This lawsuit is one of the first attempts by a state to enforce recent bans on such medical practices, which have been heavily supported by Republican lawmakers.

Announced by Republican Attorney General Ken Paxton, the lawsuit targets Dr. May Lau for allegedly administering hormones to more than 20 minors, in direct violation of a Texas ban that has been in effect since last year. This is the first known instance of Texas enforcing the law, according to Harper Seldin, a staff attorney for the ACLU's LGBTQ & HIV Project. Seldin also noted that no other states have yet tried to enforce similar bans.

"This is the beginning of holding those accountable who have broken the law," Paxton's office declared in the suit, which was filed in Collin County. The Texas ban prohibits individuals under 18 from accessing hormone therapies, puberty blockers, and transition surgeries, although such surgeries on minors are rare.

Seldin criticized the lawsuit, calling it a "predictable and terrifying result" of the enforced law. "Doctors should not have to fear government retribution for using their best medical judgment," he said. Seldin added that politicians like Ken Paxton are improperly positioning themselves between families and their doctors.

Dr. Lau is listed as an associate professor in the pediatrics department at UT Southwestern Medical Center in Dallas and has hospital privileges at two Children's Health hospitals in the area. The lawsuit accuses her of falsifying medical records, prescriptions, and billing documentation to hide the gender-affirming nature of the care provided.

Paxton is seeking a court injunction against Lau and is asking for fines of up to $10,000 for each violation. As of Thursday, neither Dr. Lau nor UT Southwestern had responded to requests for comment. Children's Health stated that it complies with all state healthcare laws.

Currently, at least 26 states have enacted laws restricting or banning gender-affirming medical care for transgender minors, with most facing legal challenges. Federal judges have ruled bans in Arkansas and Florida as unconstitutional, although a federal appeals court has stayed the Florida ruling. Enforcement of Montana’s ban is temporarily blocked by a judge’s order, and New Hampshire’s restrictions are slated to take effect in January.

The lawsuit emerges just weeks before an election, with Republicans leveraging their stance on gender-affirming healthcare as a critical talking point. Notably, Republican Senator Ted Cruz has vigorously criticized his Democratic opponent, U.S. Rep. Colin Allred, for supporting transgender rights. The Texas ban was signed into law by Republican Governor Greg Abbott, the first governor to mandate investigations into families of transgender minors receiving gender-affirming care.