Targeting trans Texans again, Ken Paxton investigating pharmaceuticals over puberty blockers

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Texas Attorney General Ken Paxton is investigating two pharmaceutical companies — Endo Pharmaceuticals and AbbVie Inc. — for allegedly advertising puberty blockers to children and their parents to treat gender dysphoria rather than the other medical conditions they are approved to treat.

Paxton opened the investigation in December and filed civil investigative demands with the two companies on Thursday.

This is the latest move in an ongoing effort by Paxton and Gov. Greg Abbott to limit access to gender-affirming medical care for transgender teens in Texas.

Gender-affirming care is a treatment model to address gender dysphoria, the distress a person feels when their gender identity does not match the sex they were assigned at birth. Young people often focus on social transition — dressing a certain way or using different pronouns — but can be prescribed puberty blockers or hormone therapy in consultation with a doctor.

Last month, Paxton issued a nonbinding legal opinion that equated gender-affirming medical care, including fully reversible puberty blockers, with child abuse. Abbott then directed the state’s child welfare agency to investigate parents who provide these medical interventions to their children.

At least nine families are under investigation. A state court temporarily suspended the investigations, a decision that was upheld earlier this week by an appeals court. Paxton has asked the Texas Supreme Court to overturn that injunction and allow the investigations to continue.

In December, Paxton announced investigations under the Texas Deceptive Trade Practices Act into Endo Pharmaceuticals and AbbVie Inc., the two companies that sell puberty blockers. He claimed in a press release that the drugs are approved to treat precocious puberty and forms of prostate cancer but were being marketed and prescribed off-label to treat gender dysphoria.

“These drugs were approved for very different purposes and can have detrimental and even irreversible side effects,” Paxton said. “I will not allow pharmaceutical companies to take advantage of Texas children.”

On Thursday, Paxton issued letters to the companies, demanding certain documents related to the sale and advertisement of the drugs.

In a statement, a spokesperson for Endo said the company does not promote its medications for off-label uses and is cooperating with the investigation. AbbVie did not immediately respond to comment.

Access to gender-affirming care has narrowed significantly since the governor’s directive last month. Several major health care providers have stopped providing hormone therapy in the last month, including Texas Children’s Hospital in Houston, the largest pediatric hospital in the country.

In November, the state’s largest gender-affirming health care provider, GENECIS, stopped accepting new patients for hormone therapy under pressure from Texas Republicans.