Does the state think transgender care is abuse? Ken Paxton’s comments contradict Texas legal position

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AUSTIN — Fighting to keep his job in a heated GOP primary this year, Attorney General Ken Paxton has repeatedly insisted that certain medical treatments for transgender youth offensive and illegal.

But in the relative calm of a court hearing, state attorneys said something quite different: Gender-affirming care for minors is not abuse in all cases, and the state will not sue parents just because their trans child receives these treatments. .

“Despite frankly breathless media coverage of these important issues, there have been no calls to investigate all trans youth or all young people undergoing these gender-affirming procedures or therapies. It’s not,” Assistant Attorney General Ryan Kercher told court last week in the first legal test of the state’s policy of investigating some care for trans minors as abuse. .

The conflicting statements confuse state workers, strike fear among parents and children — and raise questions about what the state’s new directive targeting gender-affirming treatment for women means in practice. young trans.

Although there may be conflicting interpretations, the immediate effects are already visible.

Since Gov. Greg Abbott asked state agencies to investigate certain medical care as abuse last month, the state has opened nine investigations based on that directive. Parent of transgender teenager sues to block Abbott’s order. And the state’s largest children’s hospital has suspended some gender-affirming therapies.

When the Biden administration offered advice for families with trans children, Paxton sued. He did not parse the words to criticize gender-affirming care, describing them in a tweet as “a radical new form of child abuse.”

Myko Gedutis, coordinator of the union organization that represents CPS social workers, said there was a dangerous lack of clarity from the state about when and how to complete the guidelines.

“There has been no meaningful communication to staff about the meaning of this directive and serious questions have remained unanswered,” Gedutis said. “Real harm is already being done to families and children who live in fear of not knowing what to expect.”

In February, Paxton posted a review that said several methods to treat gender dysphoria in minors, such as puberty blockers and hormone therapies, “may legally constitute child abuse” under applicable state laws. gender dysphoria is the feeling of discomfort or distress that can occur in people who identify with a gender different from the gender or sex assigned at birth.

The opinions of the Attorney General are not binding and no new law has been passed to codify his opinion. But Abbott took the advice and ran with it, sending a strongly worded letter to several state agencies ordering them to investigate any reports of minors receiving such treatment.

Abbott warned that those required to report child abuse – “including doctors, nurses and teachers” – could be criminally prosecuted for failing to do so.

A week later, the state of Texas was sued by an anonymous DFPS employee who was furloughed and investigated for having a teenage trans daughter receiving medical treatment. Paxton’s agency went to court, arguing that the public and media misinterpreted the state’s actions.

Kercher, the assistant attorney general, said Paxton’s opinion intentionally used “formulated” language. Gender-affirming treatments are not necessarily or per se abusive, he added, but “that these treatments, like virtually any other tool, could be used by someone to harm a child”.

“It is inappropriate and incorrect” to say that public opinion calls for every young person undergoing “this kind of treatment and procedure” to be investigated, he said.

Two days later, however, Paxton appeared to contradict his deputy’s interpretation in a tweet that left no room for such nuance.

“When performed on children, so-called sex reassignment procedures, puberty blockers and hormone therapies are ‘abuse’ under Texas law. They are illegal.” paxton wrote. “Family courts and government family law agencies must do their part to end this. »

Paxton also appeared on Conservative radio host Rick Roberts’ show the same week and spoke about his own experience as a father of four.

“They have to have the opportunity to grow up and have some life experience and understand what they want, not have a parent make the decision that permanently affects that child, maybe much more. beyond the life of the parent,” he said. “It’s not right, and it really is child abuse.”

Paxton said Abbott’s order in particular was intended to tell agencies “to investigate any parent who forced their child to take puberty blockers or undergo surgery for it.”

Abbott and Paxton are both re-elected this year. Abbott won his GOP primary, beating conservative challengers who pushed him to take a more aggressive stance against transgender rights.

Paxton, however, was pushed into a Republican runoff with Lands Commissioner George P. Bush. As Election Day approaches, Abbott’s campaign strategist said questioning transgender health care for minors could lead Texas voters to support Republican candidates.

“It’s a winning question,” Dave Carney said on a call with reporters, according to several points of sale. “Democrats across the country are out of touch.”

Neither Abbott nor Paxton responded to inquiries about the interpretation of the new guidelines they follow: All gender-affirming care is abuse and should be investigated, or only neglect or abuse. abuse disguised as gender-affirming care is a problem.

The Department of Family and Protective Services also did not respond to this question.

The Dallas Morning News contacted several organizations representing teachers, doctors and social workers to see what they tell their members.

The Texas Medical Association, which represents more than 55,000 doctors and medical students, said it hasn’t issued any specific guidelines. But in a blog post on Mondaythe association said it was in ongoing talks with heads of state on guidelines for trans care.

The TMA also reiterated its opposition to the widespread criminalization of gender-affirming care for trans youth, which is shared by the Texas Pediatric Society. These groups, along with the American Medical Association, American Psychiatric Association, and American Academy of Pediatrics, all support the provision of individualized, age-appropriate care for children with gender dysphoria.

Like social workers, teachers also received no guidance from the state on implementing the directive Abbott ordered them to implement, according to the Association of Texas Professional Educators.

Spokeswoman Kate Johanns said on Tuesday that none of their members had yet sought advice. If they do, educators will be reminded that state law has not changed. The Texas Association of School Boards has received a few calls from districts asking if they should update child abuse reporting or training practices.

“At this time, we are advising them to follow the current law on mandatory reporting of child abuse,” spokeswoman Theresa Gage said. “Should there be any relevant developments, we will provide an update.”

Gedutis of the Texas State Employees Union said many CPS employees felt asking them to report parents of transgender children violated their ethics and professional standards.

“This directive should be dropped immediately and publicly,” he said.

On Friday, a Travis County District Court judge will hold a hearing in the lawsuit filed by the parent of the transgender teenager. Last week, the judge granted the parent’s request to temporarily halt the state’s custody investigation.

She could also decide to extend the stay statewide and stop all investigations into the care of trans children. Paxton said Thursday he would appeal to fight the suspension to the Texas Supreme Court.

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