Dallas health care program for transgender kids formally dissolved after becoming target of conservative criticism

Protestors participate in a rally against anti-transgender legislation at the southern steps of the state capitol in April. (Evan L'Roy/The Texas Tribune, Evan L'Roy/The Texas Tribune)

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Less than two months ago, officials at Children’s Medical Center Dallas told a local website that their program offering mental health services and hormone treatments to transgender children was vital for young people with gender dysphoria.

Hospital officials said the care available through the program, which focuses on multi-level care for those children and is considered the first of its kind in the Southwest, helped reduce the “significant suffering and extraordinarily high suicide” rates among transgender kids.

Last week, the GENder Education and Care, Interdisciplinary Support program was formally dissolved.

Known as GENECIS, the program has been criticized in recent weeks by activists who have organized protests targeting hospital board members and accused the program of committing child abuse.

The activists’ allegations echo broad claims Republican Texas officials and political candidates have made this year about the gender-affirming health care that transgender children receive — assertions that medical experts say are false because doctors are not allowing children to go through with irreversible medical treatments.

The harassment experienced by healthcare providers “trying to uphold their Hippocratic oath to save lives” is “heartbreaking,” according to Ricardo Martinez, CEO of Equality Texas.

“Accessing healthcare can be a courageous act for many LGBTQ+ people because of how difficult it is to find providers who are knowledgeable about our needs and the poor treatment we have experienced by insurers and/or providers in the past,” Martinez said in a statement.

Officials at the children’s hospital and UT Southwestern Medical Center, which jointly operated the program, declined Friday to say what prompted them to stop GENECIS, other than to say it would benefit the patients and their families for privacy reasons. And they said in a statement Friday that current patients will continue to get the hormones and mental health treatments they were receiving before the program ended.

“Pediatric endocrinology, psychiatry and adolescent and young adult care coordinated through this program are now managed and coordinated through each specialty department,” the statement says. “We do not anticipate any interruption of care or services for our existing patients who already receive care with these specialty teams.”

Unlike the public fanfare that accompanied the program’s opening in 2015, last Friday’s closure of the program as it has operated came with no official announcement.

“The choice to remove branding for this care offers a more private, insulated experience for patients and their families,” the joint statement said.

References to the GENECIS program, which was under the umbrella of endocrinology at the children’s hospital, have been removed from the facility’s website.

Hospital officials said in the statement that new patients will be seen in “appropriate specialty departments” and offered mental health and counseling services.

“We accept new patients for diagnosis, including evaluation of gender dysphoria, but will not initiate patients on hormone or puberty suppression therapy for only this diagnosis,” the statement said.

Criticisms of the program came amid a wave of anti-transgender political sentiment in Texas. Lawmakers this year banned transgender student athletes from participating on the school sports teams that match their gender identity. That new law came after unsuccessful legislative attempts to ban treatments like those offered through GENECIS and define such health care as child abuse.

Medical experts have pushed back on those portrayals. Leading health care organizations in Texas have said gender-affirming care is the best way to provide care to transgender children. That includes the use of puberty blockers, a type of medical treatment that delays puberty and is completely reversible. Such treatment has been approved for children for decades.

Gov. Greg Abbott earlier this year directed the Texas Department of Family and Protective Services to determine whether some gender confirmation surgeries for transgender children are child abuse. But medical experts say the surgeries Abbott cited — orchiectomies, hysterectomies and mastectomies — rarely, if ever, are part of gender affirming care for transgender children.

That request came after former state Sen. Don Huffines, who will challenge Abbott in next year’s Republican primary, criticized the governor for not doing enough to protect Texas children from “mutilation.”

GENECIS served families through referrals from psychologists, pediatricians and other providers as well as from families contacting them directly.

The clinic offered hormone replacement therapy to older children after a rigorous screening process, but also counseling and mental health services that involved no medical intervention.

The clinic did not offer surgical options, or gender confirmation surgery for either children or adults.

Several employees and program leaders contacted by the Texas Tribune did not return requests for comment.

In September, hospital officials told The Dallas Express in an email that the program was needed in the community.

“With a suicide attempt rate of up to 41% for children and adolescents with gender dysphoria, there is a need for comprehensive care for these youth,” the email was quoted as saying. “Given the significant suffering and extraordinarily high suicide rate in these children, offering a comprehensive, multidisciplinary approach is needed to help treat this medical problem.”

Areana Quiñones, executive director for the Texas nonprofit organization Doctors For Change, has defined gender-affirming care as judgment-free, individualized care oriented toward understanding and appreciating a person’s gender.

Providers often work with counselors and family members to ensure they have everything they need to navigate the health care system.

Under the gender-affirming model of care, more time is spent allowing kids to socially transition instead of focusing on medical treatment. A social transition consists of the steps a child takes to affirm their identity. An example could include allowing a child assigned male at birth to wear clothing, grow their hair or use a different name that better fits their identity.

Sometimes, more medical support is needed for the child. Puberty or hormone blockers are used to give a transgender kid time before deciding what permanent transition-related treatment they want.

The rate of suicide attempts among transgender youth is three times higher than among their cisgender counterparts, according to recent studies by the U.S. Centers for Disease Control and Prevention.

LGBTQ advocates have said the mere specter that several of the GOP measures pushed in the Legislature this year could become law did mental health damage to transgender people. Throughout multiple legislative sessions this year, transgender Texans, parents and advocates spent late nights and early mornings fervently testifying, holding rallies and lobbying legislators.

Staff writer James Pollard contributed to this report.

Disclosure: Equality Texas and UT Southwestern Medical Center have been financial supporters of The Texas Tribune, a nonprofit, nonpartisan news organization that is funded in part by donations from members, foundations and corporate sponsors. Financial supporters play no role in the Tribune's journalism. Find a complete list of them here.