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Texas parents can be investigated over gender-affirming care for trans children, state Supreme Court rules

“Certain ‘sex change’ procedures and treatments...when performed on children, can legally constitute child abused under several provisions of chapter 261 of the Texas Family Code,” said a ruling by the Texas Supreme Court.
Demonstrators gather on the steps to the State Capitol to speak against transgender related legislation bills being considered in the Texas Senate and Texas House, Thursday, May 20, 2021, in Austin, Texas. Eric Gay/ AP

Story at a glance

  • The Texas Supreme Court ruled the state’s Department of Family and Protective Services can continue investigating parents seeking gender-affirming care for their trans children. 

  • Texas Gov. Greg Abbott (R) described gender-transitioning procedures as child abuse. 

  • The court lifted a temporary injunction on Abbott’s directive. 

Texas’s Supreme Court has cleared the state to continue its child abuse investigations against parents who help their transgender children get gender-affirming care, reversing a temporary injunction Friday.  

The state’s child welfare agency is still blocked from investigating the family of a transgender child who sued the state in March, but is allowed to investigate other families, according to the ruling. The court also affirmed that state agencies do not have to follow directives from Attorney General Ken Paxton or Gov. Gregg Abott (R) to carry out such investigations.  

In February, Abbott sent a letter to state agencies directing them to investigate gender-affirming care for transgender children as child abuse. Following that letter, Paxton issued a lengthy opinion on whether certain medical procedures performed on children constitute child abuse. He cited chapter 261 of the Texas Family Code saying certain sex change procedures and treatments, when performed on children, can legally constitute child abuse. 

The American Civil Liberties Union (ACLU) of Texas and Lamda Legal quickly filed a lawsuit on behalf of the mother of a 16-year-old transgender youth who says the state’s Department of Family and Protective Services (DFPS) investigated her following Abbott’s letter. 

The lawsuit asked for an emergency order to be issued to ensure an injunction was put in place during the appeals process.  

The injunction was granted in March, despite pushback from Texas Attorney General Ken Paxton (R), who said on Twitter, “Democrat judge tries to halt legal and necessary investigations into those trying to abuse our kids through ‘trans’ surgeries and prescription drugs. I’m appealing. I’ll win this fight to protect our Texas children.” 


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Notably, the state Supreme Court concluded in this latest ruling that Abbott’s letter to Texas’ DFPS was not legally binding and that state agencies were not obligated to follow it: “The governor and the attorney general were certainly well within their rights to state their legal and policy views on this topic, but DFPS was not compelled by law to follow them.” 

The ACLU of Texas called the Supreme Court’s decision a win, publishing a series of statements on Twitter which said in part, “Today’s decision is a win for our clients and the rule of law. The court made clear that the governor’s letter and attorney general’s opinion targeting transgender youth are just that: opinions. Neither change Texas law.” 

The group also noted that, “denying healthcare to trans kids is life-threatening. As calls to mental health and crisis hotlines have skyrocketed throughout the state, it is immeasurably cruel for politicians to continue these heartless attacks.” 

Paxton also viewed the Supreme Court’s ruling as a win, issuing a statement on Twitter, “Just secured a win for families against the gender ideology of doctors, big pharma, clinics trying to ‘trans’ confused innocent children. SCOTX green-lighted investigations that lower Dem courts froze.” 

“’Transing’ kids through surgery/drugs are abuse & I’ll do all I can to stop it,” continued Paxton. 

Megan Mooney, a licensed psychologist who is a mandatory reporter under Texas law, said she could not comply with the governor’s directive without harming her clients and violating her ethical obligation, according to the ACLU. Mooney was listed as a plaintiff in the lawsuit. 

Texas isn’t the only state targeting gender-affirming care. Alabama Gov. Kay Ivey (R) also signed a measure into law that criminalizes gender-affirming care for transgender and nonbinary minors. Doctors in the state who provide or recommend puberty blockers, hormone therapies or other interventions to patients younger than 19-year-old risk committing a felony punishable by up to a decade in prison. 

When signing the bill into law, Ivey said, “I believe very strongly that if the Good Lord made you a boy, you are a boy, and if he made you a girl, you are a girl.” 

Alabama’s law also immediately faced legal action, with multiple suits filed by physicians, families and LGBTQ+ advocacy groups who claim it threatens the health and well-being of transgender and nonbinary children. 

An annual report from the Trevor Project found close to two-thirds of LGBTQ+ youth reported experiencing symptoms of anxiety this year, up slightly over last year’s 72 percent. LBTQ+ youth who seriously considered taking their own life jumped up to 45 percent, up from 40 percent in 202 and 42 percent in 2021. 

The White House has even sounded the alarm on legislation targeting LGBTQ+ youth, with Assistant Health Secretary Rachel Levine saying trans youth are being, “driven to depths of despair,” and committing suicide at alarming rates.  

Levine herself is openly transgender, the first for a federal official to be confirmed by the U.S. Senate. She was also a doctor for decades before becoming Pennsylvania’s secretary of health. 

“Gender-affirming care is medical care. It is mental health care. It is suicide prevention care. It improves quality of life, and it saves lives,” said Levine during the Out For Health Conference in April.  


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