Some experts doubt that classifying gender-affirming care as child abuse would hold up in court, but families still feel targeted by Gov. Greg Abbott’s new order
By Sneha Dey and Karen Brooks Harper, The Texas Tribune
Every couple of months, Adamalis Vigil drives eight hours from the Rio Grande Valley to North Texas so her 13-year-old transgender daughter Adelyn can receive health care. They talk and sing the whole trip.
The care she receives there is unavailable in her hometown but pivotal to her sense of identity — and her mental health.
“It makes me feel who I truly am, and I don’t feel singled out for not being like other girls in school anymore,” Adelyn said. “It’s just very special for me that mom takes me all the way over there.”
Adelyn — who stands tall at 5 feet, 5 inches and is outspoken in class — had been having panic attacks in school as she approached puberty. After she started seeing the doctors in North Dallas, the attacks stopped.
But last week, the panic attacks started again when Republican Gov. Greg Abbott — seven days before the GOP primary election in which he’s being accused of not being conservative enough — ordered state child welfare officials to launch child abuse investigations into reports of transgender kids receiving gender-affirming care.
Adelyn is terrified she will be forcibly separated from her mother. So great is her anxiety that she doesn’t want to sleep in her own bed. The Vigil family agreed to speak with The Texas Tribune but did not feel safe disclosing details about Adelyn’s medical care.
Abbott’s directive followed a nonbinding legal opinion from Attorney General Ken Paxton — who is also in the fight of his political life in Tuesday’s primary election — that said gender-affirming care constitutes child abuse.
Paxton’s opinion cited body modification surgeries that medical experts say are rarely, if ever, performed on children. But he also said it would be child abuse to administer gender-affirming care that is widely accepted by leading health care groups, like puberty blockers, which are completely reversible. Under the gender-affirming model of care, experts say, more time is spent allowing kids to socially transition instead of focusing on medical treatment.
Shelly Skeen, a senior attorney with Lambda Legal, said it’s highly unlikely that a judge would justify child abuse charges or removal of a child based solely on the use of gender-affirming therapy.
“Texas law has a very clear definition of what child abuse is, and it’s not this,” Skeen said.
Still, the attorney general’s opinion and governor’s directive drew fire from families, lawmakers, doctors, advocates and the White House, among others. Advocates say that calling gender-affirming therapy child abuse could lead to it being weaponized in divorce cases, create legal issues for physicians and therapists who treat transgender youth and empower people to attack the young people themselves — as well as the family members and others who support them.
“It’s not a far stretch to think that you could be harassed, assaulted, killed,” said W. Carsten Andresen, an associate professor of criminal justice at St. Edward’s University in Austin.
Child abuse investigations based on gender-affirming care are almost unheard of in Texas. Officials at the Texas Department of Family and Protective Services say that there have been three reports last week “meeting the description in the AG opinion and Governor’s directive” but offered no other details. No investigations have been launched, officials said.
But families with transgender kids and their advocates say even an attempt at criminalizing certain care further stigmatizes an already vulnerable group of Texans.The officials’ moves also can block access to treatments that can prevent suicide and severe depression caused in part by gender dysphoria — discomfort related to feeling a disconnect between one’s personal gender identity and the gender assigned at birth.
A recent study showed that more than 40% of transgender youth attempt suicide. The rate of suicide attempts among transgender youth is three times higher than among their cisgender counterparts, according to recent studies by the U.S. Centers for Disease Control and Prevention.
And the moves now leave Texas families with transgender children choosing between getting their children health care that medical experts recommend or possibly facing a child protective services investigation.
“I know I have to fight. I know I have to speak up. I know I have to show up for her. But how do I alleviate her stress when I’m stressed?” Adamalis said. “The fact that she has to do the fighting, too — it’s just terrible. She had to mature so much faster than kids her age.”
Riding a wave of anti-trans politics
Abbott and Paxton have spent the past year reflecting and stoking anti-transgender sentiment among voters — many of them stirred by right-wing media. The public pressure was so intense that a Dallas program that specialized in helping transgender young people was formally dissolved.
In his statement this week, Abbott even called on other Texans to act as watchdogs and report any parents for abuse if they believe the parent is supporting their child’s gender transition with professional help.
For years, the GOP-dominated Texas Legislature has targeted transgender Texans. In 2017, lawmakers unsuccessfully sought to ban people from using bathrooms that don’t match the sex they were assigned at birth. Last year, they succeeded in limiting athletic participation by transgender students. Last year during the regular legislative session, Texas filed more anti-LGBTQ bills than any other state legislature, according to Equality Texas, which tracks such legislation.
Among the proposals was a bill that would explicitly classify some gender-affirming care as child abuse. The Texas Senate passed the bill, but the legislation died in the House.
The opinion and new directive that aim to achieve the same effect without a law passing further stigmatizes an already marginalized group by normalizing speech and actions that target them, Texas House Democrats wrote this week in a letter blasting the comments by Abbott and Paxton.
“Transphobic and false statements like those made by the Governor and the Attorney General have produced an unsafe environment in our state that has forced families to flee to protect their transgender kids, adversely affected the mental health of gender expansive youth, and perpetuated an epidemic of violence against transgender Texans, especially Black trans women,” the letter from several Democratic lawmakers read.
