Texas Supreme Court upholds ban on gender-affirming care for trans minors

Austin, Texas — The Texas Supreme Court on Friday upheld the state’s ban on gender-affirming care for minors, rejecting parents’ pleas that it violates their right to seek medical care for their transgender children.

The all-Republican court’s 8-1 ruling leaves in place a law that has been in effect since September 1, 2023. Texas is the largest of at least 25 states that have adopted laws restricting or prohibiting gender-affirming medical care for transgender minors.

Most of these states face lawsuits, and the U.S. Supreme Court recently agreed to listen a call from the Biden administration that seeks to block state bans on gender-affirming care. The case before the high court involves a Tennessee law that restricts puberty blockers and hormone therapy to transgender minors, similar to the Texas law.

Texas law prevents transgender minors from accessing hormone therapies, puberty blockers and transition surgeries, even though medical experts say such surgical procedures are rarely performed on children. Children who had already started the now-banned medications had to be weaned in a “medically appropriate” way.

“We conclude that the Legislature made a permissible and rational policy choice to limit the types of medical procedures available to children, particularly in light of the relative birth of gender dysphoria and its various modes of treatment and the Legislature’s express constitutional authority to regulate the practice of medicine”, said the decision.

The lawsuit challenging the Texas law argued that it has devastating consequences for transgender teens who are unable to get the critical treatment recommended by their doctors and parents.

A lower court found the law unconstitutional, but it was allowed to go into effect while the state Supreme Court considered the case.

Restrictions on healthcare are part of a greater clearance against transgender rights, addressing everything from bathroom access to participation in sports.

As more states move to impose restrictions on health care, families of transgender youth are increasingly forced to travel out of state for the care they need in clinics with growing waiting lists. At least 13 states have laws that protect the care of transgender minors.

More than 89,000 transgender people ages 13 to 17 live in states that limit their access to gender-affirming care, according to a research letter published in July 2023 in the Journal of the American Medical Association, although not all trans people choose or can afford gender-affirming care.

Gender-affirming care for young people is supported by leading medical organizations, including the American Medical Association, the American Academy of Pediatrics, the American Psychiatric Association, and the Endocrine Society.

Medical professionals define gender dysphoria as psychological distress experienced by those whose gender expression does not match their gender identity. Opponents of gender-affirming care say there is no solid evidence of the purported benefits and say children should not make life-altering decisions they may later regret.

Texas officials defended the law as necessary to protect children and noted a myriad of other restrictions for minors regarding tattoos, alcohol, tobacco and certain over-the-counter medications.

Several doctors who treat transgender children testified at a trial hearing that patients are at risk of deteriorating mental health, which could lead to suicide, if they are denied safe and effective treatment.

The Texas ban was signed into law by Republican Governor Greg Abbott, who was the first governor to order the investigation of the families of transgender minors receiving gender-affirming care

During legislative debate over the ban in 2023, transgender rights activists disrupted the Texas House with protests from the chamber’s gallery, prompting state police to force protesters out of the building.

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DeMillo reported from Little Rock, Arkansas.