Prosecutors Refuse to Enforce Texas Directive on Transgender Care

AUSTIN, Texas — Texas Gov. Greg Abbott issued a directive on Tuesday compelling the state child welfare agency to investigate reports of “gender-transitioning procedures” as child abuse, but some district attorneys are refusing to comply.

The directive followed Texas Attorney General Ken Paxton’s non-binding legal opinion from Monday declaring gender-affirming care to be child abuse under state laws. State lawmakers considered legislation banning gender-affirming health care for transgender children and mandating the revocation of a physician’s license for performing or prescribing the treatment, however both measures failed to pass last year.

Officials from the Texas Pediatric Society, Texas Medical Association and Texas Academy of Family Physicians opposed those efforts and testified at Capitol hearings about the treatments.

Gender-affirming treatments encompass a range of health care options such as reversible puberty blockers and hormone therapy, and the doctors testified that other permanent options are generally recommended after the age of 16 while gender reassignment surgery is generally offered around the age of 18.

Abbott and Paxton, however, have pressed on with attempts to prevent gender-affirming health care for children through other means. Abbott cited Paxton’s opinion in his letter to the Texas Department of Family and Protective Services that directed the agency to investigate providers of gender-affirming care with the threat of criminal penalties for noncompliance.

In a written statement accompanying his letter to the DFPS, Abbott said gender-affirming procedures for minors already constitute child abuse under existing Texas law. Abbott’s letter also notes Texas law imposes reporting requirements upon all licensed professionals who have direct contact with children who may undergo the treatments.

“Based on the analysis herein, each of the ‘sex change’ procedures and treatments enumerated above, when performed on children, can legally constitute child abuse under several provisions of chapter 261 of the Texas Family Code,” Paxton wrote in the executive summary of his opinion.

He continued, “In addition to analysis under the Family Code, we discuss below the fundamental right to procreation, issues of physical and emotional harm associated with these procedures and treatments, consent laws in Texas and throughout the country, and existing child abuse standards. Each of the procedures and treatments you ask about can constitute child abuse when performed on minor children.”

Meanwhile, district attorneys from some of the state’s largest counties are refusing to cooperate with the order. The DAs from Travis, Bexar, Dallas, Nueces and Fort Bend counties issued a joint statement on Wednesday promising to support the families of transgender youth.

The DAs maintained they would not interfere with medical decisions made among children, their parents and medical physicians. They also characterized the state executives’ course of action as “politically motivated attacks.”

“We are deeply disturbed by Gov. Abbott and AG Paxton’s cruel directives treating transgender children’s access to life-saving, gender-affirming care as ‘child abuse,’” the DA’s wrote in the joint statement. “This is part of a continued onslaught on personal freedoms. Elected officials should be protecting our most vulnerable. These two, instead, want to irrationally target and restrain children seeking medical assistance — and force caregivers to participate.”

El Paso County Attorney Jo Anne Bernal said on Wednesday her office will not prosecute reports of child abuse for providing gender-affirming care despite the governor’s order, as first reported by El Paso Matters. The County Attorney’s Office represents Child Protective Services in court giving Bernal the legal authority to determine which CPS cases to prosecute in her county.

Transgender people who received puberty blockers during their adolescence had a lower risk of suicidal thoughts as adults than those who did not receive them, according to a 2020 study published in the medical journal Pediatrics. The study led by Harvard Medical School resident psychiatrist Jack Turban surveyed 20,619 transgender individuals and found that 90% of them who wanted but could not access puberty blockers experienced suicidal thoughts.

“In a state where we’ve seen attack after attack on the lives of transgender children, Ken Paxton is once again showing his disregard for children’s lives,” Texas Freedom Network President Val Benavidez said in a written statement following Paxton’s opinion.

“Transgender people already experience stigma and discrimination, harassment, and violence simply because of who they are. It is abundantly clear that Paxton sees transgender children as nothing more than political pawns. Their safety is certainly not his concern.”

Reece can be reached at [email protected].