Texas Senate resumes push to ban transition-related medical care for transgender children, days after bill failed in House

Ali Cross of the Austin Cheer squad waves a trans flag while her squad mates hold her up on the steps of the state Capitol at a rally against anti-trans legislation on April 28, 2021.

The Texas Senate on Monday quickly revived and advanced a bill banning gender-affirming health care for children under 18 days after a similar House bill failed to advance in the lower chamber.

Under Senate Bill 1311, any physician who prescribes hormone therapy or puberty suppression treatment for the purpose of gender transitioning would have their medical license revoked and could not be covered under liability insurance. It would also apply to doctors who perform transition-related surgeries for children, which is rarely used before puberty. The Senate gave the bill initial approval in a 17-13 vote. The bill still needs a final approval in the upper chamber before it can be considered by the House.

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LGBTQ advocates have decried the bill as unconstitutional and criticized its negative impact on mental health. In a Senate State Affairs committee hearing, transgender Texans and medical experts testified that access to gender confirmation care is key to reducing the elevated risks of suicide and depression among transgender Texans. Businesses leaders also singled out S.B. 1311 as a bill they say may scare workers and businesses away from Texas.

The bill’s author, Edgewood Republican Bob Hall, said its intent was to improve the mental health of Texans who may later come to regret their transition, citing statistics that many children may cease to experience gender dysphoria later in life.

However, experts have said those studies often include children who aren’t transgender, but just don’t conform to typical gender norms, such as a boy who plays with dolls.

In a 2021 study, the Fenway Institute and Massachusetts General Hospital found that only 13.1% of transgender people have detransitioned 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.

Later, Hall and the Senate at large rejected an amendment by Sen. José Menéndez, D-San Antonio, which could create an exception allowing children who have attempted suicide or experienced other severe mental health effects to receive treatment.

Hall also dodged questions about constitutionality, though Sen. Sarah Eckhardt, D-Austin, said on the floor that the bill had “an extremely high probability of being struck down as unconstitutional.”

Last week, Lambda Legal and the ACLU of Texas vowed to challenge in court House Bill 1399, the House’s version of the ban, if it passed. Though the bill later failed to meet a deadline in the House last week, Shelly Skeen, a senior attorney for Lambda Legal said the bills were “nearly identical” and presented similar legal issues.

Similar bills have been proposed by 19 other states and passed by one — Arkansas, according to the ACLU. The Texas Senate also previously passed Senate Bill 1646, a bill defining the transition-related medical care as child abuse. That bill is currently awaiting a hearing by the House Public Health committee, which voted in favor HB 1399 earlier this session. The Senate also passed Senate Bill 29, restricting transgender students’ participation in school sports.

While this is the Senate’s third vote on a bill concerning transgender children, the bills have yet to make an appearance on the House floor.

Last session, Beaumont Republican Dade Phelan who is now House Speaker told The Texas Tribune in a podcast interview that he was “done talking about bashing on the gay community.”

“It’s completely unacceptable,” he said at the time.

Phelan has not responded to a request for comment on the current legislation.

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For LGBTQ mental health support, call the Trevor Project’s 24/7 toll-free support line at 866-488-7386. You can also call the National Suicide Prevention Lifeline at 800-273-8255 or text 741741 from anywhere in the country to text with a trained crisis counselor. Read our mental health resource guide for more information.