Texas law banning gender-affirming care for trans youth harms children, families and trans adults

CAROLINE SAVOIE | Contributing Writer
CaroSavoWrites@gmail.com

Tina Biffle started P.L.A.C., the Parker County LGBTQ+ Awareness Community, in Weatherford in 2019. In 2023, Republican lawmakers passed Senate Bill 14 restricting doctors in Texas from giving minors puberty blockers and hormone therapy to treat gender dysphoria, the dissonance some people feel between their sex assigned at birth and their gender identity.

nder the law, doctors who provide puberty blockers or hormone therapy to minors to treat gender dysphoria can have their medical licenses revoked. The law also prohibits health insurance plans from covering these treatments for gender dysphoria.
Biffle said she’s worked with many young people who experience gender dysphoria. She said that, with SB 14 now on the books as law, she fears for their lives.

“We’ve seen a rise in suicide attempts and self-harm [since the bill passed] because these kids are not being allowed to continue the health care they once had,” Biffle said. “Especially those in poverty who are on Medicaid and Children’s Health Insurance Program. Where they were once able to afford therapy, they don’t have access to that anymore.”

She’s also talked with parents of transgender children, noting that, “In our community, parents of trans teens are very scared their kids won’t make it to adulthood, just based on these bills and the fear-mongering against the trans community.”

So, Biffle said, parents are taking matters into their own hands when it comes to receiving care for their children. “We’re seeing an uptick of parents reaching out to find other avenues to support their children because medical avenues aren’t able to progress in Texas,” she explained, adding that she knows parents who are finding support groups, homeschooling their children and even moving out of state to seek gender dysphoria health care.

Bri Flowers, a transgender psychiatric nurse practitioner at Flowers Family Psychiatry, said she provides therapy and prescribes medication treatments for other transgender people. But, she added, “I have many clients who have not been able to access treatment. I also have many clients who were previously receiving treatment who are not able to anymore.”

She said some of her patients are making “escape plans” to properly care for themselves or their children.

“I was working with a family who had a trans child, and they made the decision to leave the country,” Flowers said. “The problem isn’t just in Texas; It’s all over the [United] States.”

Thanks to SB 14, Texas is now one of 23 states that restrict some form of gender-affirming care for transgender people under 18. Other states, like California and New York, have passed laws protecting access to care.

Flowers said that in West Virginia, the legislature is targeting therapists, psychiatrists and psychologists who treat transgender people. In South Carolina, a bill proposed in January would ban mental healthcare for transgender youth under 18 years old.

“The only thing that’s really gonna do anything about it is sweeping federal legislation,” Flowers said. “This is not isolated; it is widespread. A lot of my patients are correct in their fears that if things don’t go their way in November, this is all going to get a lot worse.”

P.L.A.C. offers a service called Transformation Station, a shop that helps people who are transitioning find clothing that fits their gender expression. It was “born out of a growing need for LGBTQ-inclusionary clothing,” Biffle explained. “We don’t cater to children, and we only offer adult clothing. But we do see teenagers come in on occasion.”

Biffle said she’s watched her daughter’s transgender friends struggle to feel safe in their own bodies. She said she researched puberty blockers, among the medical treatments banned by SB 14, and has found them to be a safe alternative to struggling with gender dysphoria.

“They don’t hurt you; they just delay puberty,” Biffle said. “Puberty starts when you get off of them. After therapy, it’s the safest option for trans children. And years of therapy have to happen before you work up to puberty blockers.”

But, Flowers said, while hormone replacement therapy and puberty blockers are both incredibly important, the first place patients receive gender-affirming care is in a therapist’s office. “No one in Texas has written legislation targeting that, but I don’t think it’s far-fetched to think that may happen,” she warned.

In January, the Texas Supreme Court heard a case, Loe v. Texas, in which a group of parents argued the new law violates their parental rights by stopping them from providing medical care for their children. They also argue it discriminates against transgender children on the basis of sex.

“I absolutely think a parent has every right to choose what their child needs,” Biffle said. “Just as parents are arguing that they have the right to choose what school their child goes to, they also get to choose their child’s healthcare.”

She said that she believes that children who are emancipated from their parents have the right to choose what happens to their body as well: “If they have the rights of an adult, they have the right to choose to care for themselves as well.”

In court, lawmakers argued that this ban would protect children from undue medical procedures.

But, Biffle said, “Parents are constantly trying to protect their children. And treatments like puberty blockers, talk therapy and, later on, hormone treatments, help those children stay alive.

“Hell would freeze over before a parent lets their child suffer through a life-threatening condition without seeking help.”

She also noted that transgender humans make up 0.6 percent of the population. According to a 2022 study by the Williams Institute, 1.4 percent of the transgender population were between 13 and 17 years old. That means that there are roughly 300,000 children suffering from gender dysphoria in the United States.

“It’s not like throngs of people are making these decisions for their children,” Biffle said.

Flowers argued that the parental rights argument is a red herring rooted in hypocrisy. “The legislature will defend those parents as long as the parents align with their point of view,” she said. “They say, ‘You can do whatever you want with your kids’ healthcare — unless we don’t agree with it.’

“It doesn’t really matter what parents want, it’s what the people in power want. What they don’t like, they’ll criminalize.”

Flowers said rhetoric around SB 14 is deterring trans adults from medically transitioning, as well. She said it’s affecting adults who thought gender-affirming care was no longer legal in Texas for them, either.

“I have people who are deciding if they want to medically transition who are waiting until after the 2024 election, people who are thinking it will get worse before it gets better,” Flowers said. “Legislation has been targeting the youth, but the rhetoric has been bleeding into the entire trans community overall.”

While Prism Health North Texas never offered transitioning services to minors, the organization does offer assitance to adults living with gender dysphoria in Texas. PHNTX’s website says that the organization is dedicated to providing a safe space for transgender health care needs, as long as the patients are at least 18 years old.

The organization offers hormone therapy, PrEP, routine wellness exams, behavioral health counseling, medical support letters for name and gender change, HIV/STI testing and treatment, cervical and anal pap smears and approvals, and referrals for gender-affirming surgery.

“If you are 18-years-old or older, planning on transitioning, or have already begun your transition journey, we have the right health care services for you,” the site reads.

The organization is also catering to those who don’t have the proper insurance coverage: “Insurance is accepted, and some services can be provided at little to no cost.

Whether you are under-insured, have low income or simply cannot pay, you will not be turned away. Our access to financial aid programs will help you afford the care you need.”

As the 2024 elections loom ever closer, both Flowers and Biffle said they’re anxious about laws that will be drawn up and passed to further oppress the LGBTQ community. “With how the legislature’s rhetoric is trending, this year is going to be even worse than last year,” Flowers said. “I’m not looking forward to it.”