A Seattle hospital filed suit against the Texas attorney general's office in an escalating battle over gender-affirming care for children that now crosses state lines, according to court records.

Texas Attorney General Ken Paxton's office is seeking to force Seattle Children's Hospital to hand over medical records of Texas residents who might have received gender-affirming care at the facility, prompting the action by the hospital this month.

The attorney general's consumer protections division is investigating the hospital and its physicians for possible violations of a Texas provision that include "misrepresentations regarding Gender Transitioning Treatments and Procedures and Texas law," the office said in subpoenas issued to the hospital.

The subpoenas, issued Nov. 17, demand that the hospital provide records about minor Texas residents treated anytime beginning Jan. 1, 2022, including details about gender-related issues and care.

The demands are part of a yearslong effort by Texas Gov. Greg Abbott, Paxton and the state GOP to eliminate gender-affirming care for minors in the state, which in some cases has driven families with transgender children to move to states such as Washington.

Gender-affirming care measures that are legal for minors in Washington — including puberty blockers, hormone therapy and certain surgeries — became illegal in Texas in September after the Legislature passed Senate Bill 14. Long before that law went into effect, Abbott ordered Child Protective Services to investigate families of transgender children reported to be receiving puberty blockers or hormone therapy.

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The hospital is arguing that Texas courts and officials don't have jurisdiction to subpoena the Washington-based health care system, according to a Dec. 7 complaint filed in Travis County, Texas.

Seattle Children's does not provide gender-affirming care in Texas or administer such care via telemedicine to patients in the state, the hospital's filing states, and it does not advertise its gender-affirming treatments in Texas. Its only employees in Texas are remote administrative workers, not clinicians.

The lawsuit also argues that the attorney general's subpoena would require the hospital and its associates to break federal privacy laws restricting the release of medical records as well as Washington's "Shield Law," which prevents reproductive and gender care providers from cooperating with out-of-state efforts to pursue criminal and civil penalties.

In the filing, the hospital said the demands for records "represent an unconstitutional attempt to investigate and chill potential interstate commerce and travel for Texas residents seeking care in another state."

The hospital asked the court to block Paxton's request or, barring that, to limit the scope of the information requested in the subpoena.

Seattle Children's said through a spokesperson that it is protecting private patient information and complying with the law for all the health care services it provides.

The attorney general's office issued the subpoenas less than two months after SB 14 went into effect in Texas, prohibiting doctors from providing certain gender-affirming medical treatments to minors experiencing gender dysphoria, a condition in which a person’s gender identity doesn’t match their sex assigned at birth.

Paxton began investigating an Austin-based children's medical center in May over possible violations of state law or misrepresentations related to gender transition-related care. His subpoenas of Seattle Children's suggest he might be expanding the investigation to other hospitals.

The attorney general's office did not respond to repeated requests for comment Friday.