Texas Supreme Court upholds ban on transition-related care for minors

Parents and medical providers of transgender adolescents sued Texas, challenging the constitutionality of a restriction on puberty blockers and hormone therapy.

The Texas Supreme Court upheld a recent state law that prohibits doctors from prescribing gender-affirming care to transgender minors after parents and medical professionals challenged the constitutionality of the restriction.

Justice Rebeca Aizpuru Huddle, who delivered the opinion of the court, said that although “fit parents” have a right to raise their children, without government interference, but also said that such a right is not absolute.

“When developments in our society raise new and previously unconsidered questions about the appropriate line between parental autonomy on the one hand and the Legislature’s authority to regulate the practice of medicine on the other, our Constitution does not render the Legislature powerless to provide answers,” she wrote.

State lawmakers barred transgender teenages from accessing puberty blockers and hormone therapy last year, despite fierce opposition from LGBTQ+ advocacy groups and parents of trans children. Texas’ ban on transition-related care mirrored those in dozens of states led by Republican legislatures.

Texas parents, doctors and advocacy groups argued in a lawsuit filed last summer that Senate Bill 14 violated their right to make decisions about their children’s health, which is enshrined in the state constitution.

During an August hearing in Travis County district court, Texas medical professionals testified that the state law would strip them of the ability to provide the standard of care to transgender patients.

Doctors prescribe puberty blockers and hormone therapy to treat gender dysphoria, a dissonance felt by some transgender people between their sex assigned at birth and their gender identity. The terms transition-related care or gender-affirming care can also include surgeries, but those are rarely performed on minors.

Trans kids, their parents and major medical groups say puberty blockers and hormone therapy are important to protecting the mental health of an already vulnerable population, which faces a higher risk of depression and suicide than their cisgender peers. At the same time, doctors say cutting off these treatments — gradually or abruptly — could bring both physical discomfort and psychological distress to trans youth, some of whom have called it forced detransitioning.

The law was part of a broader coalition of bills that LGBTQ+ advocates say have targeted their community. Some Texas Republicans campaigned on prohibiting transition-related care under the banner of protecting children.

The Texas Supreme Court, which is composed of nine Republican justices, heard the case in January after a Travis County district court temporarily blocked the law from going into effect. State district court Judge Maria Cantú Hexsel said that the law infringed on Texas parents’ right to make medical decisions about their children. But a state appeal to the Texas Supreme Court enabled the law to go into effect in September.

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