According to the hospital’s statement, leadership made the decision to stop the endocrine treatments because of the state’s recent choice to officially treat gender modification as child abuse.
“The mission of Texas Children’s Hospital is to create a healthier future for all children, including transgender children, within the bounds of the law. After assessing the Attorney General’s and Governor’s actions, Texas Children’s Hospital paused hormone-related prescription therapies for gender-affirming services,” the hospital stated.
“This step was taken to safeguard our healthcare professionals and impacted families from potential criminal legal ramifications.”
On February 21, Texas Attorney General Ken Paxton issued an official opinion arguing that gender transition procedures constitute child abuse under existing Texas law. Specifically, Paxton observed that courts have long recognized a fundamental liberty interest in procreation, a right endangered by the endocrine and surgical treatments used to aid sex transitions before adulthood.
The next day, Governor Greg Abbott directed the Texas Department of Family and Protective Services (DFPS) to investigate the use of these drugs as child abuse.
DFPS is the state agency tasked with child protection. It manages the state’s foster care system and investigates allegations of child abuse or maltreatment.
Texas is a mandatory-reporting state, meaning it is illegal to let abuse go unreported. Any person with a reasonable cause to believe that a child’s health has been adversely affected by abuse or neglect must report the allegation to DFPS or other law enforcement.
The law reserves particular scrutiny for licensed professionals, such as teachers, doctors, daycare employees, or correctional officers. After witnessing or learning of abuse, these licensees have 48 hours to report the maltreatment. They cannot delegate the task to another person.
Failure to report abuse or neglect is a Class A misdemeanor, unless the licensee meant to conceal the maltreatment, in which case it becomes a state jail felony.
State Rep. Matt Krause (R-Fort Worth) set the process in motion that led to Abbott’s DFPS directive.
Krause, one of several lawmakers who had filed bills in the regular legislative session to ban child gender modification, submitted the official opinion request to the office of the attorney general.
Once an authorized official submits an opinion request, the attorney general has 180 days to resolve it, according to the Texas Government Code.
Abbott had previously directed DFPS — without an attorney general opinion — to treat genital transition surgeries as child abuse under current law. Krause’s opinion request asked whether the same law might apply to puberty blockers and surgeries to other parts of the body, such as mastectomies, meant to aid transition.
Pressed by radio host Mark Davis in December, Abbott said his office had prepared another DFPS directive that would apply to those procedures but had to wait on Paxton’s opinion before issuing it.
The bill that Krause filed in the legislature would not have tasked DFPS with enforcement. Instead, it would have authorized the Texas Medical Board to punish doctors by license suspension or other means for performing surgeries or administering drugs meant to change a child’s sex.
His bill died without receiving a vote on the floor of the Texas House.
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