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Texas lawmakers debate future of gender-affirming care for trans kids

A large crowd of protesters stands in front of the Texas State Capitol dome. They're holding trans pride flags.
Eric Gay
Demonstrators gather on the steps to the State Capitol to speak against transgender related legislation bills being considered in the Texas Senate and Texas House, Thursday, May 20, 2021, in Austin, Texas.

The Texas legislature heard public testimony for the first time Thursday on a bill addressing gender-affirming care in the state.

For resources and support, call Trans Lifeline at 877-565-8860 or The Trevor Project at 866-488-7386.

Physicians, psychologists and advocates spoke out publicly for hours about a bill to ban gender-affirming care for transgender children Thursday during a Texas Senate Committee on State Affairs hearing.

Debate at the hearing for Senate Bill 14 lasted about three hours, and afterwards, more than 60 people testified for and against the bill, which would end access to gender-affirming care for people under 18 in Texas. It would also revoke the medical licenses of any doctors who provided such care.

The Texas Medical Association, the American Academy of Pediatrics and the Texas Pediatric Society have spoken out in support of gender-affirming care and opposed bills targeting trans youth for the past few years.

Gender-affirming care practices — which can include social affirmations like using correct names and pronouns, and health affirmations like puberty blockers and hormone replacement therapy — are linked to improved mental health outcomes for young people, like decreases in depression and anxiety.

Louis Appel, the president of the Texas Pediatric Society, called SB 14 a “blunt instrument for the state to use,” which “prohibits treatment options that are critical for the health and wellbeing of transgender youth with gender dysphoria.”

John Carlo, the chair of the Texas Medical Association Council on Legislation, testified that the association was neutral on the bill. That’s a different message than the group sent last year, when it said state actions involving gender-affirming care would “create barriers in access to care for transgender adolescents, a vulnerable population that already faces barriers in access to care.”

Carlo said the issue was “complex,” and raised concerns about physicians losing their licenses.

He also discussed the potential harm to young people currently undergoing hormone therapy if they have to stop that care, and he urged the committee to amend the bill to allow those patients to be “grandfathered in” to continue care.

State Sen. Donna Campbell, R-New Braunfels, one of the authors of SB 14, said the bill is about “child protection.”

“Physicians that oppose this bill need to think twice,” Campbell said.

Similar bills — SB 17, SB 28, HB 65 and HB 22 — failed to gain traction in 2021. But last year, Gov. Greg Abbott and Attorney General Ken Paxton directed the Texas Department of Family and Protective Services to investigate the families of trans youth for providing gender-affirming care. The directives mirrored language and arguments put forth in the 2021 bills that did not pass.

As a result, health providers and families of trans children were left uncertain about the future of their livelihoods and practice, and some young people urged their families to move out of the state.

Cody Miller, a trans Texan, spoke out against SB 14 during the committee meeting.

“This issue is near and dear to me,” they said. “This is my community that’s being affected. Being trans is not cool, it’s not a fad. We deserve your protection, not your hatred.”

Advocates and policy organizations are tracking more than 130 anti-LGBTQ+ bills this session, which range from stopping trans athletes from participating in school sports to allowing people to sue drag performers.

Other states, like Arkansas, Oklahoma, Florida and Kansas, are also considering bills targeting trans rights and trans health care access.

Andrea Segovia, the senior field and policy advisor for the Transgender Education Network of Texas, told KERA News last week that the unifying theme of these bills is “the erasure of trans people from the public eye, from existence.”

The bill still has to be voted on by both the state Senate and House and adopted by both chambers. If passed, it would then be sent to the governor to become law.

Got a tip? Email Elena Rivera at You can follow Elena on Twitter @elenaiswriting.

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Elena Rivera is the health reporter at KERA. Before moving to Dallas, Elena covered health in Southern Colorado for KRCC and Colorado Public Radio. Her stories covered pandemic mental health support, rural community health access issues and vaccine equity across the region.