Monday, December 5, 2022 Dec 5, 2022
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GENECIS Founder: Governor’s Office Pressured UTSW to Shut Down Clinic for Transgender Kids

Dr. Ximena Lopez said doctors have had to deny treatment to 98 children since the changes were made. "It's criminal," she says.
By |
Jill Broussard and Elizabeth Lavin

The founder of the now-closed pediatric transgender clinic at UT Southwestern Medical Center testified in court on Monday that Gov. Greg Abbott’s office directly pressured the president of the medical school to stop providing gender-affirming treatment to new patients. 

Dr. Ximena Lopez joined the faculty of UT Southwestern Medical Center and Children’s Health in 2012. Two years later, Lopez founded the GENECIS clinic, the only treatment clinic for pediatric patients with gender dysphoria in the southwestern United States. 

Earlier this month, the Dallas Morning News reported that Lopez was suing UT Southwestern to learn more about why the medical center unbranded her clinic and stopped offering puberty blockers and hormone therapy to new patients. The change of policy from UT Southwestern followed a protest from an anti-transgender group at a board member’s home.

On Monday, Lopez testified that she was called into a meeting last May and told that the governor’s office had contacted UT Southwestern CEO Dr. Daniel Podolsky to request that he shut down the pediatric transgender clinic. 

Under questioning from her lawyer, the Harvard-educated pediatric endocrinologist said that administrators requested that she help transition all patients out of the clinic so they could receive their care elsewhere. Lopez said she was shocked; there had been no negative feedback from the 1,000-plus patients the clinic had treated. She testified that she told her bosses that she felt she would be abandoning the clinic’s current 600 transgender pediatric patients, who already face significant discrimination in non-medical settings. 

“I can’t emphasize how life saving this treatment is,” Lopez said during her testimony.

The American Academy of Pediatrics endorses gender-affirming care, which includes hormone therapy and puberty blockers, even as states like Texas continue to make restrictions that conflict with what medical authorities say is the standard of care for patients with gender dysphoria.

Lopez said she refused to participate in shutting down the clinic and argued that it was against the oath she took as a physician to do no harm. In addition, she felt like closing the clinic would put herself in legal jeopardy because she would have to deny best-practice care to patients. Lopez said she told the hospital that it might also be subject to legal attacks for medical abandonment if they terminated the clinic’s operations. 

Lopez said she made multiple requests to meet with Podolsky, but that meeting never happened.

The clinic didn’t immediately shut down. Instead, leadership told Lopez that the process had become more complicated, and that she was able to continue treating her patients with the full range of treatments. She continued to accept new patients after the meeting, she said.

In July 2021, about two months after that first meeting, Lopez again met with a group of administrators that included Dr. John Warner, the CEO of UT Southwestern’s hospitals, and Dr. Andrew Lee, the dean of the medical school. She said she was told that the hospital was again under pressure from the governor’s office and other legislators to stop treating patients with hormone therapy and puberty blockers. She recalled the executives assuring her that no decision had been made about the future of GENECIS. 

She later learned that UT Southwestern would be removing the website, phone numbers, and branding from the clinic. Doctors would continue to treat existing patients, but would do so within their own specialties—not from the centralized, branded center of care. 

“They wanted to make it seem like it didn’t exist,” she testified.

In November 2021, she was told the clinic would no longer be allowed to accept new patients. Lopez worried that she or the hospital could be sued for not delivering the accepted standard of care. She said she reached out to medical societies and experts to see what could be done. Since November, she said the clinic has turned away 98 patients seeking hormone therapy. “It’s criminal. It’s awful,” she testified.

Months later, Lopez retained counsel and filed what’s known as a 202 petition, which is a request for discovery to determine whether a party has a case for a potential lawsuit. 

“There was no space for medical dialogue,” she testified. “This was the only way out I thought we had.”

Attorneys representing the Texas Attorney General, UTSW, Warner, Podolsky, and Children’s Health did not question Lopez during the hearing. (The governor’s office have not yet responded to an interview request, and UTSW referred our request to the statement below.)

Lopez’s lawyers filed the request to depose Podolsky and Warner. They also want to collect correspondence that they believe would detail what led up to stopping hormone therapy for new patients.

Her lawyers argued that they needed more information to determine who to name in a potential lawsuit. Lawyers representing Warner, Podolsky, and the Texas Attorney General’s office (which represented UT Southwestern) argued that the administrators had not acted illegally and, as government employees, had sovereign immunity from being deposed.

The shuttering of GENECIS predated efforts by the state to classify gender-affirming pediatric treatment as child abuse. Gov. Greg Abbott issued an executive directive in February ordering the Texas Department of Family Services to investigate families whose children have undergone this treatment. Similar legislation had previously failed in the Texas statehouse. 

A Texas judge temporarily stayed the directive after a lawsuit was filed against Abbott, but Texas Attorney General Ken Paxton says he plans to continue the investigations. Some DFS investigators told the Texas Tribune that they have resigned or are looking for other work because of the directive.

The Human Rights Coalition published a letter in the News protesting the state directive, which was cosigned by 60 corporations that included Apple, Microsoft, Johnson & Johnson, Meta, Google, and Capital One.

A couple weeks after Lopez filed the 202 petition, UT Southwestern and Children’s Health released a joint statement to “clarify” the decision to dissolve the clinic. The statement says the organizations stopped admitting new patients to avoid shutting down the entire program.

The statement says that political opposition was part of the reasoning behind the change. 

“Children’s Health and UT Southwestern weighed the momentum of opposition to hormone therapy for gender dysphoria for minors – and efforts to curtail it – against the unquestioned need for our other gender-affirming care efforts and decided to focus on these important services,” it reads. “Though we discontinued enrollment of new patients into puberty suppression therapy for the indication of gender dysphoria, families and patients seeking hormone therapy for gender dysphoria have access to outside practitioners not affiliated with a public institution that is ultimately accountable to the state and which, inevitably, must consider conflicting public viewpoints.”

The statement argues that GENECIS was never a standalone clinic. The once-heralded brand had become “a lightning rod for the controversy over hormone therapy and gender dysphoria,” and removing the branding would help protect current patients. Alabama and Arkansas have already passed bans on gender-affirming care for transgender youth.

Three days after UT Southwestern released the statement, 200 staff, students, and community activists staged a protest on campus against the GENECIS decision.

Lopez argues that UT Southwestern violated its own nondiscrimination policy and blocks her from treating patients to the best of her ability. 

The hospital administers hormone therapy and puberty blockers to existing patients and patients who need that treatment because of early-onset puberty—just not to new transgender patients.

The legal counsel for UT Southwestern argued that government officials are free to use their influence to affect how state institutions are run. Lopez’s lawyers did not demonstrate that anything illegal had been done nor that Lopez herself had been discriminated against.

Attorneys for the state argued that her case has no standing because of this. They contend that because UT Southwestern is a government institution, it is not subject to the corporate practice of medicine laws that prevent an organization from controlling what care a physician provides

Despite the clinic’s negative attention and the pending legal action, the international support she has received for taking this action is a boon to her spirits. Lopez said she was reluctant to take the legal route and feels that the legal action is distracting her from doing what she loves: caring for her patients. 

“I tried my best to restore care,” she testified. “I never wanted to be here.” 

Judge Melissa Bellan said she would issue a ruling by the end of the week, which will determine whether Lopez’s lawyers can depose the UT Southwestern administrators.


Will Maddox

Will Maddox

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

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