In the latest lawsuit brought by Texas Attorney General Ken Paxton (R) against health care providers who treat trans youth, the state is arguing that a doctor broke the law by not reporting the sex assigned at birth of some of the patients he treated and instead reporting their genders.

Pediatric and adolescent gynecologist Dr. Jason Jarin, who works at the UT Southwestern Medical Center in Dallas, is accused of not listing patients’ gender correctly and using the wrong billing codes in order to prevent Texas’ Medicaid and CHIP programs from denying claims while treating trans youth with hormone therapy and puberty blockers. Texas bans gender-affirming care for transgender youth, but it doesn’t ban such care for cisgender youth.

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Children’s Health System of Texas, which is also named as a defendant in the lawsuit because Dr. Jarin is the division director there, denies the allegations.

“Our top priority is the health and well-being of the patients and families we serve,” the organization said in a statement. “We comply with all applicable local, state, and federal health care laws.” 

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Dr. Jarin told KERA News he has no comment.

The lawsuit says that Dr. Jarin continued to prescribe hormone therapy for his trans patients after September 1, 2023, when the state’s ban on gender-affirming care went into effect, so that his patients wouldn’t have to detransition. The law allows for patients who were receiving hormone therapy before that date to continue getting hormones for 12 months, but only with diminishing dosages so that they could be “weaned off” the treatments.

The lawsuit states that Jarin “falsely billed transgender claims as ‘endocrine disorders.'” It accuses him of prescribing puberty blockers to trans kids and coding it as treatment for precocious puberty, hormones to suppress menstruation to trans boys and coding it as a treatment for “excessive” or “irregular” periods, and hormone therapy to trans girls but billed for it as “contraception.”

The complaint lists 12 unnamed trans patients Dr. Jarin treated and says that he listed many of their genders incorrectly in medical claims. For example, Dr. Jarin is accused of prescribing testosterone to Patient Two, who he identified as “male.” Paxton says in the suit that Patient Two is “a biological female.” Patient Two is likely a trans boy.

The gender of the patients is an issue because the 2023 Texas law that bans gender-affirming care for trans youth does not ban any treatment in particular. Puberty blockers and hormone therapy are still perfectly legal under the law; they’re only banned if they’re prescribed to trans youth in relation to transgender health care. A cis boy can be prescribed testosterone under the law if a doctor believes that the boy needs it, but a trans boy cannot be prescribed testosterone under the law, even if a doctor believes that the boy needs it.

This discrimination was central to trans advocates’ Equal Protection claims in the Supreme Court case Skrmetti v. U.S., which challenged Tennessee’s ban on gender-affirming care. They said the fact that cis youth can still receive these treatments not only shows that the state does not believe the treatments are inherently dangerous but also shows that the law discriminates against transgender people.

While the main focus of the lawsuit is on billing and arguments attacking the science behind gender-affirming care, the lawsuit is fundamentally about ideology. Paxton is trying to suppress support for gender-affirming care in the state. To that end, the lawsuit lists statements Dr. Jarin has made in support of gender-affirming care, saying that it proves his “entrenched commitment to a gender ideology that advocates for the medical transition of a child’s biological sex.”

“I will use every legal tool available to ensure radical gender activists like Jarin face justice for hurting our kids,” Paxton said in a statement. “This criminal extremist not only permanently harmed children, but he also then defrauded Medicaid and stuck Texas taxpayers with the bill for this insanity. Experimental ‘transition’ procedures on minors are illegal, unethical, and will not be tolerated in Texas.”

All major medical associations in the U.S., including the American Medical Association, the Endocrine Society, and the American Psychological Association, support gender-affirming care for trans youth and oppose attempts to ban such care.

This is Paxton’s fourth lawsuit against a doctor for allegedly providing health care to trans youth in the state of Texas.

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