Texas Governor Gregg Abbott created a firestorm last week when he directed state health agencies to classify medical treatments provided to transgender adolescents to help align their biological bodies with their self-indentified gender as child abuse under Texas law. According to the New York Times, Abbott’s order followed an earlier opinion by Texas Attorney General Ken Paxton that said providing medical treatments like puberty-suppressing drugs to transgender teenagers should be investigated as child abuse.

Abbott said that all licensed professionals who have direct contact with children – including doctors, nurses and teachers – have to report any such abuse observed to the Texas Department of Family and Protective Services, which must then mount an investigation.


Abbott’s and Paxton’s critics claim that so-called “gender-affirming” medical care is necessary to avoid self-harm among transgender young people, the Times reports. Both sides acknowledge, however, that some of the treatments in question carry medical risks.

Puberty-blocking drugs suppress the production of testosterone and estrogen, which can weaken bone development and under some circumstances can lead to fertility loss. Minors are prohibited from purchasing cigarettes, alcohol, or even getting a tattoo before a certain age; they, or even their parents, should not be allowed to make irreversible life-altering decisions about their bodies while they are of minority age.

Transgenderism is a subject that is fraught with much emotion. One thing that is particularly sensitive here is the fact that children are involved and, as noted above, a child’s decisions are oftentimes circumscribed in ways that the decisions of adults ordinarily are not. It is an important question: When may society run interference for a child in order to avoid a decision with irreversible consequences that the child might come to regret after reaching adulthood? At issue as well is the imposition of a criminal sanction when someone believes he or she is acting in the best interests of a child.

The issues are likely to come before the Texas courts soon, and perhaps we’ll get some illumination there.


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