What is gender-affirming medical care for transgender children?

Major legislation targeting transgender Texans has been introduced in recent regular legislative and special sessions. In 2017, Abbott called a special session to, among other issues, pass a controversial bathroom bill that would have restricted which restrooms transgender Texans could use. The legislation ultimately failed in that special session after also failing in the preceding regular session.

Experts warn legislation like this demonizes transgender people, which can lead to them facing higher rates of violence and mental health issues.

“These kids already suffer from much higher rates of mental health concerns related to anxiety and the higher levels of suicidal ideation because of all the stress that they’re under,” said Kaplan, president of the Texas Pediatric Society. “And so these laws have the potential to just have a dramatic impact on these families.”

In 2019, Black transgender women like Muhlaysia Booker and Chynal Lindsey were killed in Dallas during a year that almost every transgender person murdered was a Black woman. Booker was found dead one month after being assaulted in a Dallas parking lot. When advocacy groups showed lawmakers pictures of Booker’s face, they stated every single lawmaker had a hard time looking at the photo.

“This was the first time legislators were faced with the reality of what was happening in a deeper way,” Emmett Schelling, Transgender Education Network of Texas’ executive director, said in a 2019 conversation about building trans political power. “In the midst of tragedy we were able to really make legislators understand the cost of the rhetoric and what our community was paying.”

Yet little more than a month after the conversation, Abbott and Paxton urged state agencies to investigate whether a mother supporting her 7-year-old child’s gender transition was committing “child abuse.” Jeffrey Younger, the child’s father, posted falsehoods on his blog about gender-affirming care, capturing outrage from Republican politicians like Abbott, Paxton and U.S. Sen. Ted Cruz. Younger is running as a Republican for Texas House District 63 in North Texas and is headed into a runoff with Ben Bumgarner in May.

Texas lawmakers promised to file legislation in response to the Younger case. Equality Texas CEO Ricardo Martinez said midway through the 2021 legislative session that Texas filed more anti-LGBTQ bills during that session than any other state legislature. That includes House Bill 25, which requires that student athletes play on sports teams that correspond to the sex listed on their birth certificate, and the certificate athletes present must have been issued near the time of birth. The law went into effect in January, making Texas the 10th state in the U.S. to enact similar legislation.

According to bill tracker Freedom For All Americans, only Tennessee matched the amount of anti-transgender legislation introduced in Texas. In July 2021, a federal court in Arkansas blocked a law criminalizing gender-affirming care from going into effect. Seventeen state attorneys general — including Paxton — had filed a brief in support of the law.

Krause and state Sen. Charles Perry, Republicans who championed some of the bills targeting transgender children in 2021, did not respond to the Tribune’s request for comment. Abbott also did not respond.