Texas
Legal fight over Texas law banning transgender health care for youth centers on whether treatments help or hurt
Texas families and health care providers sued the state over Senate Bill 14, which restricts transgender youth from accessing gender-affirming care. The groups are requesting an injunction from a state district court judge before the law goes into effect on Sept. 1.
This article originally appeared in The Texas Tribune
At the heart of the legal fight over Texas’ new ban on puberty blockers and hormone therapy for transgender children is an ongoing debate about whether those treatments help or hurt youth with gender dysphoria.
During a two-day hearing over an attempt to block the law from taking effect Sept. 1, medical experts testified that such gender-affirming treatments are safe. The state attorney general’s office called on its own scientific professionals, who cast doubts on the existing research.
Families of trans youth and medical professionals are suing Texas, asserting that state lawmakers discriminated against trans youth in crafting the prohibition and that the law violates the rights of parents to choose medically approved care for their children.
The new law does not ban any particular treatments or medical care outright. They are prohibited only for the purpose of gender transitioning.
“Make no mistake, our doctors are not being targeted for the type of care they provide. They are not being targeted for the quality of their care. They’re being targeted because of the community they are providing care for,” Alex Sheldon, executive director of GLMA, an association of LGBTQ+ health professionals that is one of the plaintiffs, told reporters outside the courthouse on Wednesday.
The state rejected the claim of discrimination. In her opening statement, Assistant Attorney General Heather Dyer rejected the plaintiffs’ claim that Senate Bill 14 discriminates based on sex because, she said, people with gender dysphoria are not a protected class.
“SB 14 was designed to protect minors from scientifically unsound treatments,” Dyer said.
The new law would ban transgender youth from taking puberty blockers, receiving hormone therapies and having transition-related surgery, the latter of which is rarely performed on minors. Such medical interventions are used to treat gender dysphoria, a medical term for the distress someone experiences when their gender identity doesn’t match their body. The plaintiffs assert that the new law violates their parental rights and interferes with their ability to practice medicine.
Legal groups including the American Civil Liberties Union of Texas, Lambda Legal and the Transgender Law Center requested that Travis County District Court Judge Maria Cantú Hexsel issue an injunction against the law.
Doctors defend gender-affirming care
Dr. Johanna Olson-Kennedy, a doctor who treats adolescents and has been providing gender-affirming care for 17 years, said the body of medical research demonstrates these treatments have a high success rate in improving mental health outcomes of trans youth. But in her clinical work, the evidence is more obvious.
“Recently, I had one of my patients tell me, ‘If you had not allowed me, and helped shepherd me through these interventions, I don’t think I would be here,’” said Olson-Kennedy, the medical director of the Center for Transyouth Health and Development at Children’s Hospital Los Angeles.
She added that hundreds of her patients have expressed the same sentiment in her nearly two decades treating roughly 1,100 young patients.
A central argument of lawmakers supporting SB 14 during the legislative session was that puberty blockers and hormone therapies put young patients at risk for fertility loss and a reduction of bone density. Defense attorneys for the state repeated these claims.
The medical experts called on by the plaintiffs rejected those claims Tuesday, arguing that the scientific literature supports the use of hormones or puberty blockers as a means to improve the mental health of transgender youth and reduces the dysphoria these young people feel.
“I would not consider estrogen or testosterone the end of the story for fertility,” said Dr. Daniel Shumer, a pediatric endocrinologist at the C.S. Mott Children’s Hospital in Ann Arbor.
Pediatric endocrinology is the field of medicine that specializes in transgender adolescent health care.
Representing the state, Assistant Attorney General Johnathan Stone asked Shumer about the number of his patients who stopped receiving gender-affirming treatment. A group of people who refer to themselves as detransitioners have been vocal opponents of gender-affirming care for youth in legislative hearings throughout the country. During this year’s regular Texas legislative session, Republican lawmakers called on several people who had detransitioned to testify in support of SB 14.
Shumer said of his roughly 400 patients, 10 had stopped taking puberty blockers, a reversible treatment that delays the onset of puberty, and two had stopped taking hormones.
Olson-Kennedy noted that there are a variety of reasons people detransition — including a lack of acceptance of their new identity or a loss of health care access — but overall, the number of people who do take this step is very small.
