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Lawsuit seeks to block Texas from banning gender transition-related care for children

People gathered in the Capitol to protest Senate Bill 14, which seeks to ban puberty blockers and hormone therapies for transgender youth, before it was debated in the House on May 12, 2023. (Evan L'Roy/The Texas Tribune, Evan L'Roy/The Texas Tribune)

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Several families with transgender children are asking a judge to block a new Texas law that would stop minors from accessing many types of transition-related health care, including puberty blockers and hormone therapies.

The families argue the new law, which goes into effect Sept. 1, violates their parental rights by stopping them from providing medical care for their children and discriminates against transgender teens on the basis of sex. Several doctors have also joined the lawsuit, arguing the law interferes with their licensure and ability to practice medicine.

The lawsuit, which was filed in state court Wednesday, relies on legal arguments similar to those that have halted or blocked restrictions in several states, including Florida, Arkansas and Tennessee.

“The attack that Texas legislators and the governor have launched against transgender youth and their families and providers is stunning in its cruelty,” said Paul D. Castillo, senior counsel for Lambda Legal, which filed the lawsuit. “They are actively ignoring the science, dismissing best-practice medical care, intervening in a parent’s right to care for and love their child, and explicitly exposing trans youth in Texas to rampant discrimination. This law is not just harmful and cruel, it is life-threatening.”

All major medical associations support the use of puberty blockers and hormone therapy to treat gender dysphoria, the distress someone feels when their gender identity doesn’t match the sex they were assigned at birth. But in recent years, conservative groups have launched an all-out war on gender-affirming care, branding it “genital mutilation.”

Earlier this year, Republicans in the Texas Legislature passed Senate Bill 14, which Gov. Greg Abbott signed into law in June. The law stops transgender minors from accessing puberty blockers, hormone therapies or transition-related surgeries, which medical experts say are rarely performed on children. Children already receiving this care are required to be weaned off in a “medically appropriate” manner, the law says, which many doctors say would be unethical.

“The science on gender dysphoria lacks sufficient high-quality evidence documented, and there’s a growing list of harms, established side effects that accompany patients,” state Rep. Tom Oliverson, a Cypress Republican who sponsored the bill in the House, said during debate on the bill. Oliverson has said the bill was written to withstand expected court challenges.

Oliverson and state Sen. Donna Campbell, a Republican from New Braunfels who authored the bill, released a joint statement one week after the lawsuit was filed. The two lawmakers expressed confidence that SB 14 would withstand the legal challenge.

“We believe that extraordinary interventions require extraordinary justification, and that justification doesn’t exist in this case. The State of Texas maintains its stance that there is insufficient evidence supporting continued medical experimentation on children,” the statement read.

After the lawsuit was filed, Republican state Rep. Jeff Leach of Plano tweeted that the challenge was expected: “What should also be expected is the State of Texas vigorously defending this law that protects children from dangerous and irreversible modification and mutilation procedures. We will fight. And we will win.”

The Texas attorney general’s office did not immediately respond to request for comment.

Although the law has yet to go into effect, health care options for transgender minors are already narrowing in Texas. In May, Houston-based Texas Children’s Hospital announced it would discontinue hormone therapy and other gender-affirming care treatments. The same month, adolescent health specialists at Dell Children’s Medical Center in Austin parted ways with the hospital after Attorney General Ken Paxton announced an investigation into the hospital.

“I can’t tell you what it feels like to be on the end of a call of a parent who has lost their child because their child looks out into the world and sees a world [where], overwhelmingly, adults are telling them and bullying them that they do not belong here, that they are not well, that they are not who they are,” said Emmett Schelling, executive director of the Transgender Education Network of Texas. “Then you strip away what’s already a thin layer of the system of health care to support our communities here in the state of Texas. And it’s an even worse outcome.”

Schilling said the law’s “chilling effect” is also diminishing health care options for transgender adults. Some families have decided to leave Texas to ensure their children can continue to receive health care.

“Because my daughter might need puberty blockers in the next few months, I am temporarily relocating out of state with her and my other child,” said one of the plaintiffs, identified in the lawsuit as Mary Moe, who is the mother of a 9-year-old transgender daughter. “I am heartbroken to have to take my children away from their home and their father, even temporarily. But I know that Texas is not a safe place for my daughter if this law forbids her access to this care.”

Texas is the largest of 18 states that have recently passed restrictions on gender-affirming care for minors. But these laws, which mostly sailed through Republican-dominated statehouses, are running into significant barriers in the courtroom.

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.

“Rather than protecting children or safeguarding medical ethics, the evidence showed that the prohibited medical care improves the mental health and well-being of patients and that, by prohibiting it, the State undermined the interests it claims to be advancing,” the judge wrote.

Federal judges in Florida, Kentucky and Tennessee have also blocked those states’ laws from going into effect, although an appeals court intervened to allow Tennessee to implement its ban.

This lawsuit is filed in state court, citing parental-right protections laid out in the Texas Constitution.

“The Texas Constitution provides stronger rights for parents, stronger rights in the guarantees of equality ... and much stronger rights with respect to the individual rights of autonomy,” Lambda Legal senior counsel Paul Castillo said. “Those decisions that rest with parents are at their apex when they are made in consultation with physicians who recommend this medically necessary care.”


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