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Texas commissioner says gender-affirmation surgery for minors is 'child abuse'

LGBTQ advocates in the state say the commissioner and Texas Gov. Gregg Abbott are addressing a nonexistent health care issue for political gain.
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The head of the Texas department charged with protecting the welfare of the state’s children said Wednesday that gender-affirming surgery, which she refers to as “genital mutilation,” constitutes “child abuse” under state law.

“Such mutilation may cause a ‘genuine threat of substantial harm from physical injury to the child,’” Jaime Masters, commissioner of the Texas Department of Family and Protective Services, wrote in a letter addressed to Gov. Greg Abbott, a Republican. “This surgical procedure physically alters a child’s genitalia for non-medical purposes potentially inflicting irreversible harm to children’s bodies. Generally, children in the care and custody of a parent lack the legal capacity to consent to surgical treatments, making them more vulnerable.”

Masters’ letter came five days after Abbott requested that her department “issue a determination of whether genital mutilation of a child for the purposes of gender transitioning through reassignment surgery constitutes child abuse pursuant to state law.” Her letter also notes that doctors, nurses, teachers and other professionals licensed or employed by the state must report suspected child abuse or face a fine, jail time or both.

State Rep. Erin Zweiner, a Democrat and founding member of Texas House LGBTQ Caucus, told the Texas Tribune that legislation would have to be passed to change the Texas Family Code in order for there to be any major change following Commissioner Masters’ letter. However, she added, it could still present a barrier to trans minors seeking gender-affirming care and “opens the door to any parent of a trans kid being accused of child abuse.”

Texas is one of at least 20 states that has tried to legislatively ban transgender health care for minors this year alone, according to a tally by the American Civil Liberties Union. So far, Arkansas and Tennessee are the only states to pass such bills, though Tennessee’s only applies to prepubescent minors.

While supporters of such measures say they’re necessary to protect vulnerable children, critics say these efforts are driven by politics, not science. In fact, the American Medical Association urged governors earlier this year to oppose legislation prohibiting transition-related care for minors, calling such proposals “a dangerous governmental intrusion into the practice of medicine.”

Critics also point out that genital surgery for transgender minors is essentially nonexistent. The standard of care for someone under 18 is typically social transitioning and puberty-suppressing hormones, which are reversible. The World Professional Association for Transgender Health states in its standards of care that surgery “should not be carried out until (i) patients reach the legal age of majority in a given country, and (ii) patients have lived continuously for at least 12 months in the gender role that is congruent with their gender identity.”

“Using inflammatory language to paint gender-affirming care as something it is not continues the strategy of fearmongering about the lives of transgender people, which fuels discrimination and dehumanization, further alienates kids who are already in crisis from an unprecedented level of cruel legislative attacks on LGBTQ+ people, and contributes to Texas remaining the leading state in the murders of Black transgender women,” Ricardo Martinez, CEO of Equality Texas, a statewide LGBTQ advocacy group, said in a statement. “The language used in Gov. Abbott’s letter to Texas DFPS and in the DFPS response is offensive to our community and has nothing to do with the reality of life-saving affirming healthcare practices for transgender people, further illustrating that politicians and government appointees should focus on governing actual emergencies and not fictitious ones.”

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