Physicians at Children’s Health will be able to offer the full suite of gender-affirming care for transgender pediatric patients through next year after a temporary injunction restored all services until a trial scheduled for April 2023.
The care offered to transgender pediatric patients at the former GENECIS clinic has been on a legal and organizational roller coaster over the last several months. Last fall, Children’s Health removed the information about the clinic from the website, and leaders at Children’s and UTSW decided to stop offering puberty blockers and hormone therapy to new patients, even though existing patients were able to receive those services.
The founder of the once-heralded clinic, Dr. Ximena Lopez, has been locked in a legal battle with her employer about the clinic’s care since that time. She first sought to depose the UT Southwestern leaders to learn more about the decision to unbrand the clinic and limit the services. When that legal route was caught up in the appeals process, Lopez filed a new lawsuit against Children’s Health.
That lawsuit argued that the changes made to the clinic violated the rules against the corporate practice of medicine, limiting the influence an organization can have over care provided by a physician following the standard of care. Hormone therapy and puberty blockers are considered best practices for patients with gender dysphoria by medical authorities, partly because of the psychological impact of the disease and the high rate of suicide attempts amongst transgender children.
“When Children’s Medical Center gave Dr. Lopez privileges to provide pediatric endocrinology, she has been authorized to do anything within the realm of pediatric endocrinology that she believes is in the best interest of the patient in within her medical judgment,” says Lopez’s lawyer Brent Walker. “Children’s doesn’t have a medical license. They cannot make medical judgments. They cannot tell a doctor what treatment to provide.”
Earlier this month, Judge Melissa Bellan ordered a temporary restraining order that returned the services offered at the clinic to what they were when it was founded, but the order was set to end on May 26. The new injunction will extend the stability at the clinic and allow the full range of care to continue until April, when a trial on the merits of the care will decide the permanent fate of the care.
At the trial, Lopez’s legal team will seek to make the injunction permanent, which would permanently undo the changes to the clinic that were implemented last fall and not allow Children’s Health or UT Southwestern to limit the care in the future.
“What this means is that Dr. Lopez and her colleagues can treat new and existing patients as they see fit, free from any interference from outside sources, for at least as long as this case works its way through the system,” says Carla Aldous, who is part of Lopez’s legal team (all of whom are doing the case pro bono), in a statement. “And it means the families of these kids can take a breath and not have to worry about care disappearing later this week. It’s the best possible outcome to this ill-conceived and politically driven policy.”
Lopez argues that the clinic changes are discriminatory against certain transgender patients. These limited treatments are offered to new patients for other conditions, such as precocious puberty, but not to new transgender patients with gender dysphoria.
“We know it’s the standard of care and because that’s what Children’s had on their website up until about November of last year,” Walker says. “In fact, they’re continuing to do it for continuing patients. They’re just not letting new patients receive the benefit of this standard of care of medicine. They are violating the law by discriminating against people based on their gender identity.”
UTSW and Children’s Health do not comment on ongoing legal proceedings.
Will is the managing editor for D CEO magazine and the editor of D CEO Healthcare. He’s written about healthcare…