We’re living in a bully moment, and Texas Gov. Greg Abbott just doubled down.
The governor wrote a letter Tuesday to the Texas Department of Family and Protective Services calling on authorities to classify and investigate gender-affirming medical care for transgender youth as child abuse.
“Because the Texas Department of Family and Protective Services (DFPS) is responsible for protecting children from abuse,” he wrote, “I hereby direct your agency to conduct a prompt and thorough investigation of any reported incidents of these abusive procedures in the State of Texas.”
Doctors, nurses, teachers and other licensed professionals who witness youth receiving gender-affirming care and don’t report it to authorities are subject to criminal penalties, the letter states.
“Texas law also imposes a duty on DFPS to investigate the parents of a child who is subjected to these abusive gender-transitioning procedures,” Abbott writes, “and on other state agencies to investigate licensed facilities where such procedures may occur.”
The medical care Abbott is targeting, including puberty-blocking drugs and hormone treatments, have been researched and endorsed by numerous major medical groups. The American Academy of Pediatrics released a policy statement in 2018 promoting acceptance and affirmation of transgender children.
“As pediatricians, we base all of our medical decisions around evidence-based guidelines in regards to gender,” said Kathryn Lowe, who serves on the AAP Section on Lesbian, Gay, Bisexual, Transgender Health and Wellness Executive Committee.
“When it comes to providing gender-affirming health care, the model we follow is a model oriented toward understanding and appreciating each individual youth’s experience with gender. Our approach stresses working together with parents, caregivers, mental health professionals, social support services — it’s really a collaborative approach.”
But Abbott’s move has nothing to do with evidence. Or understanding. Or collaboration.
Or children’s safety, for that matter. If it did, Abbott would consider the fact that transgender youth are already at a perilously high risk for suicide and depression before he worked to criminalize their health care.
“Even this discussion, that someone could be reported for child abuse, is already doing incredible harm to many youth and their families and their providers,” Lowe told me.
“It scares me to know this is even being talked about. It scares me that there’s going to be even greater levels of anxiety and depression and suicide. We have a lot of research showing that youth who are able to get the affirming medical care they need do a lot better.”
The push to criminalize their medical care follows a long line of attempts to stigmatize and dehumanize and transgender youth. The AAP, to its great credit, keeps rising to bat them back. In 2021, in response to a rash of bills aiming to keep transgender youth from competing in sports, the AAP released a statement, written by then-President Lee Savio Beers, condemning attempts to further marginalize a group of children.
“The American Academy of Pediatrics recommends that youth who identify as transgender have access to comprehensive, gender-affirming, and developmentally appropriate health care that is provided in a safe and inclusive clinical space,” the 2021 statement read. “We also recommend that playing on sports teams helps youth develop self-esteem, correlates positively with overall mental health, and appears to have a protective effect against suicide.”
“Politics has no place here,” the statement continued. “Transgender children, like all children, just want to belong. We will fight state by state, in the courts and on the national stage to make sure they know they do.”
But politics have a way of worming themselves into our most sacred spaces.
And Abbott’s move is a cynical exploitation of this particular moment in time — when scientific research and evidence are shouted down by zealots, when medical experts are maligned and ignored, when dogma trumps facts, when the threat of prosecution is wielded to control what books educators teach, which parts of history educators acknowledge, and how much of their students’ identity educators can discuss and affirm.
In 2019, it’s worth noting, Abbott vetoed a bill requiring children under 2 to ride in a rear-facing car seat, calling it “an unnecessary invasion of parental rights and an unfortunate example of over-criminalization.”
Oh, the irony. At the expense of our humanity.
I called Lowe because I wanted to make sure the voices of the experts in this field — the field of medical care for children — were elevated in the discourse around Texas. I wanted to know where the research, not the rhetoric, points us. She ended our interview with a simple plea.
“As a pediatrician, I always like to keep the child or the youth at the center of everything we do,” she said.
“I think If we can all focus on the kids here and keep them at the center of the actions we take and decisions we make, that can help us come together and help our kids thrive.”
It’s a beautiful North Star. I hope it’s not obscured in this climate of fear-mongering and bullying.
