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Texas attorney general calls trans surgeries, puberty blockers 'child abuse' in formal opinion

Transgender
A sign outside a classroom taken in 2016. |

Texas Attorney General Ken Paxton has released a formal opinion concluding that performing certain gender reassignment procedures on children constitutes child abuse under state law.

In Opinion No. KP-0401, released last Friday, Paxton said that certain sex-change procedures and treatments “can legally constitute child abuse under several provisions of chapter 261 of the Texas Family Code.”

Such procedures and treatments include castration, the removal of healthy body parts as well as the prescription of puberty-blocking drugs among others. 

“Beyond the obvious harm of permanently sterilizing a child, these procedures and treatments can cause side effects and harms beyond permanent infertility,” the opinion states. 

“The medical evidence does not demonstrate that children and adolescents benefit from engaging in these irreversible sterilization procedures.”

Paxton argued that such invasive gender reassignment procedures, like removing private parts, “would deprive the child of the fundamental right to procreate, which supports a finding of child abuse under the Family Code.”

“Because children are legally incompetent to consent to sterilization, procedures and treatments that result in a child’s sterilization are unauthorized and infringe on the child’s fundamental right to procreate,” the opinion continued.

“The lack of authority of a minor to consent to an irreversible sterilization procedure is consistent with other law. The federal Medicaid program does not allow for parental consent, has established a minimum age of 21 for consent to sterilization procedures, and imposes detailed requirements for obtaining that consent.”

In a statement Monday, Paxton said that there was “no doubt that these procedures are ‘abuse’ under Texas law, and thus must be halted.”

“The Texas Department of Family and Protective Services (DFPS) has a responsibility to act accordingly. I’ll do everything I can to protect against those who take advantage of and harm young Texans,” he added. 

Last August, the Texas Department of Family and Protective Services Commissioner Jamie Masters published a letter asserting that “genital mutilation of a child through reassignment surgery is child abuse, subject to all rules and procedures pertaining to child abuse.” 

Masters' letter came after Texas Republican Gov. Greg Abbott requested that the agency “issue a determination of whether genital mutilation of a child for purposes of gender transitioning through reassignment surgery constitutes child abuse.”

Last December, Paxton’s office announced an investigation into Endo Pharmaceuticals and AbbVie Inc. under the Texas Deceptive Trade Practices Act due to the promotion of medications as puberty blockers. The Food and Drug Administration has not approved the use of puberty-blocking drugs for the sake of gender transition but has approved such medication for children who start puberty at a very young age.  

Some medical organizations, however, contend that puberty blockers and other gender transition procedures for minors can be beneficial to children suffering from gender dysphoria.

The American Medical Association, for example, released an open letter last April arguing that state governments should not prohibit gender reassignment procedures for youth.

“Such decisions must be sensitive to the child’s clinical situation, nurture the child’s short and long-term development, and balance the need to preserve the child’s opportunity to make important life choices autonomously in the future,” stated the AMA in a letter.

“We believe it is inappropriate and harmful for any state to legislatively dictate that certain transition-related services are never appropriate and limit the range of options physicians and families may consider when making decisions for pediatric patients.”

According to the Mayo Clinic, the benefits of puberty-blocking medicines for gender dysphoria “might” include reducing depression among youths and preventing the need for future surgery.

Nevertheless, the clinic warns that taking puberty blockers remains a “big step” that can have a long-term impact on bodily growth, bone density and fertility.

“In addition, delaying puberty beyond one’s peers can be stressful,” the Mayo Clinic explained. “Your child might experience lower self-esteem.”

The conservative American College of Pediatricians, an association of physicians and healthcare professionals "dedicated to the health and well-being of children," has long voiced its opposition to using puberty-blocking drugs on children with gender dysphoria. 

"There is not a single long-term study to demonstrate the safety or efficacy of puberty blockers, cross-sex hormones and surgeries for transgender-believing youth," the association says in an online statement. "This means that youth transition is experimental, and therefore, parents cannot provide informed consent, nor can minors provide assent for these interventions. Moreover, the best long-term evidence we have among adults shows that medical intervention fails to reduce suicide."

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