Gender Reaffirming Care Is Not Child Abuse

Sadie Basila, Managing Forum Editor

On Feb. 22, Texas Governor Greg Abbott issued an order to the Texas Department of Family and Protective Services (DFPS) to begin investigating “child abuse” in the form of gender affirming care. 

This order categorized “reassignment surgeries that can cause sterilization, mastectomies, removals of otherwise healthy body parts, and administration of puberty-blocking drugs or supraphysiologic doses of testosterone or estrogen” as abusive gender transitioning procedures. 

On Friday, District Judge Amy Clark Meachum temporarily blocked this order. Meachum wrote that the directive was unconstitutional because it created the effect of a new law without any actual new legislation. The separation of powers as dictated by the Constitution does not allow for governors, as part of the executive branch of a state, to encroach upon the powers given to the legislative branch to create new laws. 

Despite exaggerated reports from conservative media claiming that U.S. President Joe Biden stated children as young as 8 may be transgender and therefore undergo “chemical castration,” it should be noted that young transgender children are not typically receiving any gender reaffirming surgeries as part of their medical care. 

Firstly, there is a difference between being transgender and choosing to receive medical gender reaffirming care. Secondly, there is a difference between medical gender reaffirming care and specific surgeries involving the genitals. A child who is five might be socially transitioning, wearing clothing they feel comfortable in or receiving a legal name change, while receiving therapy or other types of care. A child who is 13 might be taking puberty blocking drugs to prevent unwanted physical changes associated with their assigned sex at birth. Both of these situations fall under the umbrella of gender reaffirming care and do not involve any surgeries. 

Such distinctions, while important for highlighting the misinformation campaigns of the anti-transgender administration and for educating the general population on the realities of what transitioning means for a child, are not ultimately that important to me. What matters to me is protecting the health, safety and privacy of transgender children and their families. Though the order has been blocked, it has had a significant negative impact on trans youth and their families in Texas, who had to deal with the possibility that their children may be taken from them just because they allowed them to be who they are. 

In my opinion, it should actually be considered child abuse to prevent your child from accessing support as they come to an understanding about their gender identity. Mental health issues are very common among LGBTQ+ youth; a 2018 study found that over half of adolescent transgender men reported having attempted suicide. A recent Stanford study found that mental health outcomes were better for transgender adults who started hormone therapy as teenagers than transgender adults who waited until adulthood to receive hormone treatment or wanted it but never got it. These studies are simply examples, and there are numerous other studies with similar findings. By no means am I suggesting that any one type of treatment or therapy is necessary for a transgender person to have better mental health, but it is clear that for those who desire treatment in adolescence, mental health can be improved by starting that treatment in adolescence.

In the vast majority of circumstances, the medical situations of children, regardless of whether they are transgender or cisgender, should be known only to them and their families, and should not be subject to prodding by any state agencies. The public position of Abbott and Attorney General Ken Paxton on gender reaffirming care is certainly scary for transgender children and their families, regardless of whether or not their order can be enforced.