Texas GOP’s bills targeting transgender children have exacted a mental health toll, even if they don’t become law

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Houston mother Lisa Stanton says every parent’s instinct is to keep their children safe.

When she and her young daughter, Maya, earlier this year traveled to the Texas Capitol to testify against two bills restricting transgender children’s access to transition-related medical care, including hormone therapy and puberty suppression treatment, she worried for her daughter’s well-being — both physical and mental.

“We don’t want our kids to face adversity,” Lisa Stanton said. “And that’s the thing I struggle about the most.”

Maya was scared, too. At just 10 years old, she faced a difficult task: convincing a conservative-leaning group of legislators not to advance legislation that would label her mother a child abuser and revoke the license of her doctor for providing gender-affirming medical care.

The Stantons are among the transgender Texans, parents and advocates who have spent late nights and early mornings fervently testifying, holding rallies and lobbying legislators not to support bills targeting transgender people this session.

Texas is one of at least 20 states that have considered bills limiting access to transgender health care in 2021, according to the ACLU, and one of at least 31 states with bills that would limit the school sports teams they can join. But according to Equality Texas, there have been more anti-LGBTQ bills introduced in Texas this legislative session than any other state.

The Senate passed a slate of bills targeting transgender Texans this session, but they faced resistance in the House.

Two bills affecting transgender medical care missed a House deadline Sunday night after leaders in the lower chamber failed to put them on calendars for consideration during the final days of the session. Senate Bill 29, which would limit transgender athletes' participation in school sports, made it past that hurdle. But it was among several bills that missed another necessary House deadline Tuesday.

For now, those missed deadlines spell doom for the major bills focused on transgender Texas children. But LGBTQ advocates say the mere specter that such measures could become law has already done damage. And the school sports bill is one of a handful of failed Republican measures that quickly sparked Lt. Gov. Dan Patrick to ask Gov. Greg Abbott for a special legislative session.

In The Trevor Project’s 2021 National Survey on LGBTQ Youth Mental Health, 94% of LGBTQ youth responded that recent politics had negatively impacted their mental health. That figure is higher than in previous years, according to Sam Brinton, vice president of advocacy and government affairs for The Trevor Project.

Over the last year, the organization — which offers crisis counseling for LGBTQ youth — has received over 9,400 crisis contacts from Texas.

“Young people are listening,” Brinton said.

The authors and supporters of the legislation argued the intent was to protect women and children.

“When you ignore biological reality, women get hurt,” said Jonathan Covey, director of policy for religious advocacy group Texas Values. “When you allow children to make decisions regarding life-altering treatments and procedures, when we won’t even allow children to buy cigarettes or alcohol or drive, there’s an issue that needs to be addressed.”

But LGBTQ advocates said that supportive medical care and access to school sports is key to reducing elevated rates of suicide and depression among transgender children. Several advocates held banners and signs inside the Capitol on Sunday, hours before the House deadline to schedule Senate bills.

“Legislators need to be concentrating on providing services and supporting individuals rather than limiting opportunities,” Brinton said. “In a moment of crisis, we need to make sure that LGBTQ youth can access services rather than be told no.”

After “bathroom bill” failed, Republicans mount new efforts

Though 2021 brought more anti-trans bills to state legislatures than ever before, they weren’t the first of their kind in Texas.

In 2017, the Texas Legislature considered a controversial bill that would ban transgender Texans from using public and school bathrooms that match their gender identity. It was a legislative priority for Gov. Greg Abbott and a major crusade for Lt. Gov. Dan Patrick. After that failed to pass during the regular legislative session, Abbott added it to the agenda of a special 30-day session. It failed again.

Following the bill’s eventual death, Sen. Lois Kolkhorst, a Brenham Republican and author of the legislation, declared that the battle wasn’t over.

“At the end of the day, there will be future legislative sessions and elections to continue the conversation,” she said in a prepared statement at the time.

Kolkhorst wouldn’t have to wait long for her prophecy to come true — in 2019, transgender Texans became a conservative talking point in a new way as a dispute between a divorced father and mother over their child’s gender identity caught the attention of prominent Republicans like Abbott and U.S. Sen. Ted Cruz, R-Texas.

Once again, Republican leaders promised action in the next legislative session.

State Rep. Matt Krause, R-Fort Worth, tweeted that he would introduce legislation prohibiting the use of puberty blockers under the age of 18 this year, saying, “We missed our opportunity to do so in the 86th Session. We won’t miss the next one.” This session, Krause authored House Bill 1399, banning hormone therapy, puberty suppression treatment and surgery for the purpose of gender transitioning for children younger than 18.

