What Texas’ terrifying attack on trans health care means for LGBTQ2S+ youth 

Kat Stupka has a favourite picture of her 12-year-old, Alex, that she thinks of often. It was taken during a shopping trip a year and a half ago after she told Alex to clean out their closets of all the T-shirts and sweatpants that didn’t fit the person they wanted to be. Alex had been on a long journey of coming to terms with their gender identity, one that Stupka describes as a progression of shorter and shorter haircuts: from shoulder length to an undercut and then shaving one side before finally cutting it all off. 

The photo, in which Alex leans on a table with their elbows together, may seem like an ordinary snapshot of a young person on the cusp of teenage life, but Stupka says it’s a distillation of how freeing coming out was for their child. Before they began the slow process of socially transitioning, she says Alex was “angry and really shut off.” But Stupka has since watched them bloom into a confident kid who auditions for school plays.

“They’re just so happy,” Stupka tells Xtra. “It sounds so simple, but they’re just so happy and you can see it in their face. You can see it in their posture and their demeanor, and it affects absolutely everything.”

But following a decision from Stupka’s governor targeting trans youth across the state of Texas, she worries that her child’s newfound joy may be suddenly ripped away. Earlier this week—and just ahead of the March midterm elections—Republican Gov. Greg Abbott ordered the state’s Department of Family and Protective Services (DFPS) to “conduct a prompt and thorough investigation” into any reports of Texas minors receiving “elective procedures for gender transitioning.”

Abbott’s Feb. 22 directive further refers to gender-affirming medical care as “child abuse.” It orders teachers, doctors, nurses, day care workers and mental health professionals to inform DFPS if they are aware of a Texas youth being offered treatments like hormone therapy or puberty blockers. Failure to report could result in up to a year in jail.

“It’s shocking to truly feel like the only safe option for your family is to leave.” 

Alex hasn’t begun medically transitioning yet because Stupka says they haven’t had the opportunity. Just days after she joined a Facebook group for parents of trans youth to get connected to resources in her area, the state’s most prominent gender-affirming clinic was effectively forced to close. Known as GENECIS, the program operated by Children’s Medical Center Dallas announced in November that it would stop referring new patients for treatments like hormone replacement therapy (HRT).

Stupka feels like a familiar pattern is playing out again: her family reaches a point of being able to take a step forward just to have the door shut on them before they can walk through it. She and her husband have been looking at Zillow listings in other states while they figure out how to get Alex what they need to stay on a path of progress. They even talked about moving to Costa Rica.

“It’s shocking to truly feel like the only safe option for your family is to leave,” Stupka says. “This is a country that is obnoxious about freedom and all of this stuff that they spout off about and then you’re forcing people to choose between being themselves or leaving the place that home is. It’s suffocating.”

Not every Texas family has the means or desire to move, but Abbott’s order has left trans youth and their communities scrambling as they determine what this decision means for them. While advocacy groups say the statement is non-binding and agencies across the state are not legally required to enforce it, the fallout has left LGBTQ2S+ Texans with more questions than answers. Many are confused and absolutely terrified about what comes next. 

Mellie Baggett, who lives in Plano with her 16-year-old child, Ray, says she has struggled to make sense of the directive in the three days since its announcement. She has cycled through emotions of anger and grief, wondering how someone who has never met their family could “throw our kids under the bus.” She keeps thinking to herself: “Why is my state trying to kill us?”

These thoughts are especially disheartening, Baggett explains, because Ray already deals with enough bullying on a daily basis. During a recent trip to the mall with a friend, Ray and a friend had to be escorted to their car by on-site security because someone was harassing them, she says.

“Every day, you have to wonder, ‘What’s going to happen today? Who’s going to be mean to my kid today?’” Baggett tells Xtra. “You’re not thinking that’s going to be adults.”

LGBTQ2S+ advocates have tried to offer hope to families who are struggling with this decision by assuring them that the rule of law in Texas has not changed. In an email to Xtra, Brian Klosterboer, a staff attorney at the ACLU of Texas, says that Abbott’s directive has “no legal effect” and does not “deprive any family of necessary medical care.” Every leading U.S. medical organization, as the national legal advocacy group has stressed, supports the use of gender-affirming treatments for trans youth. 

Nicholas Guillory, a fellow with Lambda Legal, adds that “no court across the country that has ever found that gender-affirming care is considered child abuse.” “This letter doesn’t determine the law, courts do,” Guillory tells Xtra. “It’s up to a court to determine what actions will be taken.”

