A new ruling from the Texas Supreme Court is raising alarm among LGBTQ advocates after the court ordered the national advocacy group PFLAG to turn over documents connected to a state investigation into transgender youth health care.
In a decision released March 13, the court ruled that the Texas Attorney General’s Office can require PFLAG to provide records tied to its investigation into whether doctors or organizations helped families access gender-affirming care for minors after the state banned most such treatments. The ruling reverses an earlier district court decision that had largely blocked the request for documents.
The investigation stems from a civil investigative demand issued by Texas Attorney General Ken Paxton in 2024. Paxton’s office argued it had reason to believe PFLAG may have information about medical providers allegedly attempting to bypass Texas law by billing gender-affirming treatments under other medical diagnoses.
Texas enacted Senate Bill 14 in 2023, which prohibits most forms of gender-affirming care for minors, including hormone therapy and puberty blockers. The law took effect later that year and allows the state to discipline or revoke the licenses of doctors who violate the ban.
According to the court’s opinion, the attorney general only needs a “reasonable belief” that relevant information exists in order to issue such investigative demands. The justices said courts should not interfere with the attorney general’s authority to pursue investigations authorized by state law.
The order requires PFLAG to produce several categories of records, including communications about “contingency plans” families may have considered to maintain care for transgender youth, referrals or lists of health care providers, and communications involving doctors named in the state’s investigation.
However, the ruling also set limits on what the state can obtain. The court said certain internal organizational documents requested by investigators were not clearly relevant and do not need to be turned over. Additionally, the revised investigative request allows PFLAG to redact or anonymize identifying details to protect the privacy of families and minors mentioned in the records.
The legal fight began after a PFLAG leader submitted an affidavit in a lawsuit challenging the state’s ban on transgender youth care. In the filing, the organization noted that some families were exploring ways to access medical treatment or considering leaving the state in response to the restrictions. State officials cited that statement as evidence that PFLAG might possess information relevant to their investigation.
The case now returns to a lower court, where PFLAG may still attempt to shield specific documents under attorney-client privilege or other legal protections.
For LGBTQ advocates and families with transgender children, the ruling highlights the increasingly aggressive legal battles surrounding gender-affirming care in Texas. Critics warn that investigations targeting support organizations could have a chilling effect on families seeking guidance or information about medical care options for transgender youth.
