Leaders of the Texas state government recently issued a letter to its state health agencies announcing that providing gender-affirming medical treatments to transgender and gender-diverse (TGD) youths “constitutes child abuse” under state law. Governor Greg Abbott then stipulated that teachers and health care providers are now legally required to report parents who aid their child in receiving age-appropriate and medically necessary gender-affirming care to the Texas Department of Family and Protective Services (DFPS).

In response, the ACLU, the ACLU of Texas, and Lambda Legal have sued to prevent implementation of these predatory actions. The U.S. Department of Health and Human Services also issued a statement which indicates that denying TGD youth medically necessary health care is discriminatory and illegal under federal law.  However, health care systems within Texas have “paused” hormone-related therapies for gender-affirming services to protect the families and healthcare professionals who could face the legal ramifications of this order.  Innumerable youth now face the possibility of abrupt cessation of their treatment, and their supportive families and healthcare providers must fear criminal investigation for providing the current standard of care.

These actions are a direct attack on TGD youth, their supportive families, and the entire TGD community that disregard well-established medical research and put the mental health and well-being of these children at stake. This proposed legislation is not an isolated event. So far in 2022, more than a dozen states have introduced legislation seeking to restrict access to and criminalize gender-affirming healthcare. In total, more than 30 states have introduced over 100 pieces of anti-trans legislation already this year, attacking not only healthcare equality, but also TGD youth’s rights to safe and appropriate restrooms and equitable participation in sports. If these discriminatory laws are passed, they will have catastrophic consequences for a vulnerable population that already suffers from higher rates of ​​anxiety, depression, self-harm, and suicide.

The Society for Pediatric Anesthesia (SPA) joins with many other major U.S. medical organizations (e.g. American Medical Association, American Academy of Pediatrics, and American Psychological Association, American Academy of Child and Adolescent Psychiatry, American College of Physicians, American Academy of Family Physicians) in recognizing that gender-affirming care is life-saving and medically necessary.  The SPA will continue to support the rights of TGD youth and help ensure that they receive the gender-affirming care that they seek.

As perioperative medical professionals and patient safety advocates, we have a duty to protect and care for all vulnerable pediatric populations. TGD youth are under attack across our country and deserve our protection. Now is the time to stand up, make our voices heard, and uphold our ethical standards in the face of injustice.

Specifically, we call on our members to:

• increase their understanding of gender-affirming care for TGD youth
• remain vigilant of the current anti-trans legislative trends, especially legislation specific to their state
• support the efforts of pediatricians and mental health practitioners who provide age-appropriate, gender-affirming care to TGD youth
• ensure equitable access to gender-affirming care, noting that the inability to access such care can result in morbidity and mortality.

SPA has made a $5,000 donation to the National Center for Transgender Equality.  You may also wish to consider a donation to one of the following organizations:

National:
National Center for Transgender Equality
Human Rights Campaign
Lambda Legal

Texas:
Equality Texas
Transgender Education Network of Texas
Texas Freedom Network