Texas House initially approves bill barring gender-affirming health care for trans children

A Texas bill that bans gender-affirming health care for transgender children is a step closer to Texas Gov. Greg Abbott’s desk after hours of floor debate on Friday.

Many Democrats pushed back against the legislation that they said is dangerous for transgender kids in the state, as mostly Republicans pressed forward with the legislation supporters say is needed to keep children and teens from being harmed.

The bill passed on Friday, but is subject to one more vote in the House before heading back to the Senate for approval as an amendment. If the change is approved, the bill heads Abbott.

The legislation would prohibit doctors from providing gender-affirming health care, including surgery and the prescription of puberty blockers, to a person under 18. A doctor who violates the rule would have their medicine license revoked. Public money couldn’t go to facilities or doctors that provide the transition-related care.

Minors who prior to June 1 were taking prescription drugs that suppress puberty and had gone to therapy at least 12 times over the course of six months would be weaned off the prescription in a way that’s safe and medically appropriate, according to the bill.

Rep. Tom Oliverson, a Cypress Republican who is anesthesiologist and carrying the bill in the House, told lawmakers that gender dysphoria is a mental health condition and treatment should be focused on mental health care. He likened it to anorexia, which elicited groans from some watching the debate from the House gallery.

“I don’t mean that flippantly,” he said. “What I mean is, that anorexia is also a distorted perception of body image, where a patient sees themself differently and feels uncomfortable when they look in the mirror.”

The American Psychiatric Association describes gender dysphoria as “distress that results from an incongruence between one’s sex assigned at birth and one’s gender identity,” which may be experienced by some people who are transgender.

“This does not ban all treatments for this mental health condition, gender dysphoria,” Oliverson said. “It actually redirects patients, parents and providers to scientifically proven methods that have been around for a long time — counseling, psychotherapy. We don’t treat mental health disorders with surgery. We treat mental health disorders with mental health treatments.”

Democrats filed amendment after amendment — 18 total — to change the legislation, but each was voted down.

One would have invalidated the bill altogether. Another would have excluded emancipated minors from those unable to access the health care. Another would have made it so the bill expires on Sept. 1, 2026, which the amendment author said would allow lawmakers revisit the law as medicine evolves.

An amendment would have allowed transition-related care when at least two doctors or mental health care providers determines its needed to prevent severe physical, emotional or psychological harm. Another would have studied the suicide rate of children affected by the law.

The bill was amended to let sections of the proposal remain in effect if another part is found invalid.

Rep. Donna Howard, an Austin Democrat, noted that the Pediatric Endocrine Society opposes bills that harm transgender youth. The society in a 2021 statement, when similar bills were in legislatures across the country including Texas, recommended “an affirmative model of care that supports one’s gender identity” that includes both mental health care and puberty suppression on a case-by-case basis.

The care has been demonstrated to improve the psychological health and well being of transgender youth, the group said.

“These prescriptions that we’re talking about are still available to children with other medical conditions,” said Rep. Mary Gonzalez, an El Paso Democrat. “We’re banning health care for one group of people, and we have to ask ourselves why. There is so much misinformation. So much politicization, and honestly, sadly, discrimination happening against transgender people, and specifically transgender youth.”

Rep. Tony Tinderholt, an Arlington Republican, called transition-related care child abuse.

“I just think it’s despicable, and I cannot believe that anyone in this room wants to do harm, physical harm, to children,” he said.

Some onlookers in the gallery cheered.

Rep. Shawn Thierry, a Houston Democrat, said she has researched the issue extensively, and after listening to the debate is convinced the age should be 18 for people to receive transition-related care.

“I am making a decision to place the safety of all young people over the comfort of political expediency,” she said, continuing that lawmakers should be consistent in giving children special conditions under the law “as they cannot really appreciate the long term consequences of their actions.”

Friday morning, ahead of the debate, advocates for LGBTQ rights packed the stairs outside the House chamber in the Texas Capitol as Democratic House lawmakers took turns reading letters from transgender children and their family members.

They shared the words a child who feared having to leave Texas and the testimony of a 12-year-old boy who wondered why there are more stories in the news about lawmakers in Austin trying to pass laws targeting transgender kids than there are about about kids being killed by guns.

“I am here as a young trans adult, as a college student, because I had access to life-saving, life-giving care as a trans youth,” said Landon Richie, a policy associate with the Transgender Education Network of Texas.