Texas Governor Greg Abbott has ordered the state's agencies to investigate gender-affirming care for transgender children, arguing that such services constitute a form of "child abuse."
"I hereby direct [the Texas Department of Family and Protective Services] to conduct a prompt and thorough investigation of any reported instances of these abusive procedures in the State of Texas," Abbott wrote in a letter to the agency on Tuesday.
The letter cited opinion written on Monday by Texas Attorney General Ken Paxton, who argued that a new interpretation of state law makes gender-affirming care – including sexual reassignment surgery, puberty blockers, and hormone replacement therapy – outright illegal.
"There is no doubt that these procedures are 'abuse' under Texas law, and thus must be halted," Paxton said earlier this week. "The Texas Department of Family and Protective Services has a responsibility to act accordingly. I'll do everything I can to protect those who take advantage of and harm young Texans."
On top of criminalizing the practice of gender-affirming care, Abbott's letter also notes that state law "provides criminal penalties for failure to report such child abuse," suggesting that any doctors, teachers, or nurses who fail to report a "reasonable cause" to believe a child is getting gender-care will be prosecuted.
The precise implications of Abbott's directive remain unclear at this point. But a spokesperson for the state's Department of Family and Protective Services told The Dallas Morning News that the agency "will follow Texas law as explained [by Paxton's opinion]," adding: "At this time, there are no pending investigations of child abuse involving the procedures described in that opinion."
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Randall Erben, a professor at the University of Texas School of Law, told the outlet that the now-illegal use of gender-affirming might be adjudicated by a judge on a case-by-case basis.
"It's up to the judge. You could find a judge that may interpret that provision of the family code the same way that Paxton does," Erben said. "It could play out in any number of ways … It certainly sets up an uncertain future for things of this nature."
Paxton's missive marks the second legal attack waged against the state's trans youth in recent months, as the Washington Post noted. Back in October, Abbott signed a bill prohibiting trans girls from participating in female sports teams in public schools.
In general, gender-affirming care has been shown to vastly improve the mental health of trans youth, a point Dr. Juanita Kay Hodax, Interim Clinical Director at Seattle Children's Hospital, affirmed with Salon back in October.
Most of the time, she said, "the patient has been talking to family members about gender for at least several months, if not, a year," Hodax said. "During the clinic appointments, we spend a lot of time discussing the benefits and risks of the medications that we're using. We talk a lot with patients about their goals."
According to the Dallas Morning News, both the Texas Pediatric Society and Texas Medical Association urged Paxton not to criminalize gender-affirming care.
Ricardo Martinez, CEO of the LGBTQ rights group Equality Texas, told the outlet that the Abbott and Paxton's moves are "campaign stunts disguised as legal opinions," largely because the governor and attorney general face primary challengers in 2022.