatrician M. Brett Cooper, accusing him of unlawfully prescribing hormones for gender transition to minors. In court filings, Cooper’s legal team has argued that the attorney general’s public statements about the case are misleading and risk prejudicing potential jurors, asserting that Paxton’s office issued press releases implying that evidence already proved knowing and illegal prescribing, even before discovery was complete.

While the state is intensifying its pursuit of Lau and Cooper, it has taken a different path with a third physician. In September 2025, Paxton’s office quietly dismissed its lawsuit against Dr. Hector Granados, an El Paso endocrinologist who had also been accused of providing gender-affirming medical care to minors. According to court records summarized by The Texas Tribune, the state acknowledged that Granados had ceased providing such care to minors before SB 14 went into effect, undercutting the basis for continuing the civil action.

The dismissal in Granados’s case contrasts with the intensified approach toward Lau and Cooper, whose cases are moving forward. Cooper’s trial is currently scheduled for May, and both he and Lau have agreed under Rule 11 arrangements not to actively practice on patients while proceedings are ongoing.

Earlier in October 2025, Lau voluntarily surrendered her Texas medical license, telling regulators she is relocating to Oregon and no longer requires authorization to practice in Texas. Public records from the Texas Medical Board show her license was cancelled at her request, even as Paxton characterized the development as “a major victory” for the state’s enforcement of SB 14.

In a statement summarized by The Texas Tribune, Lau has continued to argue that the court where Paxton filed suit—located in a county where he resides but where she did not practice medicine—lacks jurisdiction and is not a legally valid venue for the case. Lau previously served as an associate professor at the University of Texas Southwestern Medical Center in Dallas, where she specialized in adolescent health, including care for transgender youth experiencing gender dysphoria.

Conservative advocacy group Texas Values welcomed Paxton’s original lawsuit against Lau, calling the attorney general’s actions an example of “protecting kids from harmful treatments and procedures” and stating that “no one is above the law.” In contrast, major medical organizations, including the American Academy of Pediatrics and the American Medical Association , have publicly supported access to gender-affirming care for transgender youth when provided under established clinical guidelines, describing such care as evidence-based, medically necessary, and associated with improved mental health outcomes.

LGBTQ+ advocacy organizations, including the Human Rights Campaign , have warned that state-level bans like Texas’s SB 14 can severely limit access to medically recommended treatment for transgender adolescents and may contribute to increased stress, anxiety, and other adverse mental health impacts among transgender young people and their families. These groups emphasize that transgender youth are entitled to safe, affirming, and developmentally appropriate health care, and argue that decisions about care should be made collaboratively by families and qualified medical professionals rather than by state officials.

As the expanded lawsuits against Lau and Cooper proceed, Texas remains a focal point in the national legal and political struggle over gender-affirming care for minors, with outcomes that could have significant implications for transgender youth, their families, and the clinicians who support them.