Thus far, legal authorities in Texas haven’t demonstrated a willingness to enforce the order. District attorneys in the counties of Bexar, Dallas, Fort Bend, Nueces and Travis strongly condemned Abbott this week, referring to the order as “an egregious invasion of privacy” in a letter cited by USA Today. Those five counties alone represent more than 7 million people in cities like Austin, Corpus Christi and San Antonio who will not face prosecution for failing to report gender-affirming health care.

“It’s hard to see a state that I love so much be so hateful and harmful toward people that I care about.”

But others remain concerned about the vast potential for harm in a state as large as Texas. Andrea Segovia, senior field and policy advisor for the Transgender Education Network of Texas (TENT), notes that the majority of Texas’ 254 counties are located in rural and deeply conservative areas where trans youth “maybe don’t have the most progressive people on their side.”

“It’s just sad,” Segovia tells Xtra. “This is a state that I have grown up in. I’m a fourth-generation Texan. My great-grandmother came to the U.S. for this better life for herself, her family and future generations. It’s hard to see a state that I love so much be so hateful and harmful toward people that I care about.”

Even if no D.A. in any Texas county decides to act on Abbott’s directive, that doesn’t mean trans communities are out of the woods. The order is loosely modeled after Texas’ controversial Senate Bill 8, in which vigilantes can collect bounties of up to $10,000 for reporting cases where a pregnant person has been offered abortion care. Similarly, any member of the public can notify DFPS if they are aware of medical professionals offering affirming treatment to trans youth.

This policy is likely to result in trans kids and their loved ones being targeted by false accusations of abuse, as the ACLU of Texas warns. Klosterboer predicts it may “lead to misguided reports by people who believe, inaccurately, they are obligated to report trans-supportive families to the state,” along with increased bullying and harassment.

Another open question regarding the directive is how it will impact Texas family courts. Cathryn Oakley, state legislative director for the Human Rights Campaign (HRC), says that D.A.s are not involved in matters like visitation disputes, in which the state’s position on “child abuse” could be used to justify “losing custody of your kid.” Just hours before Abbott’s order was released, Texas Attorney General Ken Paxton issued his own 16-page opinion claiming transition care for minors is “against the law” in Texas.

While judges are not obligated to agree with Abbott and Paxton’s interpretation of the law, family court rulings are often sealed. Thus, LGBTQ2S+ advocates may not know how the directive is—or isn’t—being applied in these cases, Oakley says.

“There’s a lot of factors to this and make it unique enough to make people very nervous on the ground,” she tells Xtra. “The risk is very high. The risk is so high that when you’re calculating the risk, even if the risk of a bad outcome is low, the pain of the bad outcome is so high that the risk is intolerable. That is the moment that we’re in, and it’s really, really, really scary.”

“These politicians will do literally anything, and they have no bottom. They will not stop at the unconscionable.”

These questions don’t just impact LGBTQ2S+ communities in Texas, according to HRC. More than 20 states introduced legislation last year seeking to limit the types of health care that can be offered to trans youth, including Texas. Only Arkansas and Tennessee signed their bills into law, but additional efforts to limit access are already underway in 2022. Oakley says legislation that would make it a felony to provide transition care for minors in the state of Alabama is “poised to pass into law” as soon as next week.

“We’ve got all of the other states where legislation is moving,” she says. “Let that be a wake-up call: these politicians will do literally anything, and they have no bottom. They will not stop at the unconscionable. We have got to keep fighting wherever these bills come up because those are somebody’s babies in Texas and they’re somebody’s babies in Alabama. These are kids, and they deserve to be loved and affirmed.”

As the mother of a trans kid, Kat Stupka says that she has felt “helpless” in the wake of these attacks against families across the country. Being able to find a doctor that will treat trans children in a compassionate, knowledgeable manner was already a difficult task, sometimes requiring long drives to other corners of the state, and now their family has no idea where to go. Their family isn’t even sure if Alex’s pediatrician is a “safe space now,” Stupka says. 

Like many parents of trans kids in Texas, Stupka isn’t sure what the future holds. But no matter where they end up, Stupka says she doesn’t want her child to ever feel like they need to hide part of themselves or “be smaller” ever again.

“It’s on us to protect them as they live the best way that they can,” she says. “I don’t know what’s gonna happen, but I box. I’ll beat someone up.”