Full Transgender Care Returns to Children’s Health, For Now

Dr. Ximena Lopez has received recognition from a body of her peers and a brief reprieve in the courtroom just as the state again gears up to investigate families with children who have received gender-affirming care.

In the same week that she received the Pediatric Endocrinology Society’s first-ever Clinician Award, a Dallas County court ruled that the entire suite of gender-affirming care can continue for the next two weeks at Children’s Health, which housed her GENECIS clinic in partnership with UT Southwestern Medical Center.

A Dallas County judge on Thursday issued a temporary restraining order that temporarily reverses the administration’s decision to stop providing care to new transgender pediatric patients. This frees Lopez’s clinic to provide puberty blockers and hormone treatment for 14 days while the court considers the merits of her case.

Lopez’s lawyer framed the strategy as a way to keep offering services to new patients while getting to the bottom of who made the decision to un-brand the clinic and stop accepting newcomers. Lopez had already filed a petition in court against UT Southwestern in an attempt to depose her former bosses; she argued to a judge that deposing top administrators was necessary to determine who to name as a defendant in a lawsuit.

This recent decision is not a victory for Lopez, but does allow for a flicker of normalcy. In unbranding the clinic, UT Southwestern and Children’s stopped providing new patients with hormone therapy and puberty blockers. Existing GENECIS patients were already able to receive hormone therapy and puberty blockers even after the clinic was disbanded, but the specialties were no longer housed under the same program.

“The hospital and UT Southwestern were very proud of this program and they should be,” Lopez said in a statement. “But all of that changed when this became a political issue rather than a medical one. I’ve seen patients across all sectors of society from families conservative, liberal and everything in between. They need this care.”

Children’s Health declined when asked for a statement: “We do not comment about ongoing legal proceedings.”

In a true win for Lopez, she was selected by the PES awards and honors committee to be the first-ever winner of the Clinician Award for having “exemplary clinical acumen, knowledge and expertise,” according to the organization.

Lopez founded the GENECIS Clinic in Children’s Medical Center Dallas in 2014, creating the state’s only dedicated center for pediatric transgender patients. The changes came after a conservative group picketed at the home of a Children’s Health board member. The benefit of GENECIS was having the full suite of services available under one proverbial roof, with experts who could steer patients to the type of care they needed.

A Dallas County judge has already granted her request to depose UTSW CEO Dr. Daniel Podolsky and Hospitals CEO Dr. John Warner, even after the two men filed a letter admitting they were the decision-makers. UTSW appealed the ruling, and a judge put a temporary stay on the depositions. Now it is stuck in legal limbo, and no depositions have taken place.

Lopez said during the hearing that she was told that the changes were being made to the clinic because of pressure from Governor Greg Abbott’s office.

Abbott has had transgender care in his sights for the last few months. He requested the Texas Department of Family and Health Services to investigate families that allow their children to receive specific gender-affirming care, claiming it is child abuse. Those treatments are recognized as the standard of care for gender dysphoria by several professional organizations. An appeals court established a statewide injunction against the child abuse allegations earlier this year, but the Texas Supreme Court stuck down that ruling on Friday, freeing the state to continue investigating parents whose children have received puberty blockers and hormone therapy.

The Children’s Health suit is separate from the 202 petition. In the new suit, Lopez accuses Children’s of violating the corporate practice of medicine law, which prohibits a hospital entity from making medical decisions about physician-advised treatments. Children’s website noted that the treatments were considered the standard of care before the language was removed last fall.

Once a hospital grants Lopez privileges, she argues she has the right to make medical decisions without interference—so long as it aligns with the accepted standard of care. So for two weeks, things at GENECIS can return to what they were before the changes were made last fall. Lopez’s lawyer, Brent Walker, says the “phone is ringing off the hook” with parents trying to get new patients enrolled in the clinic.

Gender-affirming care is under attack across the country. A UCLA School of Law report found that 54,000 transgender kids out of 150,000 are at risk of losing some of the care physicians say they need because of proposed laws by conservative-led state legislatures.

At least 15 states have passed or proposed laws limiting transgender care by banning insurance reimbursement or criminalizing the treatments. In addition to state-led investigations, some are incentivizing private residents to file lawsuits against doctors who provide the care.

Amid all that controversy, the Pediatric Endocrinology Society is recognizing Lopez for her commitment to her practice. A PES member survey found that 95 percent of respondents said the organization should support healthcare for transgender youth that is aligned with current clinical guidelines.

PES also signed an amicus brief last summer in an Arkansas court protesting the ban on some gender-affirming care in the state, which says, in part: “Because the Health Care Ban would prevent health care providers in Arkansas from providing crucial medical care, it is antithetical to the values of amici, all of whom are committed to ensuring that all patients, including transgender adolescents, receive the best possible medical care and the opportunity to thrive both physically and emotionally.”


Full Transgender Care Returns to Children’s Health, For Now

Will is the managing editor for D CEO magazine and the editor of D CEO Healthcare. He’s written about healthcare…