Texas Attorney General Ken Paxton has opened a fresh legal front, suing Children’s Health System of Texas and a Dallas-area pediatric specialist, accusing them of running illegal gender-related care for minors and defrauding state Medicaid programs in the process. The lawsuit singles out Dr. Jason Jarin and claims the disputed care included puberty blockers and cross-sex hormones for patients reportedly as young as 9, with the filing seeking injunctive relief, restitution, and more than $1 million in civil penalties.
What the lawsuit alleges
The new case, filed in Collin County, alleges that Jarin and Children’s Health prescribed and billed for puberty blockers and cross-sex hormones even after Texas' 2023 ban on such care for minors took effect, and that they masked those services with inaccurate diagnoses and altered billing codes, according to the Texas Attorney General's Office. The petition says the defendants billed Medicaid and CHIP for services for the purpose of transitioning children and again points to patients as young as 9. Paxton also blasted the care in a public statement, vowing to use "every legal tool" against what he called "radical gender activists like Jarin," according to the Texas Attorney General's Office.
Children’s Health pushes back
Children’s Health has publicly pushed back, saying patient safety drives its decisions and that it complies with applicable law, in a statement the system provided to local media, according to The Dallas Morning News. Hospital officials declined to get into a back-and-forth over the specifics of the petition, reiterating instead that the "health and well-being of the patients and families we serve" remains the system’s priority.
The law at the center
At the heart of the case is Senate Bill 14, the 2023 Texas law that bars a wide range of medical gender-transition interventions for people under 18 and gives regulators new tools to discipline providers, according to the text of the statute from the Texas Legislature. Paxton’s team is pairing alleged SB 14 violations with claims under the Texas Health Care Program Fraud Prevention Act, using the combination to seek both injunctive relief and financial penalties tied to Medicaid billing. If a court sides with the state, physicians could face professional discipline and significant fines under those laws.
Part of a larger enforcement push
The lawsuit is the latest in a series of moves by Paxton to crack down on gender-affirming care for minors. His office has sued several Texas doctors over similar issues in the past two years and has started layering in fraud claims on top of alleged treatment violations, legal coverage has noted. Not every case has stuck: a high-profile lawsuit against an El Paso pediatric endocrinologist was later withdrawn after the state said it found "no legal violations," according to AP News. Even so, the Collin County filing joins a string of recent, attention-grabbing enforcement actions by the attorney general’s office, Bloomberg Law reports.
Doctors, advocates weigh in
Major medical organizations have repeatedly warned against broad government interference in individualized treatment decisions, arguing that criminalizing or tightly restricting gender-affirming care weakens the patient-physician relationship and can put vulnerable youth at risk, according to the AMA and other groups. Civil-rights advocates and some clinicians say these lawsuits can scare providers away from treating patients who need care and saddle doctors and families with heavy financial and emotional burdens, even in cases that are eventually dropped. Critics pointed to the El Paso lawsuit’s quiet end as an example of how the legal process itself can feel like a punishment, regardless of the final ruling.
What’s next
The state is asking a Collin County judge for injunctive relief, court-ordered restitution and civil penalties, with the petition laying out the evidence Paxton’s office says backs up its fraud and deceptive-practice allegations. The Texas Attorney General's Office also wants ongoing oversight of specific billing practices and is requesting more than $1 million in monetary relief. Expect early fights over venue and over how much patient-record information the state can obtain, and if the case goes the distance, it will serve as a high-profile test of how aggressively Texas can wield SB 14 and related fraud laws against major hospital systems. However it lands, the outcome is likely to influence how children’s hospitals and pediatric specialists across Texas approach gender-related care for youth.