Dr. Aron Janssen, a psychiatrist at the Ann & Robert H. Lurie Children’s Hospital of Chicago, testified to the evidence that psychotherapy alone cannot alleviate gender dysphoria, asserting that puberty blockers or hormone therapy is medically necessary. By restricting access to these treatments, young patients will have worse outcomes, Janssen said.
“There’s an intense improvement we see amongst these kids,” Janssen said of his clinical experience.
The defense
The state disputed the efficacy of puberty blockers and hormone therapy based on the amount and quality of research. Other witnesses for the state argued transgender people can not change their sex and that young people cannot comprehend the long-term implications of these treatments.
The state’s first witness on Tuesday was evolutionary biologist Colin Wright, who has a Ph.D. in evolutionary biology and ecology from the University of California Santa Barbara. Wright testified that humans can only be “observed and recorded” as either the male or female sex. While individuals can modify their secondary sex characteristics, like body hair and breast development, Wright said people cannot change their sex.
Lawyers for the plaintiffs noted that Wright was not an expert in gender dysphoria and had not published original research on the topic of biological sex. Wright, who is vocal on his social media platforms about his opposition to gender-affirming care for minors, was asked if he thought transgender individuals were delusional. Of the idea that people can change their sex from what was assigned at birth, he said, “that specific belief is a delusional belief.”
Dr. Michael Laidlaw, an endocrinologist affiliated with the Sutter Roseville Medical Center in California, said Wednesday that the risks of using puberty blockers and hormone therapy outweighed the benefits. He said reviews of the existing research on these treatments indicate there is limited evidence to show the benefits of using puberty blockers on minors.
Katrina Taylor, an Austin-based therapist designated as an expert witness in psychotherapy, offered starkly different testimony about the origin of gender dysphoria in children.
“When there is gender dysphoria, I see it as a symptom of the family,” said Taylor, the state’s expert witness on psychotherapy. “There’s something going on in that family system that is awry, that is going wrong.”
The state focused attention on the concept of “informed consent” — the agreement to provide care between a health care professional and their patient — and whether minors could agree to receive puberty blockers, hormone therapies and surgery.
Dr. Clifford Hopewell, a North Texas neuropsychologist and former Texas Psychological Association president, said an adolescent’s reasoning was limited based on their brain development and therefore couldn’t appreciate the risks of some gender-affirming care treatments.
“They don’t know what puberty blockers are,” Hopewell said. “An adolescent doesn’t understand that.”
Texans testify
Wednesday was the second day of Nathan Noe’s new school year, but instead of spending the morning at high school, he was in the Travis County Civil and Family Courthouse testifying on how SB 14 would cut him off from life-changing medical treatments. For two years, Noe — who is using a pseudonym as a plaintiff for the lawsuit — has been taking testosterone, which he said dramatically shifted his life for the better.
“I was able to go about my life as a teenage boy, like I wanted to,” Noe said, smiling on the stand.
Parents of trans youth like Noe testified about the impact SB 14 would have on their families. Another parent, identified by the pseudonym Mary Moe, said she and her daughter have moved out of the state in the wake of SB 14.
“I would like to return to Texas, but Texas has become very ugly to me and my family,” Moe said.
Texas health care workers, also named as plaintiffs in the lawsuit, spoke to SB 14’s impacts on their practice. Dr. David Paul, a pediatric endocrinologist who works at Texas Children’s Hospital in Houston, said SB 14 would strip him of the ability to provide the standard of care for his transgender patients.
“They are probably the most positive outcomes of all the patients I see,” Paul said of patients who receive gender-affirming care. If his patients couldn’t access this type of care, Paul said he worries their physical and mental health will deteriorate. He added he has already lost one of his patients to suicide.
To attest to the regret some people experience after receiving gender-affirming care, the state called on Soren Aldaco, a woman who took testosterone when she identified as transgender boy and received top surgery when she was 19.
Aldaco testified that her mental health did not improve after taking hormones and was forced to deal with a number of complications from receiving chest reconstruction surgery. She has since filed a lawsuit against her medical providers for failing to follow their duty of care.
Texas’ new law will still allow transgender people 18 or older to receive chest reconstruction surgery. It will also allow cisgender girls under 18 to have breast augmentation surgery.
