The Texas Supreme Court on Friday upheld the state’s ban on gender transition treatment for children, solidifying Texas’ position as one of at least 25 states, and the largest, with restrictions on such treatment. This law, in effect since September 1, 2023, prohibits children under 18 from accessing hormone therapy, puberty blockers, and gender transition surgery. Children already on these medications were required to gradually discontinue their use. Exemptions exist for children in early puberty or with a medically verifiable genetic disorder of sex development.
The lawsuit challenging the law argued that it harms transgender teenagers by preventing them from receiving gender transition treatment recommended by their physicians and parents. The court, composed entirely of Republicans, delivered its ruling in an 8-1 decision.
Justice Rebeca Aizpuru Huddle, writing for the majority, stated, “We conclude the Legislature made a permissible, rational policy choice to limit the types of available medical procedures for children, particularly in light of the relative nascency of both gender dysphoria and its various modes of treatment and the Legislature’s express constitutional authority to regulate the practice of medicine.”
The lone dissenting judge, Justice Debra Lehrmann, argued that the court’s decision granted the state government the power to “legislate away fundamental parental rights.” She wrote, “The State’s categorical statutory prohibition prevents these parents, and many others, from developing individualized treatment plans for their children in consultation with their physicians, even the children for whom treatment could be lifesaving. The law is not only cruel — it is unconstitutional.”
A lower court had initially ruled the law unconstitutional, but it was permitted to take effect while the state Supreme Court considered the case. Following the ruling, Texas Republican Attorney General Ken Paxton tweeted that his office “will use every tool at our disposal to ensure that doctors and medical institutions follow the law.”
The groups who initiated the lawsuit condemned the ruling, arguing that it is detrimental to transgender children and their families. Karen Loewy, senior counsel and director of Constitutional Law Practice at Lambda Legal, one of the groups that sued the state on behalf of doctors and families, told The Associated Press, “It is impossible to overstate the devastating impact of this ruling on Texas transgender youth and the families that love and support them.”
Ash Hall, ACLU of Texas’ policy and advocacy strategist for LGBTQIA+ rights, stated that the government should not “deprive trans youth of the health care that they need to survive and thrive,” adding that “Texas politicians’ obsession with attacking trans kids and their families is needlessly cruel.”
Gender transition treatment for transgender children is supported by major medical organizations, including the American Medical Association, the American Academy of Pediatrics, the American Psychiatric Association, and the Endocrine Society. However, one justice dismissed the medical groups’ position as irrelevant to the constitutionality of the Texas law. Justice James Blacklock wrote in a concurring opinion, “The fact that expert witnesses or influential interest groups like the American Psychiatric Association disagree with the Legislature’s judgment is entirely irrelevant to the constitutional question. The Texas Constitution authorizes the Legislature to regulate ‘practitioners of medicine.'”
During a lower court hearing, several doctors treating transgender children testified that patients could face deteriorating mental health, potentially leading to suicide, if denied gender transition treatment. Texas officials defended the law as necessary to protect children, citing other restrictions for minors intended to ensure their safety, including those related to tattoos, alcohol, tobacco, and certain over-the-counter drugs.
The Associated Press contributed to this report.
