DALLAS — The Texas Department of Family and Protective Services has begun investigating parents of transgender adolescents seeking gender-affirming medical care for potential child abuse, according to a lawsuit filed Tuesday in Travis County court.
The investigations follow a directive from Gov. Greg Abbott to state agencies to investigate reports of transgender youth receiving gender-affirming care as child abuse. He warned that educators, medical professionals and others who don’t report alleged abuse could face consequences. The Dallas Morning News has reached out to Abbott’s office and is awaiting a response.
One day prior to Abbott’s order, Attorney General Ken Paxton released a nonbinding opinion that said certain types of medical care for trans adolescents — including hormone therapy and puberty blockers — are a form of child abuse.
Lambda Legal and the American Civil Liberties Union of Texas went to court in Travis County to try to halt an inquiry into a DFPS employee who has a 16-year-old transgender child.
The unnamed employee was put on administrative leave last week, according to the lawsuit. DFPS, which sent an investigator to visit the employee on Friday, is reportedly seeking medical records for the child, referred to as Mary Doe in the court filings.
Megan Mooney, a licensed psychologist in Houston who is considered a mandatory reporter under Texas law, joined the family as a plaintiff in the suit. Mooney cannot comply with Abbott’s directive without “harming her clients and violating her ethical obligations,” according to a statement from Lambda Legal.
Transgender youth and their families could face harm “when they’re subjected to an investigation that is completely baseless and unwarranted and could have really serious consequences,” Currey Cook, senior council for Lambda Legal, said in an interview.
“For this family, it means that they could ultimately have a finding of abuse or neglect against them, be put on the state registry — and that has serious implications for employment,” he said.
Abbott’s and Paxton’s orders do not change Texas law, so it’s unclear whether they will hold up in court.
The office of Travis County District Attorney José Garza confirmed that they will not take legal action against abuse allegations based on Paxton’s opinion. Dallas County District Attorney John Creuzot also said he will not prosecute families whose children receive gender-affirming care.
Reporting a situation regarding a trans adolescent’s gender-affirming medical care for abuse or neglect is still up to the discretion of social workers, said Alison Mohr Boleware, government relations director for the Texas chapter of the National Association of Social Workers.
The recent orders have heightened the sense of uncertainty for transgender youth and their families in Texas. Nearly 14,000 Texans between the ages 13 and 17 self-identified as transgender in 2017, according to a survey by the Williams Institute at UCLA. The total size of the Texas transgender community at that time, the survey showed, hovered around 125,000 people.
Republican politicians have increasingly put health care for transgender children under the spotlight. During the 2021 legislative session, Texas lawmakers tried unsuccessfully to change state law to ban certain medical treatments for minors experiencing gender dysphoria.
Gender dysphoria is the feeling of discomfort or distress that can occur in people who identify as a gender that is different from the gender or sex assigned at birth.
After this legislative failure, under pressure from Abbott, DFPS changed its definition of abuse to include transgender “reassignment surgery” for minors. Paxton’s recent opinion addressed surgical interventions and other nonsurgical treatments.
But surgery to treat gender dysphoria is not recommended until a patient has reached the legal age of maturity and lived continuously for at least a year in the gender role consistent with their gender identity, according to best practices set out by the World Professional Association for Transgender Health, or WPATH, the group that authors the standards of care for the health of gender-diverse people.
Best standards dictate that medical interventions like hormones should be explored only for youth who have experienced the onset of puberty and after undergoing mental health evaluation. For children who have not reached puberty, mental health care is the primary form of treatment for gender dysphoria.
The decision to redefine all treatment for minors experiencing gender dysphoria as “abuse” contradicts the advice of the largest and most established state and national medical groups.
The American Medical Association, American Psychiatric Association and American Academy of Pediatrics all support providing age appropriate, individualized care for children experiencing gender dysphoria. The Texas Pediatric Society and Texas Medical Association also both urged Paxton not to target transgender children’s access to these treatments, The News has learned.
“Targeting trans youth, their parents, and their health care providers for political gain is unconscionable. We strongly denounce this alarmist and misguided opinion which could obstruct access to medically necessary care,” WPATH said in a statement to The News.
Paxton’s opinion was also met with condemnation by LGBTQ rights groups. They accused Republican politicians who are duking it out in a competitive GOP primary seasons of using transgender Texans as punching bags.
Both Abbott and Paxton face primary opponents. The governor’s GOP challenger, former state Sen. Don Huffines, has repeatedly pressured Abbott to take a more aggressive stance against gender-affirming care for children.
“We urge all Texans to be skeptical about campaign stunts disguised as legal opinions from a corrupt politician who has no expertise in health care and who has built their career spreading disinformation about marginalized communities,” Ricardo Martinez, CEO of the LGBTQ rights group Equality Texas, said in a statement last week.
A group of more than 100 people protested Abbott and Paxton’s opinions at the Texas Capitol Tuesday, The Texas Tribune reported.
(Dallas Morning News staff writer Lauren McGaughy contributed to this report.)