Texas lawmakers’ efforts to restrict gender-affirming care in Texas followed nearly identical campaigns from other Republican-led state legislatures. Across the country, 19 other states have passed similar legislation. Prohibiting doctors from providing gender-affirming care to trans youth is widely popular among Republican voters — over 85% of registered GOP voters in Texas supported these restrictions to some degree, according to an April poll by the Texas Politics Project.
But the wave of new legislation invited a series of lawsuits across the country seeking to block the laws from going into effect. Those suits have largely proved successful in federal courts.
In June, a federal judge ruled that Arkansas’ ban on gender-affirming care for minors is unconstitutional because it violates the due-process and equal-protection rights of transgender children and their families. Federal judges in Florida, Kentucky and Tennessee have also blocked those states’ laws from going into effect. An appeals court intervened to allow Tennessee to implement its ban, and the Kentucky federal judge lifted the injunction he issued, allowing the law to go into effect.
This lawsuit is filed in state court and claims SB 14 violates parental-right protections laid out in the Texas Constitution.
Disclosure: The ACLU of Texas has been a financial supporter of The Texas Tribune, a nonprofit, nonpartisan news organization that is funded in part by donations from members, foundations and corporate sponsors. Financial supporters play no role in the Tribune’s journalism. Find a complete list of them here.
The Texas Tribune is a nonpartisan, nonprofit media organization that informs Texans — and engages with them – about public policy, politics, government and statewide issues.
Education
Under Katy ISD gender policy, student identities disclosed to parents 19 times since August
Public records obtained by the Houston Landing offer the first glimpse at how often the new, hotly contested policy has been used to disclose LGBTQ+ students’ identities to parents — even if the students aren’t ready.
Since narrowly passing a controversial gender policy two months ago, Katy Independent School District has sent 19 notifications informing parents that their child identified themselves as transgender or requested to use different names or pronouns at school.
The number of parental notifications, obtained by the Houston Landing through a public records request, is the first glimpse at how often the new, hotly contested policy has been used to disclose LGBTQ+ students’ identities to parents — even if the students aren’t ready.
So far, the district averages a notification to a parent roughly once every three days.
The district’s policy requires staff to inform parents if their student requests to use different pronouns or names, or if they identify themselves as transgender — and obtain written parental consent to comply with the request. It also prohibits employees from asking for students’ preferred pronouns and discussing “gender fluidity,” and requires students to use bathrooms that align with their sex assigned at birth.
Jarred Burton, a student leader at Tompkins High School’s Sexuality and Gender Alliance, said the number of notifications already sent to parents is both depressing and surprising. Critics, including Katy parents, LGBTQ+ students and local advocates, have blasted the policy as a dangerous measure with the potential to expose students’ gender identities to unsupportive parents, further harming a community that already faces a higher risk of mental health issues than their peers.
“It’s just sad to see this actually happening,” Burton said. “It shows that (the policy) is not a bluff.”
Board members who supported the policy hailed it as a measure that would center parents’ right to be informed about their child’s gender identity and protect teachers from making uncomfortable decisions about concealing such information from parents.
“(Parents are) supposed to be looking after the health and welfare of their child,” Board President Victor Perez said at a late August meeting. “Withholding that information from the parent, that is a great burden on staff.”
It’s unclear how many parents were already aware of their child’s gender identity. District officials also did not make any board members available for an interview on the matter.
“The policy is intended to provide parents and guardians the opportunity to be made aware of their child’s name change request, and the opportunity to grant or deny approval of said request,” Katy spokesperson Nick Petito said in a statement Wednesday.
Ash Thornton, a transgender man and a junior at Tompkins High School, said the number of notifications being sent home will discourage LGBTQ+ students from feeling safe to explore their identities.
“It signals that it’s something bad, them being transgender or expressing gender in a way that’s different,” Thornton said. “It definitely messes up student-teacher relationships.”
Employees are not required to comply with a student’s name or pronoun change even if a parent gives consent, the policy states.
One staff member on every campus is responsible for processing and sending notifications to parents and guardians, Petito said. The policy makes an exception for “cases of suspected abuse.”
Students belonging to LGBTQ+ clubs have told the Landing the policy has caused their schools to become less of a safe space and has instilled fear among LGBTQ+ youth in Katy.
“There’s just been this looming cloud of dread over a lot of people,” Burton said in a September interview. “There’s gonna be a lot of people that get in trouble by their parents or get hurt. … It just sometimes keeps me up at night a little bit because it’s hard to imagine how much hate people can have to pass something like this.”
