AUSTIN, Texas (AP) — The Texas Supreme Court on Friday upheld the state’s ban on gender reassignment surgery for transgender youth, rejecting objections from parents that it violates their right to medical care for their children.
The all-Republican court’s 8-1 ruling leaves in place a law that has been in effect since September 1, 2023. Texas is the largest of at least 25 states that have passed laws restricting or banning gender-affirming medical care for transgender minors.
Lawsuits are pending in most of those states, and the U.S. Supreme Court recently agreed to hear an appeal from the Biden administration seeking to block state bans on gender reassignment surgery. The case before the Supreme Court concerns a Tennessee state law that restricts puberty blockers and hormone therapy for transgender minors, similar to the law in Texas.
The Texas law prohibits transgender minors from accessing hormone therapy, puberty blockers and gender reassignment surgery, although medical experts say such surgical procedures are rarely performed on children. Children who had already started the now-banned drugs had to be weaned off them in a “medically appropriate” manner.
“We conclude that the Legislature made a permissible and reasonable policy decision in limiting the types of medical procedures available to children, particularly in light of the relative newness of both gender dysphoria and its various treatments and the Legislature’s express constitutional authority to regulate the practice of medicine,” Justice Rebeca Aizpuru Huddle wrote in the court’s decision.
The lawsuit challenging the Texas law says it has devastating consequences for transgender teens who cannot get the vital treatment recommended by their doctors and parents. The only judge to dissent from Friday’s ruling said the Texas Supreme Court allowed the state to “legislate away fundamental parental rights.”
“The state’s categorical legal ban prevents these parents and many others from developing individualized treatment plans for their children in consultation with their physicians, even those for whom treatment could be life-saving,” Judge Debra Lehrmann wrote in a dissenting opinion. “The law is not just cruel – it is unconstitutional.”
A lower court declared the law unconstitutional, but allowed it to go into effect while the state Supreme Court reviewed the case.
The health care restrictions are part of a larger backlash against transgender rights that affects everything from access to bathrooms to participation in sports.
As more states enforce health care restrictions, families of transgender youth are increasingly forced to travel to other states for necessary treatment at clinics with ever-longer waiting lists. At least 13 states have laws protecting the treatment of transgender minors.
More than 89,000 transgender people ages 13 to 17 live in states that restrict their access to gender-affirming care, according to a research letter published in July 2023 in the Journal of the American Medical Association. However, not all transgender people choose to seek or can afford gender-affirming care.
Gender-affirming care for adolescents is supported by major medical organizations, including the American Medical Association, the American Academy of Pediatrics, the American Psychiatric Association, and the Endocrine Society.
Medical professionals define gender dysphoria as the psychological distress experienced by people whose gender expression does not match their gender identity. Opponents of gender reassignment surgery say there is no solid evidence to support its alleged benefits and believe children should not make life-changing decisions they may later regret.
Texas authorities defended the law, saying it was necessary to protect children and pointed to a host of other restrictions on minors regarding tattoos, alcohol, tobacco and certain over-the-counter medications.
Several doctors who treat transgender children testified in a lower court hearing that denying patients secure and effective treatment puts their mental health at risk, potentially leading to suicide.
The ban in Texas was signed by Republican Governor Greg Abbott, who was the first governor to order investigations into families of transgender minors receiving gender reassignment care.
During the legislative debate on the 2023 ban, transgender rights activists disrupted the Texas House of Representatives chamber with protests from the gallery, resulting in state police forcing the protesters to leave the building.
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DeMillo reported from Little Rock, Arkansas.
