HOUSTON — Texas Children's Hospital announced Friday it's pausing gender-affirming services following Gov. Greg Abbott's new directive which targets trans youth.
"The mission of Texas Children’s Hospital is to create a healthier future for all children, including transgender children, within the bounds of the law. After assessing the Attorney General’s and Governor’s actions, Texas Children’s Hospital paused hormone-related prescription therapies for gender-affirming services. This step was taken to safeguard our healthcare professionals and impacted families from potential criminal legal ramifications," the hospital wrote in a statement.
In February, Gov. Greg Abbott and Attorney General Ken Paxton wrote to state departments calling gender-affirming or transitioning procedures "child abuse." Abbott and Paxton then asked the Texas Department of Family and Protective Services (DFPS) to investigate.
"Because the Texas Department of Family and Protective Services is responsible for protecting children from abuse, I hereby direct your agency to conduct a prompt and thorough investigation of any reported instances of these abusive procedures in the State of Texas," reads the letter. "To protect Texas children from abuse, DFPS and all other state agencies must follow the law as explained in OAG Opinion No. KP-0401."
Child abuse investigations based on gender-affirming care are almost unheard of in Texas. Officials at the Texas Department of Family and Protective Services say that there have been three reports last week “meeting the description in the AG opinion and Governor's directive” but offered no other details. No investigations have been launched, officials said.
Families with transgender kids and their advocates say even an attempt at criminalizing certain care further stigmatizes an already vulnerable group of Texans. The officials’ moves also can block access to treatments that can prevent suicide and severe depression caused in part by gender dysphoria — discomfort related to feeling a disconnect between one’s personal gender identity and the gender assigned at birth.
Several Texas leaders and parents have spoken out against this new law, including Houstonian Katie Laird, a mother of a 15-year old trans boy.
“It really cuts to the core," she said. “It’s certainly not just us as parents making random decisions for our child, deciding, 'Hey I’m going to do this.' Everything is really thoughtful, intentional.”
Shelly Skeen, a senior attorney with Lambda Legal, said major medical organizations describe gender-affirming procedures as life-saving.
“Bottomline, we are allowing the government to reach into the privacy of people’s homes,” said Skeen. “And the government should not be in our private matters.”
What is gender-affirming care?
Areana Quiñones, executive director for the Texas nonprofit organization Doctors For Change, defined gender-affirming care as judgment-free, individualized care oriented toward understanding and appreciating a person’s gender. Providers often work with counselors and family members to ensure they have everything they need to navigate the health care system.
Under the gender-affirming model of care, more time is spent allowing kids to socially transition instead of focusing on medical treatment. A social transition consists of the steps a child takes to affirm their identity. An example could include allowing a child assigned male at birth to wear clothing, grow their hair or use a different name that better fits their identity.
This transition is done with their family and community’s support.
“The most important message is that trans kids are kids,” Kaplan said. “And they deserve to have the same health care that all kids have, which is evidence-based health care that serves to promote their growth and development to help them become healthy, fully functioning adults.”
Sometimes, more medical support is needed for the child. Puberty or hormone blockers are used to give a transgender kid time before deciding what permanent transition-related treatment they want.
Are gender-affirming surgeries used on children?
Medical experts say transgender children rarely if ever have surgeries like orchiectomies, hysterectomies and mastectomies before they're adults. Still, Gov. Greg Abbott cited such procedures in an Aug. 6 letter directing the Texas Department of Family Protective Services’ top official to determine whether such gender confirmation surgeries are child abuse under existing state law.
Experts took issue with Abbott’s language in the letter, which repeatedly referred to gender confirmation surgery as “genital mutilation.”
“It's literally the harshest language possible, because he wants a reaction from his side,” said Andrea Segovia, Transgender Education Network of Texas’ field/policy coordinator. “And they can gain supporters in that of like, ‘Oh, that sounds awful. Yeah, we shouldn't be doing that to our minors.’”