Gender-affirming medical treatment for transgender kids would be considered child abuse under Texas Senate bill

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The Texas Senate tentatively approved a bill Monday in an 18-13 vote that would classify providing gender-affirming health care to transgender minors as child abuse — just one of the Legislature’s many attempts to prevent transgender children from transitioning before their 18th birthday.

Senate Bill 1646 is among several other bills that advocacy groups say erode the rights of transgender Texans. Authored by Lubbock Republican Sen. Charles Perry, it amends the definition of abuse under the Texas Family Code to include administering or consenting to a child’s use of puberty suppression treatment, hormones or surgery for the purpose of gender transitioning.

But it’s unclear what the legislation’s chances are in the House, where another major bill targeting transgender children appears to have stalled.

In a Senate committee hearing, SB 1646 attracted over four-and-a-half hours of public testimony from LGBTQ Texans, their parents and several state and national medical associations opposing the bill’s intrusion into intimate medical decisions. Social workers also testified the bill could put more transgender children into the foster care system, where they face elevated rates of suicide and depression.

Perry argued in the floor debate that the bill was necessary to prevent children from making irreversible decisions that they may regret later, but experts say both of those claims are questionable.

According to Marjan Linnell, a general pediatrician, puberty suppression treatments are completely reversible and have been used for decades to delay early-onset puberty. While other treatments such as hormones and surgery may cause irreversible changes, Linnell said the risks are discussed extensively with children and their parents before the procedures, which is typically only performed after puberty.

Research also shows that children typically solidify their gender identity around age 6 to 7, according to past Texas Psychological Association President Megan Mooney. In committee hearings and floor debates, legislators and invited experts claimed the many transgender children ceased to experience gender dysphoria later in life. However, many of the studies they cited have been widely critiqued for casting wide nets for participants that often include children who may act gender non-confirming — for example, Linnell explained, a young girl who enjoys playing with trucks — but do not identify as transgender.

A 2021 study by the Fenway Institute and Massachusetts General Hospital found that only 13.1% of transgender people have de-transitioned at some point, and 82.5% of those cases were caused by external pressure and stigma related to being transgender rather than regretting their transition.