Gender-affirming medical treatment for transgender kids would be considered child abuse under Texas Senate bill

[Leroy N. Soetoro]

https://www.texastribune.org/2021/04/27/texas-senate-transgender-child-
abuse/

The upper chamber Wednesday passed Senate Bill 1646, which is among
several other bills that advocacy groups say erode the rights of
transgender Texans. But it’s unclear what the legislation’s chances are in
the House.

The Texas Senate passed a bill Tuesday in an 18-12 vote that would
classify providing gender affirming health care to transgender minors as
child abuse — just one of the Legislature’s many attempts to prevent
transgender children from transitioning before their 18th birthday.

Senate Bill 1646 is among several other bills that advocacy groups say
erode the rights of transgender Texans. Authored by Lubbock Republican
Sen. Charles Perry, it amends the definition of abuse under Texas Family
Code to include administering or consenting to a child’s use of puberty
suppression treatment, hormones or surgery for the purpose of gender
transitioning.

But it’s unclear what the legislation’s chances are in the House, where
another major bill targeting transgender children appears to have stalled.

In a Senate committee hearing, SB 1646 attracted over four-and-a-half
hours of public testimony from LGBTQ Texans, their parents and several
state and national medical associations opposing the bill’s intrusion into
intimate medical decisions. Social workers also testified the bill could
put more transgender children into the foster care system, where they face
elevated rates of suicide and depression.

Perry argued in floor debate that the bill was necessary to prevent
children from making irreversible decisions that they may regret later,
but experts say both parts of that claim are questionable.

According to Marjan Linnell, a general pediatrician, puberty suppression
treatments are completely reversible and have been used for decades to
delay early onset puberty. While other treatments such as hormones and
surgery may cause irreversible changes, Linnell said the risks are
discussed extensively with children and their parents before the
procedures, which is typically only performed after puberty.

Research also shows that children typically solidify their gender identity
around age 6 to 7, according to past Texas Psychological Association
President Megan Mooney. In committee hearing and floor debate, legislators
and invited experts claimed the many transgender children ceased to
experience gender dysphoria later in life. However, many of the studies
they cited have been widely critiqued for casting wide nets for
participants that often include children who may act gender non-confirming
— for example, Linnell explained, a young girl who enjoys playing with
trucks — but do not identify as transgender.

A 2021 study by the Fenway Institute and Massachusetts General Hospital
found that only 13.1% of transgender people have detransitioned at some
point, and 82.5% of those cases were caused by external pressure and
stigma related to being transgender rather than regretting their
transition.

Perry rebuffed criticism of the data and asserted that he could not "in
good conscience" allow families to make the decision to medically
transition their children.

"As well intended as our medical profession is, and the folks that get
tied up in these conversations and discussions and things, they have
decided that they're smarter than our Creator," he said on the floor.

But Maya Stanton, a 10-year-old transgender Texan, previously told the
State Affairs committee that she felt being transgender was a purposeful
act of God.

"I used to say, 'I think God made a mistake and put me in the wrong
body,'" she testified. "But now I realize God put me in this body for a
reason, which was to teach people like you about diversity, tolerance and
how people can be different."

In a similar vote earlier this month, the Senate passed Senate Bill 29,
legislation that would force transgender students to participate in school
sports based on the sex originally labeled on their birth certificate.

That bill has been sitting in a House committee since the Chair Harold
Dutton, D-Houston, told the Houston Chronicle its identical House
companion bill likely didn’t have the votes to make it to the full lower
chamber.

Angela Hale, senior adviser for Equality Texas, is glad that House
committee doesn’t support the bill and said that the conversation about
restricting transgender Texans’ rights should have been left in 2017 with
the death of that year’s so-called “bathroom bill,” which would have
restricted public restrooms transgender Texans could use.

“We ask the legislature, and especially leaders in the Texas House, to
once again reject this and all unnecessary and harmful legislation and
focus on issues that unite us as Texans,” Hale said.

In the Senate, both the floor vote and committee vote on SB 29 were split
directly down party lines, with every Republican voting for and every
Democrat voting against. In both cases, Republican majorities pushed the
bill forward despite backlash from LGBTQ Texans and business leaders.

