In just four days, Texas Attorney General Ken Paxton and Governor Greg Abbott banned gender-affirming health care for trans minors, ordering everyone to report this care to the State under pain of criminal prosecution.
How did Paxton and Abbott pull this off? The Texas Legislature last year considered bills banning gender-affirming care for children, but Republicans failed to muster enough support to pass them. So GOP Rep. Matt Krause, a sponsor of the legislation, took a shortcut: He asked Paxton to declare that such treatment constitutes unlawful child abuse under the State Law. (The Texas Attorney General can provide “interpretations” of the law that are generally considered authoritative until overturned by another branch.) At the time, Krause planned to challenge Paxton in the primaries. of 2022, and he was clearly hoping to use trans kids as a corner issue. Had Paxton refused to ban gender treatment for minors, Krause would have accused him of backing down from culture wars.
Krause eventually dropped out of the race for the attorney general, but that didn’t stop Paxton from releasing his “interpretation” on Feb. 18: Virtually all gender-affirming under-18 care, he said, are already illegal in Texas. Paxton came to this conclusion by reading Texas child abuse laws as broadly as possible. These laws, for example, prohibit any action that could cause a child to suffer “physical, mental, or emotional injury” that “results in observable and material impairment of the child’s growth, development, or psychological functioning.” The use of puberty blockers and cross-sex hormones, as well as gender-affirming surgery, violate these prohibitions, Paxton claimed. And because some of these procedures can eventually lead to infertility, he claimed, they also violate a child’s “constitutional right to procreate.”
It is, to say the least, ironic that Paxton relies on an unwritten constitutional right to procreate, since that freedom derives from the same doctrine that protects access to abortion – a doctrine he vehemently disavows. More importantly, his condemnation of gender-affirming care as a physical or emotional “wound” defies scientific and medical consensus. All major medical associations, including the American Medical Association, American Psychiatric Association, and American Academy of Pediatrics, support gender-affirming treatment for trans youth. Extensive research shows that such health care improved the mental health and general well-being of minors. Paxton’s view, on the contrary, rests on cruel, bigoted and antiquated assumptions about gender that run counter to evidence-based medicine.
Just four days after receiving the attorney general’s report, Abbott issued a sweeping ban on all gender-related care for trans youth. The governor wrote that anyone who approves or performs this treatment has committed a criminal offense. Abbott has spent months proclaiming that parents have an absolute right to control their children, and Texas law already gives parents the right to consent to medical treatment for their children. Now the governor has decided he can strip parents of that most basic right when he personally disapproves of the treatment.
Abbott went even further, ordering the Texas Department of Family and Protective Services to “promptly and thoroughly investigate all reported instances of these abusive procedures in the State of Texas.” It also ordered all “licensed professionals who have direct contact with children” to report instances of gender-affirming care for minors. Teachers, nurses, doctors, child care workers and medical professionals must now notify the state if they believe a child is receiving such treatment. If they don’t, Abbott noted, they face criminal penalties under Texas reporting law, including a year in jail.
Then the governor took a final step toward vigilante enforcement. Under state law, he pointed out, anybody with knowledge of child abuse must report it to the state. Anyone who fails to report this “abuse” faces criminal prosecution and, if convicted, up to a year behind bars. Members of the “general public,” Paxton wrote, now have a legal duty to inform all parents who allow their children to receive gender-affirming care, all medical professionals who provide such care, and all parents who allow them. Here, the governor borrowed an idea from SB 8, the Texas abortion ban that delegates bounty hunters to sue abortion providers and their “accomplices” for $10,000 in state court. Republican lawmakers are increasingly deploying this tactic in their culture war, allowing individuals to sue schools that teach banned ideas or allow discussion of LGBTQ issues.
Trans children in Texas were previously attacked in 2021 when the state banned them from playing on sports teams that matched their gender identity. The latest assault on trans children further threatens their safety and well-being by criminalizing the very care designed to support them. Anyone living in the state of Texas who refuses to tell state authorities about a gender-transitioning child can be arrested, prosecuted, and imprisoned simply for not telling you. State bureaucrats are now empowered to remove trans children from their homes. Physicians specializing in trans healthcare could have their practices closed. All this to ban health care that can literally save a child’s life. Young transgender people living in Texas don’t need protection from their doctors. They must be protected from their condition.