Texas high court reinstates ban on gender-affirming care


The Texas Supreme Court on Friday upheld the state's ban on gender-affirming care for transgender minors, which parents argued unconstitutionally limits their right to care for their children. The 8-1 decision overturned a lower court ruling that said the law violates the Texas Constitution.

The law, passed last year, prohibits doctors from prescribing puberty-blocking medications or hormone treatments for minors, and it prevents them from performing surgeries that change patients' physical features to better match their gender identity. Under the law, children who began receiving such treatments before the bill was signed must eventually stop taking them, and medical professionals who violate the ban will lose their licenses.

“We conclude that the Legislature made a permissible, rational policy choice in limiting the types of medical procedures available to children,” Justice Rebecca Huddle wrote for the majority in the all-Republican court.

Texas is one of nearly two dozen states that have passed such bans as conservatives have pushed to broadly restrict transgender rights, an issue that has emerged as a point of cultural and political division in the country. Former President Donald Trump, who is running for a second term, has also vowed to end gender-affirming care for minors, NBC News reported in January. He has compared the procedures, which medical groups say are safe and sometimes medically necessary, to “child abuse.”

The state, which has a population of about 30 million, is the largest state to ban gender-affirming care. Republicans there have also pushed to ban teaching about LGBTQ+ people and issues in schools, part of an effort to expand parental rights.

Texas Attorney General Ken Paxton (R) Said X that his office would “use every means possible to ensure that doctors and medical institutions follow the law.”

The measure’s sponsor, state Rep. Tom Oliverson (R), said the state has a “duty” to regulate medical care.

“So glad to see that @SupremeCourt_TX agrees,” he wrote on X.

LGBTQ+ advocates criticized the decision, saying it would curtail parental rights and hurt transgender children in a conservative state that has increased parental control over issues such as children’s schooling.

“Instead of leaving medical decisions involving minor children to their parents and their doctors, the court here has allowed politicians … to determine the accepted course of treatment,” said Karen Lowery, a spokeswoman for Lambda Legal, one of the groups that filed the suit on behalf of the five Texas families.

Judge Debra Lehrman, who dissented in Friday’s decision, agreed with Lowy, calling the law “not only cruel” but also unconstitutional. She said it allows the state “to legislate away a parent’s fundamental rights.”

“The Court's 'parental rights are for me, but not for you' approach lacks any objective criteria and completely deprives parents of guidance about whether their parental liberties will be meaningfully protected,” Lehrman wrote. “The Court's opinion thus jeopardizes the rights of all parents.”

The majority countered that while “qualified parents” have the right to make decisions for their children without state interference, legislatures are allowed to impose limits on child labor and regulate medical care.

Ash Hall, a strategist for LGBTQIA+ rights at the ACLU of Texas, said the law has caused suffering for teens and families since it was passed in June 2023.

“Our government should not deny trans youth the healthcare they need to survive and thrive — while providing that same healthcare to everyone else,” Hall said in a statement. “Texas politicians’ obsession with attacking trans kids and their families is needlessly cruel.”

Although the plaintiffs said the court's decision left no avenue for further challenge, they would continue to challenge such measures.

On Monday, the U.S. Supreme Court agreed to review a Tennessee law that bans gender transition care for minors, marking the first time for the nation’s top court to consider the constitutionality of such bans.

The American Civil Liberties Union is tracking more than 500 bills across the country that it calls “anti-LGBTQ.”

Jamie Taylor, a political science professor at the University of Toledo whose research focuses on transgender politics and policy, said anti-transgender legislation has typically focused on issues for which trans people have less popular support, such as access to health care and restrooms.

“This fits into a broader pattern of attacks on transgender rights … and some of these are where there is little public support,” Taylor said. “In some places there is an effort to eradicate transgender people from existing, and denying care is part of that.”

According to a Washington Post-KFF poll, most Americans oppose puberty-blocking drugs and hormonal treatments for trans kids. However, for gender-diverse people, the ability to access such treatments is better According to the American Psychological Association, this impacts their overall well-being.

Major medical associations have said that treatments such as puberty blockers reduce rates of depression and suicide among transgender people and have opposed the legislation, saying laws should not discriminate against trans patients or interfere with doctors' ability to provide individualized, evidence-based care for patients.

More than 100,000 transgender youth live in states where gender-affirming care is banned, according to the Williams Institute, a research center that reports on the demographics of the LGBT community. It estimates that about 30,000 Texans ages 13 to 17 identify as transgender.




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