Texas Supreme Court Upholds Prohibition of Gender-Affirming Care for Transgender Minors

The Texas Supreme Court upheld the state’s prohibition of gender-affirming care for minors on Friday, dismissing arguments from parents that it infringes upon their right to seek medical treatment for their transgender children.

In an 8-1 decision by the all-Republican court, the ruling maintains a law enacted since September 1, 2023. Texas joins over 25 other states with similar laws restricting or banning gender-affirming medical procedures for transgender minors, many of which are facing legal challenges. Recently, the U.S. Supreme Court agreed to review an appeal by the Biden administration regarding state bans on such care, focusing on a Tennessee law comparable to Texas’.

The Texas law specifically bars transgender minors from accessing hormone therapies, puberty blockers, and transition surgeries, despite medical consensus that such surgical procedures are rarely performed on children. Children already undergoing banned treatments must be gradually weaned off in a medically appropriate manner.

In its ruling, the Texas Supreme Court justified the law as a valid policy choice by the Legislature, citing concerns about the early stage of understanding around gender dysphoria and its treatments, alongside the Legislature’s authority to regulate medical practice.

Critics, including those who challenged the law in court, argue it severely impacts transgender teenagers who are denied critical treatments recommended by their healthcare providers and families. A lower court previously deemed the law unconstitutional but allowed it to remain in effect pending appeal to the state Supreme Court.

The restrictions on healthcare access are part of a broader wave of challenges to transgender rights, encompassing issues from restroom use to sports participation. As more states implement such restrictions, families of transgender minors increasingly face the need to travel out of state for necessary care, often encountering long waiting lists at clinics. At least 13 states have laws safeguarding access to gender-affirming care for minors.

According to research published in the Journal of the American Medical Association, over 89,000 transgender individuals aged 13 to 17 reside in states with limited access to gender-affirming care. Despite varied preferences and financial constraints, gender-affirming care for youths is endorsed by major medical bodies such as the American Medical Association, the American Academy of Pediatrics, the American Psychiatric Association, and the Endocrine Society.

Medical experts define gender dysphoria as the psychological distress resulting from a misalignment between one’s gender identity and expression. Opponents of gender-affirming care argue against its benefits and caution against minors making irreversible decisions.

Texas officials defend the law as crucial for safeguarding children, citing comparable restrictions on minors for tattoos, alcohol, tobacco, and certain medications. During legislative debates in 2023, protests by transgender rights activists disrupted Texas House proceedings, prompting law enforcement to remove demonstrators from the chamber gallery.

The Texas ban, signed by Republican Governor Greg Abbott, includes provisions for investigating families of transgender minors receiving gender-affirming care.

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