The Texas Supreme Court upheld the state’s ban on gender transition treatment for children, making Texas one of at least 25 states with restrictions on such treatment. The ban has been in effect since September 1, 2023, and prohibits children under 18 from accessing hormone therapy, puberty blockers, and gender transition surgery. Exemptions are included 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 who are barred from receiving recommended treatment by their physicians and parents.

The court, consisting entirely of Republicans, ruled in an 8-1 decision to uphold the law. Justice Rebeca Aizpuru Huddle defended the Legislature’s policy choice to limit medical procedures for children in light of the nascency of gender dysphoria and its treatment options. The lone dissenting judge, Justice Debra Lehrmann, argued that the law was unconstitutional as it infringes on fundamental parental rights and prevents individualized treatment plans for children, some of whom may benefit from life-saving treatment.

Texas Attorney General Ken Paxton vowed to ensure that doctors and medical institutions follow the law after the ruling. Groups that filed the lawsuit criticized the decision, stating that it will have a devastating impact on transgender youth and their families. Major medical organizations such as the American Medical Association, American Academy of Pediatrics, American Psychiatric Association, and the Endocrine Society support gender transition treatment for transgender children.

One justice dismissed the medical groups’ position as irrelevant to the constitutional question of whether the Texas law is constitutional. The Texas Constitution authorizes the Legislature to regulate the practice of medicine. During a lower court hearing, doctors testified that patients could face deteriorating mental health and potentially suicide if denied gender transition treatment. Texas officials cited the need to protect children as the reason for the law, comparing it to other restrictions for minors, such as tattoos, alcohol, tobacco, and certain over-the-counter drugs.

The ruling has been criticized as needlessly cruel by LGBTQIA+ rights advocates, who argue that the government should not deprive trans youth of the health care they need to survive and thrive. The decision highlights the ongoing debate over transgender rights and healthcare access, with proponents of the ban arguing for the protection of children and opponents advocating for the rights of transgender individuals. The legal battle over the ban is likely to continue as advocates on both sides push for their respective positions to be upheld.

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