But once the bill reached the house, Speaker Dade Phelan, a Beaumont
Republican, assigned the Senate bill to the Public Education Committee
instead, where its House companion had been sitting since the end of
March. The day after SB 29 was assigned to the committee, House Bill 4042
was heard by the committee’s six Democrats and seven Republicans.

If the House bill had gone through the State Affairs committee like its
Senate equivalent, it would have faced a 8-4 Republican majority. Instead,
it went before what Houston Republican Rep. Dan Huberty, who was arrested
on suspicion of driving while intoxicated Saturday, called “the most
bipartisan committee we have in the Texas House” during the hearing.

However, Phelan, who assigns bills to committees, may have difficulties
making the same maneuvers for other bills, like SB 1646.

The Speaker did not return a request for comment, but previously told
Texas Tribune CEO Evan Smith in a podcast interview last session that he
didn’t support bills “bashing” LGBTQ Texans.

“It’s completely unacceptable,” he said at the time. “This is 2019.”

Last week, the House Public Health committee, made up of six Republicans
and five Democrats, narrowly passed a bill that would ban children from
receiving gender affirming medical care, such as puberty suppression
treatments or hormones. That bill hasn’t yet come up on the House floor.

Opposition to the sports ban also didn’t pertain entirely to how it would
affect transgender students. Huberty pointed out in committee hearing that
the bill is nearly identical to current University Interscholastic League
rules.

“I’m trying to figure out why we continue to pass bills that we don’t need
bills for,” he said in the hearing.

Even if the bills pass through committee and floor votes in each house,
they’ll still need to be signed by Gov. Greg Abbott to become law. Kansas
Gov. Laura Kelly vetoed legislation that would ban transgender women from
school sports, and Arkansas Gov. Asa Hutchinson vetoed another piece of
legislation that would ban gender affirming medical care for transgender
youth. Hutchinson’s veto was later overturned by the Arkansas legislature.

Two days before the Senate's vote, the American Medical Association sent a
letter to the National Governors Association — of which Abbott is a member
— urging state governors to reject legislation prohibiting gender
affirming health care, calling it "a dangerous intrusion into the practice
of medicine" that would "force physicians to disregard clinical
guidelines."

"Every major medical association in the United States recognizes the
medical necessity of transition-related care for improving the physical
and mental health of transgender people," the letter read. "We believe it
is inappropriate and harmful for any state to legislatively dictate that
certain transition-related services are never appropriate and limit the
range of options physicians and families may consider when making
decisions for pediatric patients."

Abbott did not return a request for comment, but told Fox News's Laura
Ingraham on Thursday that he would sign SB 29.

In 2017, Abbott placed a controversial “bathroom bill” on his legislative
priorities for the session which would restrict transgender Texans’ access
to public bathrooms. That bill died before reaching the House floor. But
in 2018, a Republican state legislator alleged that Abbott may not have
supported the bill after all, saying he “did not want that bill on his
desk.”

Yet Abbott in 2019 also gave credence to a father’s claim that his ex-wife
was committing child abuse by supporting their child’s gender transition.
In a 2019 tweet, Abbott said the issue would be looked into by the Texas
Attorney General’s Office and the Texas Department of Family and
Protective Services.

In response to the case, State Rep. Steve Toth, R-The Woodlands, said in a
since-deleted tweet “the 1st bill I file in the 87th [legislative session]
will add ‘Transitioning of a Minor’ as Child Abuse.” Toth is the author of
House Bill 2693, legislation that would mandate the Texas Medical Board to
revoke the medical license of any physician or health care provider who
performs or prescribes gender affirming medical care. That bill has been
sitting in the House Public Health Committee since March 17 and has yet to
receive a hearing.

Before the vote on SB 1646, Sen. John Whitmire, D-Houston, told
transgender Texans not to give up hope, saying the issue could be taken up
in court, "maybe all the way to the Supreme Court." Earlier this month,
the ACLU of Arkansas vowed to challenge Arkansas's ban in court. Brian
Klosterboer, a staff attorney for the ACLU of Texas, testified to the
State Affairs committee that the same could happen in Texas if the bill
becomes law.



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