Texas ban on puberty blockers and hormone therapy for trans kids will go into effect despite legal fight

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A Texas law banning transgender youth from accessing puberty blockers and hormone therapy will go into effect next week after the state attorney general’s office filed to block a judge’s temporary injunction against Senate Bill 14.

In her decision Aug. 25, state district court Judge Maria Cantú Hexsel wrote that SB 14 “interferes with Texas families’ private decisions and strips Texas parents … of the right to seek, direct, and provide medical care for their children.”

In response, the attorney general’s office filed an appeal with the Texas Supreme Court, a move that automatically pauses Cantú Hexsel’s injunction and will allow the law to go into effect Sept. 1. The attorney general’s office said such medical treatments are “unproven” and “pushed by some activists in the medical and psychiatric professions” in a statement announcing the appeal Aug. 25.

Following the state's appeal, the plaintiffs filed an emergency request asking the Texas Supreme Court to again temporarily block the law. On Aug. 31, the state's highest court denied that request, ensuring SB 14 will take effect on Sept. 1.

Texas lawmakers passed SB 14 during this year’s regular legislative session, in addition to several other pieces of legislation affecting the lives of LGBTQ+ people.

Texas families and doctors sued the state in July with the hope of blocking the law. They argued SB 14 violates the Texas Constitution because it strips parents’ rights to make decisions about their child’s health care and discriminates against transgender youth by prohibiting access to this population specifically.

Cantú Hexsel’s injunction would have blocked the state attorney general’s office, the Texas Medical Board and the Texas Health and Human Services Commission from enforcing the law. She wrote that transgender youth and their families would “suffer probable, imminent, and irreparable injury” if SB 14 went into effect while the legal battle ensues. A trial is set to begin May 6.

The judge indicated the lawsuit would likely succeed. Agreeing with the plaintiffs, she said that SB 14 was unconstitutional because it violated parents’ rights to make decisions about their children, infringed on doctor’s freedom to practice medicine and discriminated against transgender youth by withholding access to health care.

“This Act was passed because of, and not in spite of, its impact on transgender adolescents, depriving them of necessary, safe, and effective medical treatment,” the judge wrote.

In a hearing last week, medical experts testified to the efficacy of transition-related care in alleviating mental health issues associated with gender dysphoria — a medical term for the distress someone experiences when their gender identity doesn’t match their body.

Defense attorneys called doctors and other experts to discredit the existing evidence that supports the use of puberty blockers and hormone treatments on transgender youth diagnosed with gender dysphoria. They argued the risks of these drugs — and transition-related surgeries, which are rarely performed on children — outweigh the benefits.

In the larger medical community, there is less debate over the use of these treatments. Leading medical associations like the American Academy of Pediatrics and the American Medical Association support the use of transition-related care for people under 18.

Alex Sheldon, executive director of GLMA, an association of LGBTQ+ health professionals that is one of the plaintiffs, hailed Cantú Hexsel’s ruling before the attorney general’s office appealed it.

“This ruling stands as a testament to the unwavering dedication of Texas families and the medical expertise of GLMA's health professional members, who with each testimony have clearly demonstrated that gender-affirming care is evidence-based, life-saving care,” Sheldon said in a statement Aug. 25. “Although this was just one battle of many, we remain steadfast in our commitment to fight for the rights of trans youth and health care providers offering gender-affirming care in Texas and throughout the nation.”

Texas lawmakers joined 19 other states attempting to ban the use of transition-related care. The prohibition is popular among Republican voters in Texas — over 85% of whom support some restrictions on this health care, according to an April poll by the Texas Politics Project.

Similar to Texas’ law, restrictions to transition-related care in other states have faced legal challenges in recent months.

In June, a federal judge ruled that Arkansas’ ban on gender-affirming care for minors is unconstitutional because it violates the due-process and equal-protection rights of transgender children and their families. Federal judges in Florida, Kentucky and Tennessee have also blocked those states’ laws from going into effect. An appeals court intervened to allow Tennessee to implement its ban, and the Kentucky federal judge lifted the injunction he issued, allowing the law to go into effect.

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