This week, the attorney general of the US state of Texas took the extreme position that gender-affirming health care for children should be criminalized as a form of child abuse. Texas Governor Greg Abbott subsequently ordered state agencies to investigate parents whose children are receiving gender-affirming health care and threatened punishment for professionals who fail to report it.
The officials’ positions are not binding legislation; rather, they are interpretations of existing law.
Still, the predictable consequence will be to demonize parents who support their transgender children, deter professionals from providing care, and cruelly discriminate against transgender children. The pronouncements are also likely to divert time and attention away from actual cases of child abuse and unjustifiably strain a foster care system already in crisis, putting other children and families across Texas at risk.
This draconian approach jeopardizes human rights and the provision of medically necessary care, and threatens transgender children and the supportive adults in their lives.
Criminalizing gender-affirming care is an extreme example, but it is part of a larger assault on the rights of transgender children in the United States. Arkansas enacted a ban on gender-affirming care last year, overriding a veto by Governor Asa Hutchinson, who criticized it as “vast government overreach.” The law was swiftly blocked by a federal court. Nevertheless, similar bans have been proposed this year in at least seventeen states.
Proponents of these bills regularly exaggerate the frequency of surgical interventions on children, obscuring the fact that these are not currently recommended for children under prevailing standards of care. They have used these misrepresentations to target a wide range of medically indicated interventions that many young people do need and use.
Access to gender-affirming health care is crucial for many transgender youth. Some take medication to delay the onset of puberty, for example, to pause physical changes that may be difficult to reverse if they transition later in life.
These interventions can be vitally important for transgender young people’s physical and mental health. For that reason, the American Medical Association, American Academy of Pediatrics, and other professional organizations have condemned attacks on gender-affirming care.
Freedom from discrimination and access to health care are human rights. Lawmakers should be focused on creating systems for young transgender people to navigate their identity with safety and support, not threatening to take them from their parents or put supportive adults in jail.
