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Last week, a couple of letters from Texas Gov. Greg Abbott and Attorney General Ken Paxton started circulating. These letters, aimed at Child Protective Services, encouraged Texans to do something no other state does: view medical treatment for trans kids as abusive. These documents aren’t legally binding—in fact, after they got released, district attorneys representing five of Texas’s biggest counties all said they had no plans to enforce this directive. It’s hard to ignore the political context of this decision: There are some very vocal conservative voters who have been asking Texas officials to crack down on the medicalization of trans kids, especially the use of puberty blockers. It’s a hot-button issue for the right that’s evolved from bathrooms, to sports, to kids—and how they should be treated not just in public but also in private, at home with their families. Abbott and Paxton are up for reelection, and Tuesday is primary day. Both the governor and the attorney general are Republicans, and they face primary challenges from candidates to their right. Abbott is favored to prevail in his race, but Paxton has a shakier path to reelection. On Tuesday’s episode of What Next, I spoke with Katelyn Burns, an MSNBC columnist who was the first-ever openly trans Capitol Hill reporter, about the intent of the Abbott and Paxton’s letters and what their ultimate impact may be. Our conversation has been edited and condensed for clarity.
Katelyn Burns: In order for any child to be removed from a Texas home, there has to be a court order. No court in the United States has actually determined that affirming a child’s gender with health care equates to child abuse, so officials would need to have that precedent before they could actually start removing kids from homes. But we are seeing institutional pushback against this order because I think a lot of people see this what it really is: posturing for a primary campaign that Abbott is facing against a much more conservative candidate.
Mary Harris: If the directive may not be legally binding, I’m wondering if you can lay out why it’s alarming anyway.
This is an escalation we haven’t seen before. I think it’s particularly cruel. It’s the first time we’ve seen the internationally recognized treatment for gender dysphoria declared as child abuse. You’re talking about ripping children and adolescents out of their family homes, out of their parents’ arms. I think for a lot of people, trans issues are mostly an intellectual exercise. We spend a lot of time arguing over trans women or the sports thing or the bathroom thing, but we very rarely step back and actually see trans people as actual human beings with lives who are just trying to get from point A to point B like everybody else.
It seems like Child Protective Services in Texas has actually been investigating the parents of trans kids for years, like, it’s been something families of trans kids have even had to prepare for. What’s it been like if you have a trans kid in Texas?
I would expand this actually past Texas. I think this applies to anybody in the U.S. who has a trans kid. I’ve talked to parents in New York City who have had Child Protective Services called on them by a neighbor or a relative over affirming their child’s gender. So I want to be clear, this is not just a Texas issue. One of the really heartbreaking things that I hear any time I report on trans families or families with trans kids is that the parents have to prepare what they call a girl folder.
That’s basically a folder that documents this child’s entire life as a trans kid. It’s doctor’s appointments. It’s statements from psychologists or statements from doctors all saying, “Yes, this child is actually trans. This is not abuse.” The families have it on hand, expecting to have some stranger or acquaintance who does not approve of trans identity calling the government on them and their families.
What does Gov. Greg Abbott mean when he’s talking about gender transitioning and kids?
You could interpret that in a variety of ways. I think most people think the line is drawn at any sort of medication or medical intervention. The statute could possibly be interpreted to mean any gender-nonconforming behavior or traits.
Like if you cut your daughter’s hair very short, for instance.
Yeah, I don’t think we know for sure, right? And that’s the scary part. That’s part of the reason why trans people like myself and others who care for trans people were so upset.
One of the things specifically called out in the letters was puberty blockers. There’s the idea that when children who identify as trans reach puberty, they are often prescribed puberty blockers, which keep them in a state of stasis while they figure themselves out. My understanding is that now in Texas, puberty blockers are considered part of a gender transition. Is that how doctors think about them?
Well, puberty blockers are used for a variety of things, not just trans-related stuff. If a child has precocious puberty, they’re prescribed puberty blockers. I think there is a lot of misunderstanding about puberty blockers and what they do, because a lot of people don’t realize that puberty blockers are started after puberty starts, not before. There are no 8-year-olds on puberty blockers. You start seeing large hormonal and bodily changes in your kid, and you want to see if the child is actually comfortable with the changes that are starting to happen to their body. If they’re not, you don’t want to force the puberty on them when they feel like they’re helpless, because that leads them into a very dark and potentially dangerous place. So you introduce the puberty blockers so they can mature a little bit more and be more settled in their dysphoria. You make sure they completely understand what they’re doing before you introduce anything that’s permanent. But there has been a lot of scaremongering over this treatment over the years.
