A Dallas doctor faces legal action from Texas over accusations of unlawfully providing cross-sex hormones to transgender youths. 

Texas Attorney General Ken Paxton announced a lawsuit against Dr. May Lau on Thursday, alleging that the physician provided prohibited “gender transition” hormones to over 20 adolescents in violation of a Republican-backed ban that took effect in Texas last year.

This case is the first time a state has attempted to enforce laws that ban transgender medical procedures for minors, the Associated Press reported. 

“Today, enforcement begins against those who have violated the law,” the attorney general’s office said in the lawsuit, which was filed in suburban Collin County. 

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Under Texas law, doctors are not permitted to provide surgery, puberty blockers or cross-sex hormones to children for the purpose of affirming their self-professed gender identity in a way that is inconsistent with their biological sex. 

The lawsuit alleges that Lau, a professor at the University of Texas Southwestern Medical Center in Dallas and a specialist in adolescent medicine, illegally prescribed testosterone to at least 21 biological females between the ages of 14 and 17 to transition to male or affirm their gender identity. It refers to Lau as a “scofflaw” and “radical gender activist.” 

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Lau is accused of “falsifying medical records, prescriptions, and billing records to represent that her testosterone prescriptions are for something other than transitioning a child’s biological sex or affirming a child’s belief that their gender identity is inconsistent with their biological sex.”

The state of Texas has asked a court for an injunction that would block Lau from prescribing testosterone and estrogen to minors for the purpose of gender transition, as well as writing prescriptions and billing for gender transition treatments “under false diagnoses, such as endocrine disorder.” Lau faces fines of up to $10,000 per violation. 

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Dr. Lau and UT Southwestern did not immediately respond to requests for comment from Fox News Digital.

“Texas passed a law to protect children from these dangerous unscientific medical interventions that have irreversible and damaging effects,” Paxton said in a statement. “Doctors who continue to provide these harmful ‘gender transition’ drugs and treatments will be prosecuted to the full extent of the law.”

At least 26 states have adopted laws restricting or banning transgender medical procedures for transgender minors, and most of those states face lawsuits. Federal judges have struck down the bans in Arkansas and Florida as unconstitutional, though a federal appeals court has stayed the Florida ruling. A judge’s orders are in place to temporarily block enforcement of the ban in Montana. New Hampshire restrictions are to take effect in January.

The lawsuit comes just weeks before an election in which Republicans have attacked Democrats for supporting transgender hormone therapies and sex-change surgery for minors. GOP Sen. Ted Cruz has repeatedly blasted his Democratic challenger, Rep. Colin Allred, for his support of transgender rights.

Republican Gov. Greg Abbott signed the transgender medical procedure ban. He is also the first governor to order investigations of parents who seek transgender procedures for their children.

The Associated Press contributed to this report.