“Gender-affirming care for transgender youth is essential and can be life-saving,” Admiral Rachel Levine, deputy secretary of health for the Department of Health and Human Services and the Biden administration’s top pediatrician, said in an emailed statement. “Our nation’s leading pediatricians support evidence-based, gender-affirming care for transgender youth.”
A growing number of transgender adolescents have sought medical treatments in recent years. According to the Centers for Disease Control and Prevention, transgender teens are at high risk of committing suicide. Preliminary research has suggested that adolescents receiving such medical treatments have improved mental health. Long-term studies are underway.
Marissa Gonzales, a spokeswoman for the Texas Department of Family and Protective Services, said there were no ongoing child abuse investigations involving the described procedures, but the agency would investigate the reported cases.
Whether children can be taken from their parents to allow them to receive such medical care will ultimately be at the discretion of the courts.
“At this point, it’s unclear what child protection services, prosecutors and judges are going to do with this non-binding attorney general’s advice,” Kate Murphy, senior child protection policy officer at Texans Care for Children, a nonprofit children’s policy group, said in a statement by email. “What is clear is that politicians should not tear loving families apart — and send their children into the foster care system — when parents provide recommended medical care that they believe is in their child’s best interest.”
If local attorneys don’t prosecute cases, the attorney general’s office could do, said Mr. Menefee, the Harris County attorney, added that the position of the governor and attorney general could have a chilling effect. “It’s designed to scare parents,” he said. “It’s designed to scare doctors into even enabling gender-affirming health care.”
Some treatments used in gender-based care carry medical risks. Drugs that block puberty, which suppress testosterone and estrogen production, can weaken bone development, although there is some evidence that it recovers once puberty begins. If blockers are used early in puberty and a teen is on hormone therapy, the drug regimens can lead to fertility loss. Transgender health care standards therefore recommend that patients and their families be advised on how to preserve fertility by delaying the use of blockers if having children is important to them. The standards also recommend that doctors and families wait until the teen is of age, which is 18 in Texas, before undergoing irreversible genital surgery.