Texas Governor Signs Bill Banning Trans Surgeries, Hormone Therapies for Children

Texas Governor Signs Bill Banning Trans Surgeries, Hormone Therapies for Children
Texas Gov. Greg Abbott speaks during a news conference in Austin, Texas, on March 15, 2023. (Brandon Bell/Getty Images)
Caden Pearson

Republican Texas Gov. Greg Abbott signed a bill on Friday that places restrictions on gender transitioning procedures and treatments for minors in the state.

The bill, known as Senate Bill 14, prohibits doctors from performing certain procedures and treatments related to gender transitioning, reassignment, or gender dysphoria to children under the age of 18. It also restricts the use of public funds or public assistance for such procedures.

Last year, Abbott issued an order saying that treating transgender minors with medical procedures could be seen as child abuse. However, a judge has stopped some of the investigations related to this order in Texas.

The newly enacted law specifically bans doctors and health care providers from performing surgeries that render minors unable to have children.

This includes surgeries on males like castration (removing testicles), vasectomy (cutting tubes that carry sperm), orchiectomy (removing testicles), penectomy (removing the penis), and vaginoplasty (making a vagina). It also includes surgeries on females, such as hysterectomy (removing the uterus), oophorectomy (removing ovaries), metoidioplasty (reshaping the clitoris), and phalloplasty (making a penis).

Taking off healthy body parts or tissues, taking drugs that make one unable to have children, or removing breasts is also banned.

But there are some exceptions to the rule. Doctors can give prescription drugs to stop puberty for children who start it too early, with the permission of their parents or guardians. They are also allowed to perform medically necessary procedures or treatments on children who have genetic problems with their sex development or chromosomes.

The law also includes other exceptions for minors who are already undergoing non-surgical treatments before June 1 and those who have undertaken 12 or more sessions of mental health counseling or psychotherapy six months prior to beginning prescription drug treatments. These treatments on children may continue but the patients must “wean” off the medications with the help of their doctor.

Such treatments are considered standard care by mainstream medical associations. However, some individuals who regret undergoing such treatments have spoken out against their health care providers, with some parents saying they felt pressured to consent to their child’s transition.

Sometimes referred to as “detransitioners,” some of these individuals have spoken with lawmakers, urging bans on gender surgeries and treatments for minors, citing the negative impacts it has had on their health and quality of life. Republicans have been concerned about the long-term impacts of the treatments, often referring to them as life-altering and irreversible.

Proponents of non-surgical treatments of gender dysphoria argue that hormone therapy, which causes physical changes, can be reversed if the patient stops taking the medication. However, the Mayo Clinic notes that other changes, such as breast development, can’t be reversed.

These non-surgical treatments are typically used in response to gender dysphoria, which is psychological distress experienced by those who don’t identify with their biological gender.

Under the new law, public money can’t be used to support doctors, hospitals, or medical schools that do these procedures or treatments for minors. The Texas Health and Human Services Commission also can’t provide Medicaid reimbursement for these procedures or treatments, and the child health plan program is also not allowed to pay doctors or health care providers for these services.

If anyone breaks this law, the state’s attorney general can take action against them. The attorney general may ask the court to restrain or stop any violations by health care providers.

Texas joins at least 16 other states with Republican leaders that have banned sex change surgeries, hormone therapies, and puberty blockers for minors. Nebraska, Florida, and Oklahoma also recently implemented similar bans.