This past week, Texas Governor Greg Abbott signed off on a directive which functionally criminalizes existing as a transgender or nonbinary child in that state.
The directive, in the form of a letter sent to the Texas Department of Family and Protective Services instructs that Department to: “conduct a prompt and thorough investigation” of any reported instances of minors undergoing “elective procedures for gender transitioning.”
Given the broadness of the directive, “elective procedures” could cover a wide variety of gender-affirming care practices, from attending therapy with an LGBT+ affirming practitioner, to taking puberty blockers, choosing to dress according to one’s gender identity, taking ‘puberty blocking’ medication, and gender-affirming surgery.
The Texan government is positioning gender-affirming care as a form of child abuse, and therefore mandated reporters (such as teachers and doctors) are required to report to the Department of Family and Protective Services when they know of or suspect a person under 18 years of age is undergoing gender-affirming care.
To put a finer point on the situation, it is mandated that transgender children be reported to the government, so that their caregivers can be punished, and their life-saving care may be stopped.
The legality of this move is shaky, and it likely will not withstand any court challenge; however, in the meantime, this move will without a doubt harm transgender and nonbinary youth and their families. Further, even if the directive does not hold up to legal scrutiny, it contributes to a chilling effect against the rights of gender non-conforming people to express themselves freely and without fear of reprisal.
Even so, the question may arise in the reader’s mind: “But should kids be given ‘gender-affirming treatment’? These are permanent changes, after all.”
It is not bigoted or uncaring to ask such questions; ‘gender-affirming care’ is a broad category, and indeed some aspects may not be appropriate for a child, depending on the circumstances. We do not allow children to get tattoos, for example.
But gender is not simply a tattoo– a decoration. For many trangender and nonbinary people, gender dysphoria caused by a conflict between how they are perceived and who they know themselves to be can be excruciating, and, if not appropriately addressed, may lead to mental health issues including suicidality. Gender-affirming care is not optional; it is life-or-death.
The following is a list of some common gender-affirming care practices, as well as some criteria practitioners must follow.
This list is adapted from the World Professional Association for Transgender Health’s Standards of Care for the Health of Transsexual, Transgender, and Gender Nonconforming People (2011).
Trans and nonbinary people may pursue some of the following:
- Changes in gender expression and role (which may involve living part time or full time in another gender role, consistent with one’s gender identity)
- Hormone therapy to feminize or masculinize the body;
- Surgery to change primary and/or secondary sex characteristics (e.g., breasts/chest, external and/or internal genitalia, facial features, body contouring);
- Psychotherapy (individual, couple, family, or group) for purposes such as exploring gender identity, role, and expression;
- Offline and online peer support resources, groups, or community organizations that provide avenues for social support and advocacy;
- Hair removal through electrolysis, laser treatment, or waxing;
- Breast binding or padding, genital tucking or penile prostheses, padding of hips or buttocks;
- Changes in name and gender marker on identity documents.
These interventions are classified as: fully reversible ([medications which] suppress estrogen or testosterone production and consequently delay the physical changes of puberty); partially reversible (e.g., hormone replacement therapy); or irreversible (surgical procedures). Treatment is pursued in this order, and depending on the individual, may or may not progress past fully reversible interventions.
“Puberty blockers” are considered fully reversible, as they simply delay the onset of puberty in youth. Cisgender children who begin puberty early (known as ‘precocious puberty’ may also be prescribed such medication.
The WPATH advises: “Genital surgery should not be carried out until (i) patients reach the legal age of majority in a given country, and (ii) patients have lived continuously for at least 12 months in the gender role that is congruent with their gender identity. The age threshold should be seen as a minimum criterion and not an indication in and of itself for active intervention. Chest surgery in FtM patients could be carried out earlier, preferably after ample time of living in the desired gender role and after one year of testosterone treatment.” (emphasis added).
Interested in supporting trans* youth and families in this time of uncertainty? Consider donating to one of the organizations below. Please note that as many of these are American, a tax receipt may not be issued.
https://www.equalitytexas.org/