Texas’ governor directs state agencies to investigate some transgender medical treatments as ‘child abuse’

Texas Republican Gov. Greg Abbott this week directed state agencies to conduct “prompt and thorough” investigations into the use of gender-affirming care for transgender children, a move that follows an opinion from the state attorney general that such treatments are a form of “child abuse.”

In a Tuesday letter to the state’s Department of Family and Protective Services, Abbott cited an opinion issued Friday by Texas Republican Attorney General Ken Paxton stating that certain gender-affirming treatments for transgender children — including gender reassignment surgery and puberty-blocking medications — “can legally constitute child abuse under several provisions” of state law.

Abbott wrote that the protective services agency "is responsible for protecting children from abuse," adding in a tweet Tuesday that the agency will "refer for prosecution any such abuse."

The Department of Family and Protective Services did not immediately respond to a request for comment from The Washington Post late Tuesday on whether it would follow the directive. A spokesperson for the agency told the Dallas Morning News that it "will follow Texas law as explained [by Paxton's opinion]," adding that it had no pending investigations.

Abbott said Texas doctors, nurses and teachers have an obligation to report instances of child abuse and that existing law "provides criminal penalties for failure to report such child abuse." Members of the public have similar requirements, Abbott wrote.

The directive is the state's latest attempt to limit gender-affirming care for transgender youths. In October, Abbott signed a law that bans transgender girls from playing with female sports teams in public schools.

In August, the Department of Family and Protective Services began to recognize certain gender-affirming surgeries as "child abuse" after receiving pressure from the governor, the Texas Tribune reported.

Texas is among several states that have attempted to restrict the treatments for transgender youths, along with limits to bathroom access and participation in sports. In April, Arkansas legislators passed the country's first law banning gender-affirming treatments for minors. This month, South Dakota Republican Gov. Kristi Noem signed a bill that bans transgender girls and college-aged women from participating in female sports, joining nine other states that have passed such a ban, The Post reported.

Major medical associations, including the American Academy of Pediatrics, have supported the use of gender-affirming care for transgender children, although doctors generally recommend waiting until a child reaches puberty to begin medications such as puberty blockers or hormone treatments, The Post has reported.

The Morning News reported that it is unclear if every state agency will follow Abbott's directive, as Paxton's opinion does not carry legal force. Some prosecutors and county attorneys have said they will not follow the order, the newspaper reported.

Harris County Attorney Christian Menefee, a Democrat out of the Houston metro area, in a statement accused Abbott and Paxton of "ignoring medical professionals and misrepresenting the law to the detriment of transgender children and their families."

"As the lawyer who represents DFPS in civil child abuse cases in Harris County, I can tell you my office won't be participating in this political game," Menefee added in a tweet.

Both the district attorney’s office and the county attorney’s office in Travis County, where Austin is located, told the Morning News they would not adhere to the directive. Travis County Attorney Delia Garza, a Democrat, told the paper that “Republican leadership of this state is trying to turn loving and supportive parents into criminals, and this office will play no part in it.”