Clinic business

GENECIS Founder: Governor’s Office Pressured UTSW to Shut Down Clinic for Transgender Children

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

Dr. Ximena Lopez joined the faculty at 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 South -western United States.

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

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

When questioned by her lawyer, the Harvard-trained pediatric endocrinologist said she was asked by administrators to help get 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 more than 1,000 patients treated by the clinic. She testified that she told her bosses she thought she would abandon the clinic’s current 600 transgender pediatric patients, who already face significant discrimination in non-medical settings.

“I can’t stress 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 impose restrictions that conflict with what medical authorities say are the standard of care for patients with gender dysphoria.

Lopez said she refused to participate in the closing of the clinic and argued that it violated her oath as a doctor to do no harm. In addition, she felt that closing the clinic would put her at risk from a legal standpoint, as she would have to deny patients best-practice care. Lopez said she told the hospital he could also face legal challenges for medical abandonment if he ended clinic operations.

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

The clinic did not close immediately. Instead, management told Lopez the process had become more complicated and 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 met again with a group of administrators that included Dr. John Warner, CEO of UT Southwestern Hospitals, and Dr. Andrew Lee, Dean of Faculty. of Medicine. She said she was told the hospital was again under pressure from the governor’s office and other lawmakers to stop treating patients with hormone therapy and puberty blockers. She called back the executives, assuring her that no decision had been taken as to the future of GENECIS.

She later learned that UT Southwestern would remove the clinic’s website, phone numbers, and branding. Doctors would continue to treat existing patients, but would do so in their own specialties, not from the centralized, branded care center.

“They wanted to pretend it didn’t exist,” she testified.

In November 2021, he was told that the clinic would no longer be allowed to accept new patients. Lopez feared she or the hospital could be sued for failing to provide the accepted standard of care. She said she had contacted medical societies and experts to see what could be done. Since November, she said the clinic has turned down 98 patients seeking hormone therapy. “It’s criminal. It’s horrible,” she testified.

Months later, Lopez retained an attorney and filed what’s called a 202 petition, which is a discovery request to determine if a party has a case for a potential lawsuit.

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

Lawyers representing the Texas Attorney General, UTSW, Warner, Podolsky and Children’s Health did not question Lopez during the hearing. (UT Southwestern and the governor’s office have not yet responded to interview requests.)

Lopez’s attorneys filed Podolsky and Warner’s filing request. They also want to collect correspondence which they believe would detail what led to the discontinuation of hormone therapy for new patients.

His lawyers argued 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 directors had not acted unlawfully and, as government employees, enjoyed sovereign immunity from impeachment.

The closure of GENECIS preceded state efforts to classify gender-affirming pediatric treatment as child abuse. Governor Greg Abbott issued an executive directive in February directing the Texas Department of Family Services to investigate families whose children have undergone this treatment. Similar legislation had previously failed in the Texas state house.

A Texas judge temporarily suspended the directive after a lawsuit was filed against Abbott, but Texas Attorney General Ken Paxton said he plans to continue investigations. Some DFS investigators told the Texas Tribune they quit or were looking for other work because of the directive.

The Human Rights Coalition published a letter in the News protesting the state directive, which was co-signed by 60 companies including Apple, Microsoft, Johnson & Johnson, Meta, Google and Capital One.

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

The statement says 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 in minors — and efforts to reduce it — against the undisputed need for our other affirming care efforts. gender and have decided to focus on these important services,” it read. . “While we have halted new patient enrollment in the puberty suppression treatment for the gender dysphoria indication, families and patients seeking hormone therapy for gender dysphoria have access to unaffiliated outside practitioners. to a public institution that is ultimately accountable to the state and inevitably has to accommodate conflicting public views.

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

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

Lopez argues that UT Southwestern has violated its own non-discrimination policy and is preventing it from treating patients to the best of its ability.

The hospital administers hormone therapy and puberty blockers to existing patients and patients who need this treatment due to precocious puberty, but not to new transgender patients.

UT Southwestern’s legal counsel argued that government officials are free to use their influence to influence the management of state institutions. Lopez’s attorneys have not shown that anything illegal was done or that Lopez herself was discriminated against.

State attorneys argued that his case was worthless because of this. They argue that because UT Southwestern is a government institution, it is not subject to corporate practice of medicine laws that prevent an organization from controlling the care provided by a physician.

Despite the clinic’s negative attention and ongoing legal action, the international support she has received for taking this step is a boon to her morale. Lopez said she was reluctant to go the legal route and feels the lawsuit distracts her from doing what she loves: caring for her patients.

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

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


Will is the editor of CEO magazine and editor of D CEO Healthcare. He wrote about health care…