Medicine

Texas Classifies Medical Treatment of Trans Minors as Abuse, Threatens Parents, Orders Caregivers To Snitch

These orders aren’t about safety. They’re a complete rejection of the legitimacy of these procedures, and a denial of individual liberty.

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Texas Republican Attorney General Ken Paxton has declared all medical treatment of transgender minors to be child abuse and says that his office could prosecute parents of transgender children, as well as "mandatory reporters" who fail to report medical treatment of transgender children to the state. In tandem, Republican Gov. Greg Abbott has urged state officials to begin investigating any families that may be giving their trans kids puberty-blocking drugs or hormones, or allowing them to undergo surgical treatments.

In a 13-page memo dated Feb. 18, written in response to a query from state Rep. Matt Krause (R–Fort Worth), Paxton wrote that, based on his office's analysis, any sort of medical treatment of a trans minor, be it sex-changing surgery or puberty-blocking drugs, could constitute child abuse under Texas law.

Paxton's argues that helping a child transition can cause them physical and psychological damage and that it deprives the child of the "right to procreation." Essentially, Paxton is borrowing from the argument against forced sterilization, which he references, as an argument against voluntary trans medical treatment.

However, no one believes that any child—or adult—should be exposed to these treatments against their own wishes. To the extent that minors in Texas are receiving medical treatment for trans issues, it is likely because they requested it. Meanwhile, physicians in the U.S. are largely aligned behind the idea that sex reassignment surgery should not take place until a patient is 18.

But Paxton's policy announcement is not meant to prevent surgeries that mostly are not happening. He's also going after the use of puberty-blocking drugs and hormone treatments, which do begin when transgender patients are still minors, and the effects are more easily reversed. Drug therapy is not equivalent to surgery, and it appears Paxton has lumped them together in order to confuse the issue and undermine the legitimacy of any kind of transgender health care.

Paxton's tweet about his memo gives up the game: "These procedures are monstrous and tragic." That's not a statement that means "Some parents and children may be rushing into medical treatment, some of which is hard or impossible to reverse." It is a rejection of transgender medical care entirely, as further evidenced by the memo's concession that some types of genital surgery are "medically necessary" when they correct genetic disorders or cancer.

The big threat comes at the end of the memo:

It is important to note that anyone who has "a reasonable cause to believe that a child's physical or mental health or welfare has been adversely affected by abuse or neglect by any person shall immediately make a report" as described in the Family Code. … [This] includes teachers, nurses, doctors, day-care employees, employees of a clinic or health care facility that provides reproductive services, juvenile probation officers, and juvenile detention or correctional officers. A failure to report under these circumstances is a criminal offense.

This, apparently, is not just a friendly suggestion from the state's attorney general. On Tuesday Gov. Abbott sent a memo to the commissioners of the state's Department of Family and Protective Services summarizing Paxton's memo and ordering the agency to investigate any parents found providing transgender medical care to their children. He threatens criminal penalties for anybody who fails to report it to the government.

What about the rights of patients? And of parents? Paxton's memo argues that the Texas "Legislature has not provided any avenue for parental consent, and no judicial avenue exists for the child to proceed with these procedures and treatments without parental consent."

Apparently, it's impossible to consent to your child receiving medical care without the Texas Legislature passing a new law. That's an interesting version of conservatism.