On Thursday, district attorneys from five Texas counties — including Dallas, Bexar, Harris and Travis — took to Twitter to bash the directives as “anti-trans” and “life-threatening” and saying they would not treat gender-affirming actions as abuse.
“We want to assure our residents with transgender children that they are safe to continue seeking the care their children need,” a joint statement said.
Harris County District Attorney Kim Ogg said she would not prosecute “any parent, any facility, or anyone else for providing medically appropriate care to transgender children.”
“As a member of the LGBTQ community myself, I am particularly sensitive to the invidious nature of this order — it turns family members against each other at the expense of their children,” Ogg said in a written statement. “It is a remnant of a hateful past that I had hoped our society had matured beyond.”
Second-guessing more care
Since Adelyn’s mother sat her down and told her about the governor’s order, the teen has been reconsidering whether she wants to go to her next doctor’s appointment. She has been scrolling through TikTok videos about the order until her mother comes home from work. On Thursday, she tried to watch a Percy Jackson movie as a distraction, but the fear has been getting to her.
“When I’m at work, she keeps calling and calling: ‘When are you going to be home and how long? How much longer? Are you almost home?’” Adamalis said. “It affects her in that sense that she wants to feel that kind of security and feel safe around me.”
Five years ago, Libby Gonzales, a transgender girl, and her family told Texas lawmakers about how she never wanted to be forced into the boys’ bathroom at school, and that the idea scared her. They traveled to the Capitol to speak out against the now-infamous “bathroom bill,” which would have limited which public bathrooms transgender Texans can use. That legislation, though, died despite several attempts at getting it through the Legislature.
“I am 7 years old and I am transgender,” the nervous girl told the powerful state senators looking down at her from the dais in 2017. “Please keep me safe. Thank you.”
Today, Libby, now 11, and her family do not feel safe confirming or denying her experience with gender care anymore.
Her family — outspoken opponents of Texas Republicans’ near-constant efforts to curtail the rights of her daughter and other transgender youth — are now afraid that their efforts to support Libby will be called criminal by the most powerful men in the state.
As a result of the directive, Rachel Gonzales, Libby’s mother, has developed plans in case Texas Child Protective Services shows up at her Dallas home.
“There are so many hypotheticals that my husband and I talked through.” Gonzales said. “We have to have a plan in place. It also just helps me sleep at night.“
Skeen, the Lambda Legal attorney, said political rhetoric against transgender children is already driving families out of the state. But the Gonzales family said they are here to stay.
“My daughter is a fifth-generation Texan. We’re simply not leaving our home because of some bullies in the Texas [Legislature],” Gonzales said.
While child abuse investigations of gender-affirming care are rare, there is at least one well-known example: a DFPS investigation into the family of a transgender child over the use of gender-affirming therapy, a bitter custody battle fueled by the blogger father of a 7-year-old girl who was assigned male at birth.
In 2019, Abbott and Paxton demanded that the state’s child welfare agency investigate whether the child’s mother was committing abuse by letting the child present as a girl. At the time, the move alarmed an already fearful community of parents of transgender children.
In that case, in which no surgical or hormonal procedures were used, child welfare officials ruled out child abuse and closed the investigation. The father, Jeff Younger, lost custody of his two children in the divorce, according to his website.
Younger is now running for the Republican nomination to the Texas House in his Flower Mound district in Tuesday’s primary. He could not be reached for comment.
In their statement this week, Texas House Democrats said gender-affirming therapy is still legal for transgender youth and supported by medical professionals and that mandatory reporting laws had not changed.
And in spite of child welfare officials saying earlier this week that they would comply with Abbott’s orders, the Democratic lawmakers said no government agency “is obligated to comply with the directive of the Governor or enforce the false assertions made by the Attorney General.”
CPS investigations are only launched if “an allegation is reported, and if the allegation meets the legal definition of abuse or neglect,” said DFPS spokesperson Patrick Crimmins.
In general, CPS investigators who find evidence of abuse may decide to set up services for the family to remove the threat to the child or stage some other intervention. In extreme cases, they may ask for an order from a judge to either temporarily or permanently remove children from the home.
Their worst fear
Still, transgender kids Libby knows “are freaking out, coming home from school crying. I mean, she also has cried a lot,” Rachel Gonzales said. “That would cause irreparable harm to any family and any child to remove a kid from their home in a state where the government is very intentionally trying to hurt them.”
Even an investigation itself can be traumatic, life-altering and invasive, Andresen said. A DFPS investigator may interview family members and others familiar with a family or the child in order to decide whether there is reason to believe abuse is taking place or whether to rule it out, among other possible outcomes.
“Parents that have the money and resources are seriously thinking about looking to move outside of Texas,” said Andresen, whose wife sometimes works with transgender families in her job as a family attorney. “Even if there is no legal grounds, why would you stay here with somebody threatening to investigate you?” Also, any protection under the law could be wiped away easily if Texas lawmakers — an increasingly conservative bunch — decide to change the code, which could effectively make gender-affirming therapy for minors illegal in Texas.
Adelyn’s care has “really been life-changing” for the Rio Grande Valley girl, her mother said.
“How is that considered child abuse to accept them and love them?” Adamalis Vigil asks. “How can they overstep their power and try to come and tell me how I should love my child?”
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