Health Care

Texas commissioner says gender affirmation surgery among minors is ‘child abuse’

The head of the Texas Department of Family and Protective Services (DFPS) said Wednesday that gender affirmation surgeries on minors could count as child abuse under state law. 

The declaration from DFPS Commissioner Jaime Masters came in response to a request sent last week by Texas Gov. Greg Abbott (R) for the commissioner to issue a determination as to whether gender altering surgery could constitute as child abuse.

Abbott, like several other GOP leaders in states across the country, has sought to pass limitations on gender-affirming care among youth under the argument that it constitutes abuse. 

In her response Wednesday, Masters argued that surgeries among minors may cause a “genuine threat of substantial harm from physical injury to the child,” thus violating Texas state law. 

The declaration comes even as doctors across the country generally advise against performing gender altering surgeries among individuals under the age of 16, and many medical and insurance providers will usually only cover surgeries for patients 18 years old and older. 

However, Republican-led states have sought to implement bans on the surgeries among minors, along with other gender affirming health care for transgender youth, including hormone therapy and puberty blockers. 

Even then, several medical professional groups, including the Endocrine Society, have advised against puberty blockers for children who have not yet reached puberty, and recommends that patients be at least 16 years old before starting any hormone treatments. 

Masters said Wednesday that there may be cases under Texas law when gender affirmation surgeries among youth “may not constitute abuse,” including for “a child whose body parts have been affected by illness or trauma; who is born with a medically verifiable genetic disorder of sex development, such as the presence of both ovarian and testicular tissue; or who does not have the normal sex chromosome structure for male or female as determined through genetic testing.” 

In Texas, failure to report child abuse is a misdemeanor with a punishment of up to one year in jail and a fine of up to $4,000, the commissioner said. 

While the Texas Senate during its regular session this year passed a bill defining gender surgery and other affirming care for youth as “child abuse,” the legislation died in the state House when lawmakers failed to pass it by the bill’s deadline.

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