The number of notifications sent to parents to date leaves Thornton to wonder what else is to come.
“It’s only been two months and there’s already 19, how many more people are going to be affected by even just the end of the semester?” he said.
The Houston Landing is a nonprofit newsroom devoted to public service journalism for all Houstonians.
This article first appeared on the Houston Landing and is republished here with permission.
88th Texas Legislature
Texas’ ban on certain drag shows is unconstitutional, federal judge says
Senate Bill 12 would have prohibited performers from dancing suggestively or wearing certain prosthetics in front of children. Critics sued the state, saying it violated the First Amendment.
This article originally appeared in The Texas Tribune
Texas cannot enforce a new law that restricts some public drag shows, a federal judge said Tuesday in declaring the legislation unconstitutional.
U.S. District Judge David Hittner found Senate Bill 12 “impermissibly infringes on the First Amendment and chills free speech.” The struck-down law prohibited any performers from dancing suggestively or wearing certain prosthetics in front of children.
Hittner ruled that language discriminated based on viewpoint and is unconstitutionally overbroad and vague.
“The Court sees no way to read the provisions of SB 12 without concluding that a large amount of constitutionally-protected conduct can and will be wrapped up in the enforcement of SB 12,” the ruling reads. “It is not unreasonable to read SB 12 and conclude that activities such as cheerleading, dancing, live theater, and other common public occurrences could possibly become a civil or criminal violation.”
The plaintiffs who sued the state celebrated the order, saying in statements shared by their lawyers that the decision affirmed their rights to express themselves.
“I am relieved and grateful for the court’s ruling,” drag performer Brigitte Bandit said. “My livelihood and community has seen enough hatred and harm from our elected officials. This decision is a much needed reminder that queer Texans belong and we deserve to be heard by our lawmakers.”
Republican state Sen. Bryan Hughes, who authored SB 12, defended the bill and pledged to challenge the ruling. The Texas Attorney General’s Office will appeal the ruling, a spokesperson said.
“Surely we can agree that children should be protected from sexually explicit performances. That’s what Senate Bill 12 is about,” Hughes said. “This is a common sense and completely constitutional law, and we look forward to defending it all the way to the Supreme Court if that’s what it takes.”
Critics of the bill, though, say that Republican lawmakers and officials this year have incorrectly — and unfairly — portrayed all drag performances as inherently sexual or obscene.
While SB 12 was originally billed as legislation that would prevent children from seeing drag shows, the final version did not directly reference people dressing as the opposite gender.
However, Republican leaders, including Gov. Greg Abbott, made it clear that drag shows were the bill’s target — comments and history that Hittner wrote “the court cannot ignore.”
Last month, Hittner temporarily blocked SB 12 from taking effect on Sept. 1 after a two-day hearing for a lawsuit filed against the state by a drag queen and LGBTQ+ groups.
LGBTQ+ Texans, advocates, artists and business groups who sued the state, argued that the law discriminates against the content of performances and restricts equally protected free expression that is protected under the First and 14th Amendments.
In Tuesday’s 56-page ruling, Hittner noted a survey of court decisions “reveals little divergence from the opinion that drag performances are expressive content that is afforded First Amendment protection.”
“Drag shows express a litany of emotions and purposes, from humor and pure entertainment to social commentary on gender roles,” the ruling reads. “There is no doubt that at the bare minimum these performances are meant to be a form of art that is meant to entertain, alone this would warrant some level of First Amendment protection.”
Other states have passed similar legislation restricting drag performance, which have also been struck down by federal courts.
In June, a federal judge in Tennessee, appointed by former President Donald Trump, ruled a law there was unconstitutional in its effort to suppress First Amendment-protected speech.
Bucking that trend, another Texas federal judge last week issued an opinion that supported drag show restrictions.
U.S. District Judge Matthew Kacsmaryk said that West Texas A&M University President Walter Wendler acted within his authority when he canceled a campus drag show. Kacsmaryk wrote that Free Speech jurisprudence had “not clearly established that all ‘drag shows’ are categorically ‘expressive conduct.’”
Hittner acknowledged his Panhandle counterpart’s ruling Tuesday. Hittner pointed to a letter in which Wendler explained his reasoning for banning the show, comparing drag to blackface and a slapstick sideshow.
