Republican Lawmakers Are Coming After Gender-Affirming Care in Texas

A  slew of Republican bills aimed at the trans community will take center stage in the next Texas legislative session.
A slew of Republican bills aimed at the trans community will take center stage in the next Texas legislative session. Benson Kua
Prominent healthcare organizations, such as American Academy of Pediatrics, the American Medical Association and the Texas Pediatric Society, appears to be in agreement: Gender-affirming care is the best treatment for transgender children. It's defined broadly by the World Health Organization as treatment that can include a range of interventions including social, psychological, behavioral and medical. They're all meant to provide support for a person's gender identity when it conflicts with the gender they were born with.

“The most important message is that trans kids are kids,” Seth Kaplan, president of the Texas Pediatric Society, told The Texas Tribune. “And they deserve to have the same healthcare that all kids have, which is evidence-based healthcare that serves to promote their growth and development to help them become healthy, fully functioning adults.”

To some Republican lawmakers in Texas, though, gender-affirming care seems to mean something completely different. To them, it appears to be code for genital mutilation and child abuse. That's why they've filed several bills ahead of the upcoming legislative session that aim to clamp down on this treatment across the state. These reps also want to label every place that hosts drag shows a sexually oriented business.

Rep. Bryan Slaton, a Royse City Republican, filed House Bill 42, which would change the definition of child abuse in Texas family code to include gender-affirming care.

Under Slaton’s bill, child abuse under state law would include “acts by a medical professional or mental health professional for the purpose of attempting to change or affirm a child’s perception of the child’s sex, if that perception is inconsistent with the child’s biological sex as determined by the child's sex organs, chromosomes, and endogenous hormone profiles."

This would prohibit medical professionals from “performing surgery that sterilizes the child.” That includes castration, vasectomies, hysterectomies, oophorectomies and other procedures. The bill would also ban administration of puberty-blocking medication. All of this would be barred, unless a child has “external biological sex characteristics that are irresolvably ambiguous.”

"Today, I filed HB 42 in order to ban the barbaric practice of child gender-modification, and classify it as child abuse," Slaton wrote on social media last month. "This should have passed into law last session. Now is the time for the Tx House to step up and protect our children from these bogus medical practices."

“​​... some individuals who identify as [trans or gender diverse] may feel affirmed in their gender without pursuing medical or surgical interventions." – American Academy of Pediatrics

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Rep. Steve Toth, a Republican from The Woodlands, filed a similar bill, House Bill 41. But Toth’s would also include language that could affect insurance policies for physicians and healthcare providers who provide this care. Their insurance policies would not be allowed to include coverage for damages assessed against them.

Under Toth’s bill, healthcare professionals would be allowed to prescribe puberty blockers or suppressors only “for the purpose of normalizing puberty for a minor experiencing precocious puberty.” Exceptions are also provided for children born “with a medically verifiable genetic disorder of sex development,” according to the bill.

Toth also filed a similar bill, House Bill 122, which covers all the same ground but adds a criminal penalty. Healthcare providers who perform these procedures or prescribe these medications could be charged with second-degree felonies.

HB 122 has a companion bill in the Senate coauthored by Sens. Bob Hall, Donna Campbell and Charles Perry. Their companion bill, Senate Bill 250, would also include disciplinary action and revocation of healthcare professionals’ medical licenses and certificates.

There are also two identical bills filed in the House that would change the definition of sexually oriented business to include any place that hosts drag shows. House bills 643 and 708 were filed by representatives Jared Patterson of Frisco and Matt Shaheen of West Plano and far North Dallas, respectively.

Their bills define drag performances as any performance in which “a performer exhibits a gender identity that is different than the performer’s gender assigned at birth using clothing, makeup, or other physical markers and sings, lip syncs, dances, or otherwise performs before an audience for entertainment.”

Any place that puts on a drag show for an audience of two or more people would be considered a sexually oriented business under these two bills.

"I filed HB 643 so that any business allowing a drag show must be classified as a sexually oriented business and if kids are permitted that there will be consequences," Patterson wrote on Twitter after filing his bill. "You’re living in bizzaroworld if you think it’s family friendly to stuff dollars into the g string of a grown man."

Then, there’s Senate Concurrent Resolution 3, which was authored by Hall and co-signed by Campbell. SCR 3 would essentially label gender-affirming care as bad all around in the eyes of the state, even though organizations such as the American Academy of Pediatrics, the American Medical Association and the Children’s Hospital Association all support it. The resolution calls gender-affirming care “an unconscionable misnomer for the abhorrent practice of genital mutilation and the administration of puberty blockers.”

The American Academy of Pediatrics supports gender-affirming care, which can include medication and surgery. It even notes there are risks associated with some of these practices and the long-term implications haven’t been studied extensively.

But it also defines gender-affirming care much more broadly than medication and surgery. “​​Gender affirmation is also used to acknowledge that some individuals who identify as [trans or gender diverse] may feel affirmed in their gender without pursuing medical or surgical interventions,” according to the academy.

The Senate resolution, however, doesn’t make any distinction. Hall didn’t respond to a request for comment Wednesday afternoon. Campbell’s chief of staff, Carry Smith, told the Observer the resolution has to do with gender-affirming care for minors. “She thinks it’s wrong for any adult to make that decision for a minor when there could be negative implications later in life,” Smith said. “As far as an adult’s decision, that’s a different story than it being a minor. We make it unlawful for minors to smoke and to drink because of the implications later in life and because they’re developing. Same goes here.”

Asked if Campbell felt the same about gender-affirming from a mental health standpoint (similar to what the American Academy of Pediatrics also describes as gender-affirming care) and how the resolution would affect this, Smith said “I’m not going to respond to that.”

The upcoming legislative session officially begins in January, and if any of these bills become law the earliest they could take effect is September 2023. 
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Jacob Vaughn, a former Brookhaven College journalism student, has written for the Observer since 2018, first as clubs editor. More recently, he's been in the news section as a staff writer covering City Hall, the Dallas Police Department and whatever else editors throw his way.
Contact: Jacob Vaughn

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