Texas Supreme Court upholds ban on transgender surgeries, puberty blockers for kids

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The Texas Supreme Court has upheld a state law barring medical professionals from performing cosmetic sex-change surgeries or prescribing hormonal intervention drugs to children.

In an 8-1 ruling released Friday in the case of Texas et al v. Lazaro Loe et al., Texas’ highest court upheld Senate Bill 14, which passed last May and took effect last September. The law bans medical professionals from performing sex-reassignment surgeries or prescribing puberty blockers and cross-sex hormones to children.

Justice Rebeca Aizpuru Huddle authored the majority opinion, concluding that “the Legislature made a permissible, rational policy choice to limit the types of available medical procedures for children.”

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“We therefore conclude the statute does not unconstitutionally deprive parents of their rights or physicians or health care providers of an alleged property right in their medical licenses or claimed right to occupational freedom,” wrote Huddle.

“We also conclude the law does not unconstitutionally deny or abridge equality under the law because of sex or any other characteristic asserted by plaintiffs. We therefore reverse and vacate the trial court’s order.”

Justice Debra Lehrmann wrote the dissent, arguing that the new law “is not only cruel” but also “unconstitutional” and that the majority opinion “effectively forecloses all medical treatment options that are currently available to these children.”

“Although this Court has enshrined a robust conceptualization of parental autonomy for many years, in the blink of an eye, the Court tosses that precedent aside today,” Lehrmann added.

“Concerningly, the Court's opinion puts all parental decisions at risk of being overruled by the government. The Court's attempt to cabin its opinion to only this case makes its outcome-driven decision-making all the more transparent.”

The Alliance Defending Freedom, a conservative legal group that filed an amicus brief in support of the state law, celebrated the state supreme court decision.

“Texas rightly enacted the Minors Protection Act to protect the health and welfare of all children — supporting their natural biological development and ensuring that children experiencing gender dysphoria have a chance for comprehensive healing and compassionate mental health support,” said ADF Senior Counsel Natalie Thompson in a statement.

“And no reliable scientific evidence demonstrates that these dangerous medical procedures improve mental health. That’s why countries like Sweden, England, and Finland — which once recommended these procedures for children — are now restricting them and protecting children from the devastating effects they have had on countless lives.”

The American Civil Liberties Union of Texas, one of multiple progressive organizations that represented the families suing Texas, denounced the state high court decision.

“This decision by the Texas Supreme Court allows the suffering caused by S.B. 14 to continue across the state,” said Ash Hall, policy and advocacy strategist at ACLU of Texas, in a statement.

“Our government shouldn't deprive trans youth of the health care that they need to survive and thrive. Texas politicians’ obsession with attacking trans kids and their families is needlessly cruel. We will not stop fighting until our trans youth have the health care they deserve and our state is a welcoming place to all.”

SB 14 includes exceptions to allow such procedures or interventions in limited scenarios, such as when a minor is "experiencing precocious puberty," "born with a medically verifiable genetic disorder of sex development," or if a minor "does not have the normal sex chromosome structure for male or female as determined by a physician through genetic testing."

Shortly after the law was passed, a group of progressive organizations filed suit on behalf of five families with trans-identified minors, with the 201st Judicial District Court of Travis County granting an injunction that temporarily blocked the law.

At the end of August 2023, however, the Texas Supreme Court issued a brief order overruling the injunction, and allowing the law to take effect while the legal proceedings continued.

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