Don’t mess with minors’ sex in Texas

REPUBLICANS IN TEXAS they seem to have developed a penchant for promoting vigilantism. In September, the state empowered citizens to sue anyone involved in an abortion after about six weeks of pregnancy. And on February 22, Republican Texas Governor Greg Abbott said that puberty blocker treatment and surgeries on minors who identify as transgender should be investigated as “child abuse.” Doctors, nurses, teachers and “the general public” should report it, he said. Failure to do so could result in “criminal sanctions”.

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Although the new order is not, like the abortion ban, a law, in some respects it is more severe. It uses a criminal mechanism (instead of a civil one) and requires anyone to report an alleged violation of the law. This came after a legal opinion by Ken Paxton, the state attorney general, which concluded that such treatments may constitute child abuse under Texas law.

It is not clear what this might mean in practice. Some district attorneys have said they won’t enforce the order, in which case the state attorney general’s office could. Either way, children would not be separated from their parents without a court order, according to the Texas chapter of the American Civil Liberties Union, a people’s rights group.

Jo Ivester, an Austin, Texas, author of “Once a Girl, Always a Boy” (about her now-grown trans son) and a volunteer for Stand with Trans, a national group that works with trans youth and their families, says she has spoken to many anxious parents. “Their reactions of her range from, ‘if this happens, we have to move out of Texas,’ to those who care less [that their children would be taken from them] because they know that the cases would have to go to court.” A more immediate fear, she says, is that the order will lead to further discrimination against trans people, especially bullying at school.

There are growing concerns about the use of puberty blockers, which can be given to children who identify as trans from the age of nine, and the cross-sex hormones that in most cases follow. Blockers have not undergone a clinical trial for this purpose. They prevent bones from developing properly and can affect brain development. When combined with cross-sex hormones, they can lead to infertility and the inability to have an orgasm. Several countries are restricting its use.

On February 22, Sweden said the risks of these drugs outweigh any potential benefits and the drugs should no longer be available outside of research except as a last resort. In the United States, by contrast, where doctors take their guidance from the World Professional Association for Transgender Health (WPATH), most medical associations have endorsed the use of such medications for children. Some doctors say they prescribe them at the first consultation.

Erica Anderson, a clinical psychologist and former president of the US chapter of WPATH, herself a trans woman, is one of the few practitioners in the United States who has raised concerns that some doctors are rushing to prescribe blockers and cross-hormone. Yet she is “just horrified,” she says, “that politicians are making these draconian efforts to curb what they see as the wrong approach. Using child abuse statutes to prosecute largely well-intentioned people is immoral.”

Dr. Anderson agrees that it is difficult to make comparisons between Sweden, with its national health system and a long tradition of affirming the rights of trans people, and the United States, where there is little oversight of the proliferating gender clinics and the topic has polarized. Still, he praises Sweden’s restrictions on the use of such drugs as “brave.” “We should reexamine what we’re doing,” she says. But, “I care about what’s best for the kids, and what’s best for the kids is that some of them have a choice.”

Others disagree, believing that all such irreversible interventions for minors are wrong. However, that is unlikely to be the main reason Texas is trying to stop them. This month, both Mr. Abbott and Mr. Paxton faced major challenges; their rivals accused them of being insufficiently conservative. The absence in the United States of any discussion about how children who identify as trans are treated facilitates such political opportunism.

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This article appeared in the US section of the print edition under the headline “Don’t mess with sex in Texas.”

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