A version of this story was originally published on Aug. 30, 2023, a day before Senate Bill 14 went into effect. It has been updated with the latest information regarding the Texas Supreme Court’s decision to uphold the law.
On June 28, the Texas Supreme Court upheld Senate Bill 14, which prohibits gender-affirming care for transgender minors in the state, despite efforts from LGBTQ+ organizations to stop the law. The bill went into effect on Sept. 1, 2023.
Gov. Greg Abbott signed the bill on June 2023 as part of multiple bills that impact the LGBTQ+ community during the 88th Texas Legislative session. The bill would make Texas the largest state to ban treatments such as puberty blockers and hormone therapy.
Supporters of the bill say children shouldn’t be allowed to make life-altering decisions. Opponents of the bill argue that it violates parents’ fundamental right to make health care decisions for their children and violates the rights of transgender youths.
Here’s everything you need to know about the law and the impact it has on the LGBTQ+ community:
What is Senate Bill 14?
Senate Bill 14 prohibits “procedures and treatments for gender transitioning, gender reassignment, or gender dysphoria.” Health plans may also not provide coverage for any services “intended to transition a child’s biological sex as determined by the child’s sex organs, chromosomes, and endogenous profiles,” according to the bill language.
Medical providers are prohibited from performing surgeries that sterilize minors or “provide, prescribe, administer, or dispense” prescription drugs “that induce transient or permanent infertility.”
This law isn’t new in the United States – more than 15 states across the country have laws banning gender-affirming care. Some of those state’s laws will go into effect in the coming months. Texas officials have criticized other states that allow such medical procedures.
“This is insane,” Abbott stated last year on social media about gender-affirming laws in California. “This will never happen in Texas. In Texas, we put parents first. Also, I signed a law protecting children from sexual mutilation.”
What did the Texas Supreme Court have to say?
The Texas Supreme Court issued its opinion on June 28 with Justice Rebeca Aizpuru Huddle delivering it.
The court stated: “…we conclude the Legislature made a permissible, rational policy choice to limit the types of available medical procedures for children, particularly in light of the relative nascency of both gender dysphoria and its various modes of treatment…”
In its opinion, the Court issued that the bill does not unconstitutionally deprive rights from parents, physicians or health providers.
What do opponents of Senate Bill 14 say?
Opponents say Senate Bill 14 unfairly targets transgender youths by prohibiting treatments for children with gender dysphoria while allowing the same medical care, including puberty blockers and hormones, to be prescribed to any other minor for any other reason, said Brian Klosterboer, an attorney with American Civil Liberties Union of Texas , during a press conference Aug. 16, 2023.
Since the bill was passed, Equality Texas , an organization focused on equality for all Texans, has been having conversations with families with transgender children and providing them with resources, said Brad Pritchett, field director for Equality Texas.
“This is life-saving health care for kids and this is impacting Texas kids every day in really terrible ways,” Pritchett said. “We’re denying them health care now. But even before this bill will go into effect in September. I mean, the state was terrorizing children and people just seem to be OK with that and that’s not OK. We should be protecting these kids.”
Equality Texas, Transgender Education Network of Texas and the Campaign for Southern Equality partnered to create a micro-grant program to help families needing to travel out of Texas to receive medical care for their transgender children or who relocate completely. The organizations are providing rapid response emergency grants of $500 .
Families with transgender children face a challenge of deciding to stay in Texas or packing their bags and relocating to a state where gender-affirming care is still accessible. Equality Texas has helped families with transgender children navigate the process of relocating. Most of those families have been devastated by being forced to decide whether to leave the place they call home or provide health care for their children, Pritchett said.
“This is legislation that was designed to target a tiny group of children getting a very specific type of health care, then allowing every other child to still access that type of health care,” he said. “For Houston, it’s particularly terrible that we’re the home of the medical center and this bill is being put into effect, denying the expertise of health care professionals.”
What do supporters of the bill say?
Days prior to Abbott receiving the bill on his desk last year, he told Fox News that he would be signing it.
“This is about protecting children,” he said during the newscast. Abbott said minors under the age of 18 are not allowed to purchase cigarettes or tattoos, so they should not be allowed to make life-altering decisions.
State Sen. Donna Campbell, R-New Braunfels, introduced the bill in the legislature on March 29, 2023.
“We must protect children from medically unnecessary, irreversible gender modification treatments,” she wrote in a post on X , the social media site formerly known as Twitter.
Family Policy Alliance , a Christian ministry that says it defends faith and protects families, and Texas Values , an organization that says it’s focused on preserving and advancing a culture of family values in the state, both support Senate Bill 14.
“Today, Texas has sent a clear message: they take child safety seriously,” said Autumn Leva, Senior Vice President of Strategy at Family Policy Alliance, in a press release released June 3, 2023. “When a child is deeply struggling, he or she deserves meaningful help – not the harm of experimental hormones and surgery.”
What challenges came about before the law was enacted?
After Abbott signed the law during the 88th legislative session, the ACLU sued the state of Texas on behalf of five families, three medical professionals and two organizations.
The lawsuit ( Loe v. Texas ) says that Senate Bill 14 violates the Texas Constitution, violates parents’ fundamental right to make health care decisions for their children and violates the rights of transgender youths to not be discriminated against based on sex, Klosterboer said.
A Travis County judge granted the plaintiffs a temporary injunction on Aug. 25 , 2023. In response, the Texas attorney general’s office filed an appeal to block the judge’s decision .
The attorney general’s office issued a press release Aug. 25 , 2023, stating that it will enforce laws issued by the Legislature and protect children.
“These unproven medical interventions are emphatically pushed by some activists in the medical and psychiatric professions despite the lack of evidence demonstrating medical benefit, and even while growing evidence indicates harmful effects on children’s mental and physical welfare,” the office stated.
What happens if the law is violated ?
If medical providers violate the law, they are at risk of losing their medical license.
Where do medical providers stand ?
Attorney General Ken Paxton launched an investigation into Texas Children’s Hospital in May of last year prior to Abbott signing SB 14.
“I’ve been clear that any ‘gender transitioning’ procedures that hurt our children constitute child abuse under Texas law,” he said in a statement . “Recent reports indicate that Texas Children’s Hospital may be unlawfully performing such procedures, and my office it is working to uncover the truth.”
In response to the investigation, Texas Children’s Hospital stated that it would stop gender-affirming care for minors by Sept. 1, 2023, in response to the law.
“We will work with patients and their families to manage the discontinuation of hormone therapies or source appropriate care outside of Texas,” CEO Mark Wallace said in a letter to employees . “We will continue to offer psychosocial support and any form of care we can within the bounds of the law.”
Alex Sheldon, executive director for the Gay and Lesbian Medical Association, said doctors will not remain in Texas and will head somewhere where they don’t have to harm any patient or risk their medical licenses.
Lynly Egyes, legal director for the Transgender Law Center , said doctors are already fleeing the state or not even coming to the state.
“We know from doctors that they’re scared,” Egyes said. “They’re tired.”
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