In Houston, Texas, a pediatric hospital announced that it would no longer perform hormone therapies for transgender children. The action came in response to recent efforts by Governor Greg Abbott and Attorney General Ken Paxton indicating that they constitute abusive practices, citing state law.

In February, according to CNN, Gov. Greg Abbott (R-Tex.) ordered the Department of Family and Protective Services (DFPS) to consider transgender surgical procedures and drugs as abuse.

It also called for an investigation into “any reported cases of Texas children being subjected to abusive gender transition procedures.” 

The governor issued the order in a letter dated Feb. 22, 2022, after state Attorney General Ken Paxton asserted that such practices were a violation of Texas law. 

The state law “imposes reporting requirements upon all licensed professionals who have direct contact with children who may be subject to such abuse, including doctors, nurses, and teachers, and provides criminal penalties for failure to report such child abuse,” the letter states. 

“Texas law also imposes a duty on DFPS to investigate the parents of a child who is subjected to these abusive gender-transitioning procedures.” The AG’s order adds that other state agencies “have a duty to investigate licensed facilities where such procedures may occur.”

In a statement, Texas Children’s Hospital reported the cessation of all procedures to treat children’s gender change and said it was a direct response to Attorney General Ken Paxton’s legal opinion.

“After assessing the Attorney General’s and Governor’s actions, Texas Children’s Hospital paused hormone-related prescription therapies for gender-affirming services. This step was taken to safeguard our healthcare professionals and impacted families from potential criminal legal ramifications,” the statement read.

“Glad to hear that today Texas Children’s Hospital halted their child-abuse procedures,” Paxton tweeted after the announcement.

The Houston hospital’s move followed a move by Children’s Medical Center in Dallas, which shut down care for children with gender dysphoria in November of last year.

Children’s Medical Center, in partnership with UT Southwestern, operated a program known as GENECIS, which administered hormone-blocking drugs to children as young as 10 years old and made referrals for “sex change” surgeries, according to LifeSiteNews.

Order unclear to some

Some medical professionals stress that there is some gray in the action taken by Gov. Abbott and that they do not know how to proceed.

As reported by Fox 4, Dr. Marcial Oquendo, a pediatrician in Dallas and a member of the Dallas County Medical Society, weighed in, saying that because the governor’s directive is not law, hospitals don’t know what constitutes child abuse.

“Until it’s clear which ones they are and what is what constitutes failing to report and what constitutes the actual abuse… Is it only medications? Or is it only the surgeries? Is it everything? Is it even counseling?” the doctor said. “There is a lot of questions that still need a more clear answer, and a lot of people are trying to figure those out.”

What Attorney General Ken Paxton says

Paxton’s legal opinion, which he issued on Feb. 18, applies to medical procedures, such as genital mutilation surgeries, “several of which have the effect of sterilization,” and any other procedures that involve removing healthy body parts or tissues, as well as puberty-blocking drugs.

“Each of the ‘sex change’ procedures and treatments enumerated above, when performed on children, can legally constitute child abuse” under state law, the Republican attorney general wrote. 

“When considering questions of child abuse, a court would likely consider the fundamental right to procreation, issues of physical and emotional harm associated with these procedures and treatments, consent laws in Texas and throughout the country, and existing child abuse standards,” Paxton continued.

“The Texas Family Code is clear—causing or permitting substantial harm to the child or the child’s growth and development is child abuse. Courts have held that an unnecessary surgical procedure that removes a healthy body part from a child can constitute a real and significant injury or damage to the child,” added Paxton.

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