Ken Paxton
Ken Paxton greets his good buddy | via Texas Tribune/Reuters

To shore up his base, the Texas AG is attacking transgender medicine.

Texas AG Ken Paxton is in serious personal trouble. In any state other than Texas, Paxton’s ass might very well be the guest of a government hoosegow for securities fraud and bribery.

Moreover, Paxton — good Christianist that he is — had an extramarital affair with a woman whom he later recommended for a job with the wealthy donor who is now at the center of criminal allegations against him. Kenny is a busy boy.

Distraction du jour:

On December 13, the panderer released: AG Pax­ton to Inves­ti­gate Pro­mo­tion of Puber­ty Block­ers in Children.

First of all, no one is “promoting” puberty blockers. The market is not big enough to warrant an effort or an expenditure. Secondly, the use of puberty blockers (GnRHa) is part of gender-affirming care. Gender-affirming care underpins the clinical practice standards of both the American Academy of Pediatrics and the Endocrine Society.

Did Mr. Paxton study endocrinology or psychiatry at UVa Law? I don’t think so. Yet, according to the press release:

Attorney General Ken Paxton is investigating Endo Pharmaceuticals, Inc., and AbbVie Inc. under the Texas Deceptive Trade Practices Act. These pharmaceutical companies allegedly advertised and promoted hormone (puberty) blockers for unapproved uses without disclosing the potential risks associated with these drugs to children and their parents.

Puberty blockers are prescribed “off label.” That means the use of an FDA-approved drug for an unapproved use. In order for a drug to be approved in the first place, a company must submit clinical data and other information to the FDA for review.

“… there is a substantial body of research demonstrating that puberty blockers are effective in the treatment of pediatric gender dysphoria.”

The company must show that the drug is safe and effective for its intended use. Safety involves weighing benefits in contrast to concerns. There is no doubt whatsoever that puberty blockers are effective. Moreover, the scales tip heavily in favor of benefits over detriments.

Furthermore, the FDA permits doctors to use their clinical judgment. Roughly 25% of all prescriptions in the United State are “off label.”

I find it remarkable that the same people who oppose the use of puberty blockers are all in on ivermectin and hydroxychloroquine. That is in spite of specific FDA warnings against their use in the treatment of COVID-19.

Paxton goes on to undermine his own argument:

Medications Supprelin LA and Lupron Depot are approved to treat children with Central Precocious Puberty (CPP), when the puberty process begins prematurely. And Vantas, along with other forms of Lupron, has been prescribed for palliative treatment of prostate cancer. These drugs are now being used to treat gender dysphoria even though they are not approved for such use by the Food and Drug Administration (FDA). Gender dysphoria is a diagnosed mental disorder in which a person experiences significant distress related to a strong desire to be of another biological sex.

Where to begin? Well, for starters, there is a substantial body of research demonstrating that puberty blockers are effective in the treatment of pediatric gender dysphoria while significantly reducing suicidal ideation.

“‘Dr.’ Paxton enlightens us all.”

Furthermore, if puberty blockers are deemed safe to treat — say — precocious puberty then they are safe per se for the treatment of gender dysphoria. The toxicity, side effects and other consequences are the same.

Moreover, gender dysphoria is not a “mental disorder.” For that matter, distress is not caused by “a strong desire to be of another biological sex.”

Gender incongruence (gender identity not aligned with natal sex) causes discomfort by its very nature. That discomfort is significantly amplified by minority stress and the expectations of a child’s family even in the most benevolent of households.

“Dr.” Paxton enlightens us all:

“The manufacture, sale, prescription, and use of puberty blockers on young teens and minors is dangerous and reckless,” Attorney General Ken Paxton said. “These drugs were approved for very different purposes and can have detrimental and even irreversible side effects. I will not allow pharmaceutical companies to take advantage of Texas children.”

The only thing that is “dangerous and reckless” is half-assed lawyers and politicians playing doctor. Moreover, the use of puberty blockers is a decision that is made between doctors, patients and the patients’ parents.

The investment required to get an approved drug approved for a supplementary purpose is considerable.

Average out-of-pocket cost for each phase of clinical trials:

  • Phase I – $18.6 million
  • Phase II – $28.8 million
  • Phase III – $105.8 million

“Ken Paxton is a slime ball. Paxton’s own behavior makes that description applicable.”

On top of the cost of clinical trials is the expense associated with submitting an application for review. Ultimately, it would cost hundreds of millions of dollars to have puberty blockers approved for the treatment of pediatric gender dysphoria. It is something that is not economically feasible.

Mr. Paxton should do the job that he was elected to do. Paxton believes that his job is to fluff his own ego through the approval of his base. The most vulnerable of constituents — gender diverse kids and their parents — are being marginalized by the actions of people like Ken Paxton.

In fact, given the very credible accusations of criminal misconduct — some by former senior staff members at the AG’s office — Paxton should resign. He won’t. Paxton is running out the clock on securities fraud and he is busy trying to dodge accusations of bribery. Ken Paxton is a slime ball. Paxton’s own behavior makes that description applicable.

There is an ongoing effort in Texas to eventually outlaw gender-affirming care. That endeavor is not based on medical science. Rather, it is based on the conservative Christian defense of scripture. The actual adolescents and children who will suffer are irrelevant to the religious zealots.

By David Cary Hart

Retired CEO. Formerly a W.E. Deming-trained quality-management consultant. Now just a cranky Jewish queer. Gay cis. He/Him/His.