JudicialLocal NewsState Appellate Court Upholds Order Allowing Puberty Blockers for New Patients at Dallas Children’s Hospital

The lower court had blocked the hospital's prohibition on puberty blockers and other hormonal transition treatments for new child patients.
May 20, 2022
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After the state agency for investigating child abuse said it considered genital transition surgeries for minors to be abusive, a Dallas clinic specializing in child gender transition quietly stopped prescribing hormonal drugs to new patients. Afterward, one of the clinic’s doctors sued over the hospital’s new prohibition.

This week, an appellate court ruled in her favor that the clinic cannot stop doctors from medically transitioning children.

The case began when endocrinologist Ximena Lopez — who helped create the Gender Education and Care, Interdisciplinary Support (GENECIS) clinic at the Children’s Medical Center in Dallas — sued over the hospital’s prohibition against beginning hormonal transition for new patients. These procedures include the administration of puberty blockers and opposite sex hormones but not surgical changes to the child’s body.

Lopez said the new dictate lacked due process. The trial court judge, Dallas County Court at Law Judge Melissa Bellan, issued a temporary restraining order that stopped the hospital from “enforcing any policy or limitation that restricts or prohibits gender-affirming endocrinology care, including specifically pubertal suppression or hormone therapy, to new or established patients.”

The hospital asked the Texas Fifth Court of Appeals to reverse the trial court order and restore the prohibition on puberty blockers and hormonal transition.

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Specifically, the hospital argued that Bellan’s temporary restraining order did not show how the hospital’s prohibition harmed Lopez. Under the Texas Rules of Civil Procedure, demonstration of harm is required to issue a temporary restraining order.

“As shown below, the trial court’s temporary restraining order is void because it fails to specifically detail what harm, if any, Dr. Lopez will suffer if the order is not issued and why any such harm is imminent and irreparable as Rule 683 requires,” the hospital wrote in its petition to the Fifth Court of Appeals on May 13.

The appellate court upheld Bellan’s order on May 18, effectively siding with Lopez.

“We conclude the findings contained in the order are sufficiently specific regarding harm, and as a result [the hospital] has failed to show the trial court abused its discretion,” the court stated in a two-page opinion.

Justice David Schenck dissented, explaining that Bellan’s order does not show evidence of irreparable harm to Lopez from the hospital’s prohibition.

“Under Texas law, one of the requirements for obtaining a temporary restraining order is that the applicant prove that he or she faces ‘imminent’ and ‘irreparable’ harm if the requested injunctive relief is not granted. Consequently, under Rule 683, the trial court’s order not only must specifically identify what the alleged harm is but the reasons why that alleged harm is ‘irreparable,’” he wrote.

“Paragraph 4(c) of the trial court’s order declares that ‘[t]here is an imminent and irreparable harm to [Doctor] if a temporary restraining order is not issued as requested[,]’ but does not attempt to describe how.”

Additionally, Schenck noted that Texas law considers medical practice a privilege, not a natural right.

“As a general matter, hospitals exist to determine what services will be available at their facilities. If every decision that ‘affected a physician’s practice’ or ‘eliminate[d] a program’ were deemed a revocation of privileges requiring due process hearings, hospitals would no longer control their own policies and facilities,” he added.

Currently, the Texas Department of Family and Protective Services considers both hormonal and surgical transition procedures to be abusive when performed on children, but at the time that GENECIS stopped new hormonal treatments, only surgical procedures were considered abusive.

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Isaiah Mitchell

Isaiah Mitchell is a reporter for The Texan, a Texas native, and a huge Allman Brothers fan. He graduated cum laude from Trinity University in 2020 with a degree in English. Isaiah loves playing music and football with his family.