“The president’s sentiment reinforces this Court’s opinion that while some people may find a performance offensive or morally objectionable, it does not mean the performance is not expressive or given First Amendment protection,” he wrote. “Not all people will like or condone certain performances. This is no different than a person’s opinion on certain comedy or genres of music, but that alone does not strip First Amendment protection.”
LGBTQ+ advocates welcomed Hittner’s decision Tuesday.
“Today’s ruling is a celebration for the LGBTQ community and those who support free expression in the Lone Star State,” GLAAD President and Chief Executive Officer Sarah Kate Ellis. “Texas now joins an increasing number of states whose discriminatory and baseless bans on drag performances are being recognized as unconstitutional and an attack against everyone’s freedoms.”
William Melhado contributed to this story.
The Texas Tribune is a nonpartisan, nonprofit media organization that informs Texans — and engages with them – about public policy, politics, government and statewide issues.
Houston
Texas consistently leads the nation in attacks on trans people. Here’s how Houstonians are fighting back.
After attending the Houston Pride parade in June, Søren Beregan just wanted to dance. Beregan, a trans man, and his partner, who is nonbinary, were enjoying themselves at a Montrose-area nightclub when a man approached them.
“I’m better than you,” the man said aggressively.
Caught by surprise, Beregan laughed it off. “In a way it felt almost affirming as a trans guy to have a cis guy feel threatened by me,” he said, using a shortened form of the word cisgender, which means someone whose gender identity corresponds to their sex at birth. “But then later, I was like, wow, that sucks. It is scary to walk around in public … and know that there are people who are upset seeing you just living your life.”
Although he didn’t show it, Beregan felt helpless. In the past, when he was femme-presenting, he occasionally wore dresses and heels. “I was never taught how to fight. I was never taught how to defend myself. It was always ‘have a guy around you,’” he said.
But since transitioning over a year ago, things are different. He wants to be self-sufficient at a time where there have been increased attacks and hateful rhetoric against his community statewide.
On a recent Saturday morning, Beregan was among roughly 20 attendees in a de-escalation and self-defense workshop at the Montrose Center aimed at training participants on how to defend themselves from a physical attack, in lieu of carrying a gun.
It’s one of the ways that some trans Houstonians are taking matters into their own hands to protect themselves in Texas, a state that introduced more anti-LGBTQ+ and anti-transgender bills than any other state this year, and at a time when data shows anti-LGBTQ+ rhetoric is on the rise.
Texas lawmakers passed three bills this year that impact trans rights: Senate Bill 12, which bans “sexually oriented performances” – a term originally used to classify drag shows – in the presence of minors; Senate Bill 14, which bans medical care for trans youth to treat gender transitioning or gender dysphoria; and Senate Bill 15, which requires trans college athletes to compete on sports teams based on their biological sex. SB 14 and SB 15 went into effect on Sept. 1, while SB 12 awaits a final ruling from a federal judge in Houston after the ACLU of Texas challenged the law on behalf of several LGBTQ+ organizations.
“With all the anti-trans legislation in Texas, it’s like we’re the next target,” said George Zemanek, the president of Transmasculine Alliance Houston. The group, which organized the weekend workshop, provides community support to anyone assigned female at birth who is questioning their gender or who identifies as non-binary, female-to-male or transmasculine – a term that includes both trans men and nonbinary people assigned female at birth who define their gender as masculine, or who seek medical transition towards masculinization.
Zemanek said the thinking behind the quarterly workshops was, “Let’s do a physical safety training and let’s talk about all these things, because it may become an issue.”
The secret weapon
Trainers from Third Ward Jiu-Jitsu, a nonprofit organization that aims to provide affordable and inclusive self-defense training,led the workshop, which focused on de-escalation tactics and skills such as dodging a punch, or how to twist away if someone grabs your wrist. Instructors also reminded attendees to remain vigilant and put their phones away in public.
“If you’re just walking around with your head down like this the whole time, it is the perfect opportunity for someone to attack,” said Andrew Degar, the cofounder of the group, while demonstrating.
A studious Beregan meticulously watched as the instructors broke down different techniques. “I’m a little guy and [when] I do that frame, how do I then quickly back out of that position so that I’m not then just gripped by this giant?” he asked Degar, physically demonstrating the scenario he had in mind.
