Texas lawmakers vote to ban gender-affirming care for trans children

© Mikala Compton/AP Rep. Dade Phelan (R-Beaumont) takes the final vote for Senate Bill 14 in the Texas House of Representatives on Friday.

The Republican-majority Texas legislature passed a bill to ban health-care professionals from providing gender-transitioning treatment such as sterilization or puberty-suppressing drugs to children, sending it to Gov. Greg Abbott (R) for final approval.

If Abbott signs the bill, he will make Texas the most populous state to ban gender-affirming care for minors. At least 18 states ban gender-affirming medication or surgical care for transgender youths, according to the Movement Advancement Project, a Colorado-based nonprofit think tank that advocates for LGBTQ rights. Alabama, Florida, Idaho, North Dakota and Oklahoma have made it a felony to provide gender care.

Texas’s Senate Bill 14 threatens to take away the licenses of violating health-care providers but has some exceptions. Children who are already receiving treatment for gender transition or dysphoria may continue to receive care. But those children must “wean off” any drugs they are taking, and they will not be legally able to begin a new course of treatment.

Under the bill, banned procedures for the purpose of gender reassignment include mastectomies — the removal of breast tissue — and surgeries that would sterilize the child, as well as drugs that “induce transient or permanent infertility.”

Physicians have repeatedly objected to legislation impeding access to gender-affirming care. In 2021, six health-care associations, including the American Academy of Pediatrics, said they are “strongly opposed to any legislation or regulation that would interfere with the provision of evidence-based patient care for any patient.” This means “gender-diverse individuals” must receive gender-affirming care, they said. Doctors generally advise waiting until a child reaches puberty before taking puberty blockers or hormone treatments, The Washington Post has reported.

A family's fight against anti-trans bills in Texas

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A majority of Americans oppose puberty-blocking medications and hormonal treatments for trans children, according to a Washington Post-KFF poll. The survey was conducted in November and December, before state lawmakers introduced more than 400 anti-trans bills this year.

Abbott’s office could not be reached late Wednesday. The Texas governor has previously ordered state officials to investigate instances of “so-called ‘sex-change’ procedures,” saying the acts constitute child abuse under Texas law. (Medical professionals have challenged the science behind the Abbott administration’s logic.)

Two years ago, Abbott signed a bill banning transgender girls from playing female sports in public schools.

On the same day as the trans-care vote, the Texas House also voted for Senate Bill 15, which would require college athletes to compete on teams that align with their sex assigned at birth.