The nationwide trend to protect minors from gender transition procedures has entered a new phase. After 27 states enacted protections for minors against gender transition procedures (Legislation Phase), and the Supreme Court decisively ruled they had a right to do so (Litigation Phase), came the much more difficult task of carrying out the laws (Enforcement Phase).
The Enforcement Phase has now gone live, after a Texas doctor accused of providing gender transition procedures to 21 minors in violation of state law surrendered her medical license, Texas Attorney General Ken Paxton (R) announced Friday.
In October 2024, the Texas Attorney General’s office sued Dallas pediatrician Dr. May Lau, who also worked as an associate professor at the University of Texas Southwestern Medical Center, alleging that she illegally provided cross-sex hormones to 21 minor patients “for the direct purpose of ‘transitioning’ the child’s biological sex,” it stated in a press release. “The doctor allegedly used false diagnoses and billing codes to mask these unlawful prescriptions.”
In one case, the complaint alleged that Lau had inserted a puberty blocker device into a 15-year-old and billed the patient’s insurance using a code that indicated the patient had an endocrine disorder, rather than gender dysphoria. The lawsuit sought $1 million in civil penalties and other costs.
The allegations echo the recent testimony of two whistleblowers at Texas Children’s Hospital in Houston, Eithan Haim and Vanessa Sivadge, who said the hospital continued to provide gender transition hormones to minors after the legislature made it illegal to do so and concealed the malpractice by falsifying medical records and insurance codes.
As the case progressed, Paxton entered into a Rule 11 agreement with Lau, according to which she agreed not to practice medicine on patients while the case continued. If Lau lost the case, she stood to lose her medical license.
Faced with these penalties, Lau chose to relocate to Oregon, leaving her job at Southwestern Medical Center. This month, she asked the Texas Medical Board to cancel her license — an uncommon decision for physicians relocating to another state — which the board did. “The surrendering of her medical license permanently bars Lau from experimenting on children in Texas in the future,” said the attorney general’s press release.
“Dr. Lau decided to move her medical practice to Oregon and saw no reason to continue to maintain her Texas license,” rationalized Craig Smyser, her attorney. “Dr. Lau continues to deny the Texas Attorney General’s politically- and ideologically-driven allegations.”
Lau further claims “that the court has no jurisdiction over her, and contends that the court where the AG filed the case — the county where AG Paxton has a residence and where Dr. Lau did not practice medicine — is a legally invalid venue for the case.”
Despite Lau’s relocation to Oregon and surrender of her medical license, Paxton plans to press forward with the case against her. “Doctors who permanently hurt kids by giving them experimental drugs are nothing more than disturbed left-wing activists who have no business being in the medical field,” he declared. “My case against her for breaking the law will continue, and we will not relent in holding anyone who tries to ‘transition’ kids accountable.”
In the past year, the Texas attorney general’s office also filed lawsuits against two other doctors, alleging that they illegally provided gender transition procedures to minors. The case against El Paso endocrinologist Hector Granados was dropped due to evidence that he stopped providing gender transition procedures to minors when the law took effect. The case against Dallas pediatrician Brett Cooper is scheduled to go to trial in May 2026; Cooper entered a separate Rule 11 agreement that prevents him from practicing medicine on patients while the case proceeds.
The variety in these circumstances shows the complexity of enforcing laws protecting minors from gender transition procedures. Out of three lawsuits brought, one doctor had actually stopped providing gender transition procedures to minors, one left the state, and only one stayed to fight it out. It remains to be seen whether Texas can enforce even a monetary judgment against a doctor who relocates to a state like Oregon that shields doctors from transgender malpractice suits. As far as evidence goes, investigators cannot simply screen for treatments tied to gender dysphoria diagnoses, since a central contention is that doctors are falsifying insurance records to escape detection.
Although these factors do complicate the enforcement of laws protecting minors from gender transition procedures, Texas has proven that enforcement is not impossible. “We’re grateful for the Texas Attorney General’s leadership in protecting kids from these harmful treatments and procedures,” said Texas Values policy director Jonathan Covey. “No one is above the law, and it is horrific to hurt little children in order to advance radical gender ideology and play political games.”
Lau’s surrender of her Texas medical license shows that laws protecting minors from gender procedures can have and are having a real effect.
Originally published at The Washington Stand.
Joshua Arnold is a senior writer at The Washington Stand, contributing both news and commentary from a biblical worldview.