Other participants haven’t experienced physical attacks, but wanted to be proactive.
“I go to the University of Houston. I take public transit so I’m often out and about, so I thought knowing something about breaking away from grabs and getting away from people could be helpful,” said 31-year old Ed Kneelan who took turns practicing with the other participants.
“Fortunately I haven’t had anything fishy happen ever, but I know that can happen, so I think it’s better to be prepared,” he said.
A proactive approach
By taking a proactive approach, Zemanek believes that it will empower the trans community to be aware and know what to do in situations like a public protest, where people may be at an increased risk of physical violence.
“I foresee that at some of these protests against anti-trans legislation, you’re gonna start to see trans people getting arrested,” he said. “Some of these protests can be pretty wild.”
A spokesperson from GLAAD, an LGBTQ+advocacy organization, confirmed to the Landing that there have been 209 anti-LGBTQ incidents targeting drag events nationwide since early 2022. Texas consecutively had the most incidents and threats with 21 reported incidents so far this year, and 27 reported incidents in 2022, a representative said via email.
An April update on its 2022 analysis noted that there was an uptick in attacks beginning in Pride season that year, which is typically during June, and continuing through the midterm election cycle. At this year’s Pride celebration in Houston, participants spoke to the Houston Landing about the apprehension they felt due to the wave of anti-trans legislation. “You never know, there’s crazy people that do things that you don’t expect,” Carlos Gallardo told the Landing while celebrating Pride in Montrose.
It’s not just physical attacks and threats that have rattled the trans community. A joint report from GLAAD and the Anti-Defamation League released in June found that anti-LBGTQ rhetoric and harassment has also increased within the last year, with more than 350 hate and extremist incidents recorded in the U.S.; Texas had the third most with 30 incidents.
The return of community patrolling
The rise of anti-LGBTQ+ incidents over the last several years has motivated community activists like Ethan Ganz. He is the co-founder of the Montrose Residents Coalition, a group that is joining forces with the nonprofit Affinity Coalition To Overcome Unethical Theories HTX (ActOutHTX) to revive the work of a Montrose-area volunteer surveillance group called Q-Patrol, which launched in 1991 but dissolved in 2002 due to financial woes, newspaper archives show.
“I really think it’s necessary now,” he said to participants assembled in a circle following the training.
A group of citizens organized Q-Patrol shortly after the murders of Paul Broussard and Phillip Smith, two gay men who were killed outside a gay nightclub in Montrose. Their brutal deaths sparked civil unrest locally, led to national discussions and prompted the Houston Police Department to launch an undercover initiative, dubbed Operation Vice Versa, where officers masqueraded as gay men. Officers were attacked in multiple incidents and many people were arrested within two weeks, according to the website Houston LGBTQ History and ABC13.
Originally Q-Patrol worked in tandem with the police, but now, “That’s not really what they’re trying to do,” Ganz said. “A lot of our people do not feel safe around the police,” he added.
In the 1990s when the original Q-Patrol reigned, it was illegal to carry a handgun openly or concealed without a license, but open carry was made legal in 2021. Ganz still discourages open carry of any firearms, but said volunteers can carry a concealed weapon, mace or a taser at their discretion.
Beregan is uncomfortable carrying a gun and can’t pocket his mace or pepper spray into most bars, so he views self-defense as his best weapon. After taking a few classes recently, he now feels better equipped to defend himself and plans to continue training with the Third Ward Jiu Jitsu’s monthly LGBTQ+ focused self-defense classes. But he has no plans of joining Q-Patrol at this time.
Acknowledging their limits, Ganz said the goal of Q-Patrol is to help people before police need to get involved.
“So if we see somebody that’s alone, we’ll walk them to the car. We see someone drunk in the street, we might engage with them and see what we can do to help them. This is more about being seen engaging our community, taking care of each other.” Ganz said they will also carry power banks to help people charge their phones to call a ride.
More training is needed in de-escalation, CPR, first aid, and, eventually, shooter response practice and Narcan training to ensure safety, Ganz said, but he anticipates Q-Patrol will hit the Montrose streets soon.
The Houston Landing is a nonprofit newsroom devoted to public service journalism for all Houstonians.
This article first appeared on the Houston Landing and is republished here with permission.
