Texas officials are very concerned about surgeries trans kids aren't even getting

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Both Gov. Greg Abbott and the Texas Department of Family and Protective Services claim gender confirmation surgery for transgender minors is child abuse — even though such procedures are nearly nonexistent.

Texas officials tried to claim recently that gender confirmation surgeries for transgender individuals constitute child abuse, despite that fact that those procedures are not actually performed on minors.

On Aug. 6, Republican Gov. Greg Abbott asked the Texas Department of Family and Protective Services to look into whether gender-affirming surgeries, which are very rarely performed on anyone under 18, according to medical experts, should be considered child abuse under state law.

Examples of gender-affirming surgeries include chest surgeries and facial feminization or masculinization procedures.

In his request, Abbott referred to the surgeries as "genital mutilation."

"Subjecting a child to genital mutilation through reassignment surgery creates a 'genuine threat of substantial harm from physical injury to the child,'" he wrote. "...[The Texas Department of Family and Protective Services] determination should consider making explicit what is already implicit in the statute: that genital mutilation of a child through reassignment surgery is child abuse."

He added, "As you know, classifying genital mutilation of a child through reassignment surgery as child abuse would also impose a duty on DFPS to conduct prompt and thorough investigations of the child's parents, while other state agencies would be obliged to investigate the facilities they license."

Abbot's request followed pressure from those in his party who were upset that the governor had not included a proposed ban on all gender-affirming care for minors in his special legislative session agenda.

On Aug. 2, real estate developer Don Huffines, who plans to challenge Abbott for the governorship next year, claimed the governor wasn't doing enough to stop gender-affirming care and that it "must be put on the special session call."

Earlier in July, Abbott was also asked by conservative radio host Mark Davis why he didn't include it in the special session, which was called in order to ram through several pieces of GOP-led legislation.

The governor said he had "another solution that will address that problem that will be announced shortly" as the legislature likely wouldn't pass such a bill on its own.

Although Abbott didn't include the issue of gender-affirming care in his special session proclamation, he did call for the legislature to reconsider a ban on trans athletes playing on the sports team of their gender. A transgender sports ban has advanced in the state Senate.

The Texas Department of Family and Protective Services eventually responded to Abbott's request on Aug. 11.

Jaime Masters, the agency's commissioner, who was appointed by Abbott in 2019, wrote back, "Genital mutilation of a child through reassignment surgery is child abuse, subject to all rules and procedures pertaining to child abuse. Such mutilation may cause a 'genuine threat of substantial harm from physical injury to the child.''

Masters said allegations of "genital mutilation" would be investigated promptly.

Experts say such rhetoric is not only harmful but is also not based in fact.

Aliza Norwood, an internal medicine doctor who provides gender-affirming care for adults at Vivent Health in Austin, Texas, told the American Independent Foundation that the governor's decision to ask the agency to look into this "perpetuates a falsehood that gender confirmation surgeries are routinely practiced on minors."

"For young children, gender affirming care consists of supporting them socially and calling them by the name and pronouns they ask to be called by," she explained. "Adolescents with gender dysphoria are much more likely to identify as transgender in adulthood. Usual gender-affirming care for adolescents consists primarily of social support and sometimes reversible puberty blockers after considered and thorough evaluation by trained mental health professional and physicians in consultation with the teen and their parents."

Marjan Linnell, a Texas pediatrician who has opposed state legislation prohibiting gender-affirming care, has also spoken out against such claims.

Linnell told the Texas Tribune in April that surgery is very rare for transgender youth, and that typically the procedures are only performed after puberty. If a transgender minor wanted surgery, they would need consultations with multiple health care professionals in order to proceed, she explained.

Norwood said that use of the term "genital mutation" to describe such procedures was harmful.

"It's a stigmatizing mischaracterization of gender confirmation surgery and it disregards the beneficial health effects that transgender adults report after having those surgeries," she said.

In a Wednesday press release, Equality Texas, a state LGBTQ advocacy group, said the governor and agency officials, by issuing their respective request and memo, were spreading misinformation about transgender people "to placate a fringe minority of primary voters."

"The language used in Gov. Abbott’s letter to Texas DFPS and in the DFPS response is offensive to our community and has nothing to do with the reality of life-saving affirming healthcare practices for transgender people, further illustrating that politicians and government appointees should focus on governing actual emergencies and not fictitious ones," CEO Ricardo Martinez said in a statement.

Republican officials across the country have pushed similar rhetoric in recent months. Lawmakers have also introduced legislation prohibiting gender-affirming care for minors, including surgeries which aren't common practice.

In May, for example, Tennessee Gov. Bill Lee (R) signed a bill into law that prohibited minors who had not yet started puberty from receiving hormone treatments and puberty blockers.

Chris Sanders, the executive director of the Tennessee Equality Project, explained to the New York Times, that the law was like a "slap in the face."

"This is another example of the state government saying that the state doesn't trust trans youth and their physicians," he said.

Published with permission of The American Independent Foundation.