What do you think the misunderstandings are about this kind of treatment?
This is not a new treatment for trans people. They first started doing this treatment in the ’90s But I think it’s new to a lot of people. It’s unfamiliar, sounds scary. People don’t know whom to trust for sources, and I there’s a lot of intentionally bad actors, even in mainstream media, who intentionally muddy the waters on this issue in a way that’s not necessary.
What do they say?
They’ll call into question the safety of these treatments. They’ll point to a very small handful of examples of kids who felt like they were trans for a month and then decided they were not, so there’s scaremongering that they potentially could have ruined their bodies had they kept going with this. I look at all of this stuff and I say, Well, what’s wrong with having a trans body? Why is this so stigmatized? Maybe we should get to the point where we can accept trans bodies as normal rather than saying, This is the worst thing that a child can do. I think a lot of it is just down by prejudice.
Is there any debate among medical professionals about whether delaying gender-affirming care would be good for kids?
It is the medical consensus through every major medical association board that gender-affirming care for minors through puberty blockers is the best route to treat gender dysphoria. You see a lot of people in the psychological industry who I think somewhat selfishly want adolescents to spend more time in therapy before they start going there But the consensus among medical professionals is we’ve only found one way to really “solve” gender dysphoria, and that’s through transitioning. If there are other ways that have been proved to work and produce happy, gender dysphoria–free adults. I would happily be endorsing those other ways. But so far we haven’t discovered that.
I want to talk about how Texas got to this point. One reporter called Texas the ground zero of anti-trans legislation.
If you go back to 2015, we are fresh off the Obergefell marriage equality ruling from the Supreme Court. Religious conservatives lost huge on that issue, but they had all these structures set up that were going into anti-LGBT lobbying and advocacy. So the next subject they settled on was trans issues.
Houston, in 2015, passed a sweeping anti-discrimination ordinance written to outlaw bias against people based on their race, age, sexual orientation, and gender identity. Opponents put it to a voter referendum and pursued a campaign calling it the “bathroom ordinance,” saying it would allow dangerous men into women’s bathrooms. The ordinance was repealed, and the spurred a wave of so-called bathroom bills across the country.
Yeah, it came from Texas. And Texas tried for years to pass a bathroom bill unsuccessfully. They tried to pass a school bathroom bill where they just it was a bathroom bill, but only for school children. they have been trying for years to get something on the books against trans kids or trans people.
Texas conservatives have been particularly obsessed with this issue for several years. Part of it is they want to burnish their conservative bona fides here ahead of these primary races.
It sounds like you’re saying that trans kids are political football in Texas.
I think they are political football everywhere.
When would you say the idea of framing gender-affirming care for trans kids as child abuse began?
I would pinpoint 2019. There was a custody case in Texas between a mom and her ex-husband, who was the father of 7-year-old trans girl Luna. Luna came out to parents. The mom was supportive—she is a pediatrician from the medical field. Luna was diagnosed by several different psych professionals as having gender dysphoria. For 7-yearolds, there’s no medical treatment at all for a great number of years. So it was just different hairstyle, a different way to dress, different pronouns, maybe a different name. But the ex-husband refused to accept their child trans identity.
He kept shaving Luna’s head.
He refused to accept this child’s gender identity and basically launched a public relations campaign. He went viral on conservative media and raised hundreds of thousands of dollars to try to fight back against this. He made all these outlandish claims about his ex-wife. It really galvanized Texas conservatives against this type of care for kids.
This man, Jeff Younger, is now running for a seat in the Texas statehouse. His ex-wife has been awarded full custody of Luna. But Younger has to give permission before Luna undergoes any medical transition.
It’s just really heartbreaking.
In the next few months, what are you going to be looking for to see how this directive actually affects the lives of trans kids in Texas?
I want to see if kids are actually being investigated or pulled from homes. I want to see if families are trying to flee the state. There’s all kinds of untold fallout that could happen from this. I’m not sure it will be seen over the next couple of months, because we’re yet to see how CPS is or is not going to adopt this policy. There will certainly be a court fight over it that could last half a decade. Over the long run, the risk is that either children will be taken away from loving parental homes or it’ll make them even more suicidal than they already are.