Helping or hurting trans kids? Health care fight continues after law

AUSTIN (KXAN) — Texas is among nearly two dozen states banning transgender care for minors.

A legal fight played out as soon as Gov. Greg Abbott signed the legislation in June.

Five Texas families with transgender children along with three doctors sued the state in July to block the law, stating that it would cause "irreparable harm."

While a Travis County district judge issued a temporary injunction late in August blocking enforcement of Senate Bill 14, the Texas Supreme Court later denied a motion for temporary relief.

The Office of the Attorney General filed an appeal, which remains pending and allows the law to take effect until oral arguments are heard before the Texas Supreme Court in late January, a spokesperson with OAG explained to KXAN investigators. 

"The fight is far from over. In its ruling, the district court clearly articulated the ways in which S.B. 14 likely violates the Texas Constitution by infringing upon the fundamental right of parents to make decisions concerning the care, custody, and control of their children, infringing upon Texas physicians’ right of occupational freedom, and discriminating against transgender adolescents with gender dysphoria because of their sex, sex stereotypes, and transgender status. We couldn’t agree more, and look forward to continuing this fight," said legal advocates in a joint statement.

Chief of Staff for State Sen. Donna Campbell, R-New Braunfels, who authored the bill, said she preferred to wait until after the appeals process before commenting.

Texas joined 21 other states that have banned medication and surgical care for transgender minors, according to the Movement Advancement Project, which is an independent, nonprofit think tank that provides research on the current state of the LGBTQ+ laws and policies across the nation.

Tensions high during session

SB14, which had a companion House bill, passed during this year's regular legislative session. The law bans transgender minors from accessing puberty blocker medication, hormone therapies or surgeries. It would also revoke the licenses of doctors who provide that type of care.

"I'm begging you as a father to trust that I know my kid," said Frank Gonzales, who testified before a House Public Health Committee hearing in March. "I'll be forced to uproot my entire family — our livelihood — and leave the family and community support we have around us. It would be devastating to all of us, but it would be the only choice to keep my daughter safe. Please don’t put me in that position."

The issue of transgender rights brings new conflict at the Texas Capitol. A protester against Senate Bill 14 was apprehended by Texas Department of Public Safety officers May 2, 2023. (KXAN Photo/Ryan Chandler)

Since the bill's filing, tensions remained high around the Capitol and during public hearings. At one point, protesters were cleared out of the gallery after they started chanting in opposition of the legislation. In May, a protester opposed to the legislation was apprehended by troopers with the Texas Department of Public Safety.

"This bill is not about adults. It's not about those who are of maturity that can make a fully informed consent and decision. SB 14 is all about child protection," said Campbell. "Our children need counseling and love, not blades and drugs." 

Campbell, who is a physician, explained as she laid out the bill in March that she worried about families making a life-altering decision for a child when they're so young. She also cited a concern about long-term impacts. 

"The treatments prescribed to children diagnosed with gender dysphoria can have life-altering consequences to include sterility and potential permanent loss of bone density. The puberty blocking medications prescribed to children are not FDA-approved for this off-label use," Campbell wrote in the bill analysis in June.

A number of doctors testified, including Dr. Jessica Zwiener from Houston whose specialty is managing hormone therapy for transgender adolescents and adults. 

"Medical care for transgender youth is lifesaving. Transition is not experimental. It's not unproven. It's not unsafe. Rather, this care is supported by over 30 years of clinical experience, along with evidence showing a dramatic improvement in mental health when adolescents are able to access this care in a reasonable time," Dr. Zwiener told the lawmakers during one of the public hearings.

Throughout the session, lawmakers heard hours of testimony from supporters and those against the legislation. 

Prisha Mosley flew in from Michigan to share her experience of transitioning back to her sex assigned at birth. She stated that at 17, her doctors started her on high doses of testosterone. She added that she's still dealing with the side effects, including pain to her body and joints. 

Protests against Senate Bill 14 in May 2, 2023. (KXAN Photo/Ryan Chandler)

"I trusted my doctors in the trans community when they told me they had the cure, but it wasn't true. I stand now before you in an aching body, which is no longer mine. I don't recognize myself when I look in the mirror. I am suffering from severe medical issues with which no doctors will help me and insurance covers nothing. The medical professionals who did this to me have abandoned me and the trans community has abandoned me when doctors assisted me in mutilating myself and then left me in the cold when I wanted the harm to stop," she said during a State Affairs Committee hearing in March. 

'What if you're wrong?'

Supporters of the bill said they were concerned about parents allowing their children to make life-altering decisions at a young age. 

"SB 14 helps children struggling to embrace their sex by protecting them from harmful drugs and surgery," testified Jonathan Covey, Policy Director with Texas Values, a political advocacy organization.

There were a few children who came to the Capitol with their parents hoping to show the impact of the legislation on their lives. 

"I am again missing school to sit all day in the Capitol to try to convince you I'm a human that deserves the same rights as every other Texan — the right to a happy life," said a 9-year-old with her mom by her side at a House Public Health Committee hearing in March. "The medicine you are trying to make illegal is something I will need one day to let me be the girl I am. If you take it away, I'll start to look like a boy and I'm not a boy and that scares me."

Some lawmakers including State Sen. John Whitmire, D-Houston, said they've heard from many families impacted and said the decision should be left to parents. 

"What concerns me — what if you're wrong?" Whitmire asked during one of the readings of the bill. "I hope everyone on the floor will pause for a moment and think about what if the majority of the votes get it wrong today. It could actually be life and death matters."

The Texas Politics Project at the University of Texas looked at how transgender issues affected politics during the session. The authors of "Why Transgender Politics are So Irresistible to Republicans in the 88th Texas Legislature," pointed out, "while legislating the rights of people who are transgender is not new in Texas, the politics raised by attempts to regulate the lives of transgender people brings about discussions related to the relationship between biological sex and gender expression that are relatively new to most voters."

In April, A UT/TXPP poll showed 89% of Texas Republicans believed the only way to define gender should be the sex assigned on a person's original birth certificate. The same poll showed 86% of Republicans supported prohibiting doctors from providing gender affirming care to minors. The poll found 55% of Democrats opposed prohibiting doctors from providing gender affirming care to minors. The poll was conducted between April 14-23^rd  among a sample of 1,200 registered voters in Texas and has a margin of error of +/- 2.83 percentage points (3.39 percentage points adjusted for weighting). The respondents were matched on gender, age, race, and education. Data collection was carried out using the internet by YouGov.

"As more and more Texans are exposed to people who are transgender, their understanding of and thoughts about the relationship between biological sex and gender expression may very well change. However, in the meantime, the politics of the moment, including the politics that have made passing laws like those in Texas irresistible to Republican legislators, appears to have given momentum to the forces that seek to codify a one-to-one relationship between biological sex and gender expression in the face of significantly increased exposure to transgender people in the last few years," said Joshua Blank, one of the authors of the poll and research director for the Texas Politics Project.

In Texas and across the nation, courts are deciding how to rule on these new laws. The next step for Texas comes in late January.

Senior Investigative Producer David Barer, Creative Producer Eric Henrikson, Director of Investigations & Innovations Josh Hinkle, Lead Editor Eric Lefenfeld, Digital Executive Producer Andrew Schnitker, Digital Special Projects Developer Robert Sims and Digital Director Kate Winkle contributed to this report.