That bill died after failing to meet a deadline in the House. But hours before the deadline, the Senate pushed their own attempt forward: Edgewood Republican Sen. Bob Hall’s Senate Bill 1311, which would revoke the medical licenses of physicians who perform or prescribe medical care for gender transitioning.

State Rep. Steve Toth, R-The Woodlands, authored SB 1311’s House equivalent.

“The 1st bill I file in the 87th [legislative session] will add ‘Transitioning of a Minor’ as Child Abuse,” Toth declared in a since-deleted tweet.

A bill doing just that was later introduced by Sen. Charles Perry, R-Lubbock, in the form of Senate Bill 1646, which passed the Senate.

“Giving [children] drugs and surgical procedures at this stage in life and age limits all options going forward,” Perry said while laying out his bill in committee. “Children are too young to understand the full consequences of these life-altering decisions.”

A national push 

The anti-trans bills in Texas and across the nation can be grouped largely into two categories: ones affecting transgender children’s participation in school sports and ones affecting their access to health care for the purpose of medically transitioning.

But in many states, the bills are a popular proposed solution to a problem that doesn’t seem to exist.

Throughout the session, Texas legislators, University Interscholastic League officials and advocacy groups have not been able to identify a case of a transgender athlete causing disruptions to Texas school sports.

Instead, many supporters have referenced a Connecticut lawsuit where several cisgender athletes sued the state’s school athletic conference after two transgender women won track races. The case was dismissed last month, according to the Hartford Courant, because the two athletes had graduated.

Defense lawyers in that case also pointed out that the two transgender athletes had won only some races — in others, cisgender athletes had beaten them.

Texas’ bills targeting gender-affirming health care have also been subject to misinformation, with some legislators and supporters calling the treatments irreversible and others claiming there isn’t sufficient research to know if they are safe.

According to general pediatrician Marjan Linnell, treatments that would be banned, like hormone therapy and puberty blockers, are largely reversible. Others, like surgical procedures, would rarely or never occur before puberty. And all of them, she said, are considered best practice medicine by major medical associations such as the Texas Pediatric Society and the Texas Medical Association.

Shelly Skeen, a senior attorney for the LGBTQ advocacy group Lambda Legal, said the popularity of these bills doesn’t come from voters or even legislators themselves, but rather from conservative advocacy groups trying to consolidate the Republican base after former president Donald Trump’s loss in 2020.

Fox News aired over twice as many segments on transgender athletes in the first three months of 2021 than in 2019 and 2020 combined, according to MediaMatters.

Earlier this year, three conservative advocacy groups — the Heritage Foundation, Family Policy Alliance and Alliance Defending Freedom — came together to form the Promise to America’s Children. The promise is a list of 10 advocacy points, including upholding children’s sex assigned at birth and keeping transgender girls from competing in women’s sports.

The collaboration is largely a response to the federal Equality Act that the U.S. House passed earlier this year, which prohibits discrimination based on sex, sexual orientation and gender identity. The organizations engage in the common practice of model legislation — generic bills that legislators can use to write and introduce their own bills.

“Family Policy Alliance is proud to partner with state and federal lawmakers, families, and the network of state family policy councils — including Texas Values — to advance public policy with critical protections for children,” Autumn Leva, Family Policy Alliance’s vice president for strategy, said in a statement.

Model legislation also can start in one state and spread to another. In 2020, Idaho’s state Legislature passed a bill preventing transgender women from participating in women’s sports. Though that law has been paused as a court challenge plays out, East Idaho News reported that Alliance Defending Freedom turned Idaho’s bill into model legislation and spread it to other states.

Alliance Defending Freedom did not comment on whether they had helped bring that bill to Texas specifically, but Christiana Holcomb, legal counsel at Alliance Defending Freedom, said “ADF is often asked by legislators to review possible legislation and offer advice.”

No Texas legislators have signed on to the Promise to America’s Children, but Texas Values is one of the promise’s state partners.

On top of mobilizing Texans to testify in support of the medical and sports bills, the organization works with legislators to identify topics of legislation and offer suggestions on bill language, Covey said.

Two of the topics they worked with legislators on this session, Covey said, were transgender athletes’ participation in sports and banning gender confirmation medical care. While the Senate’s version of a bill on transgender children’s participation in sports is what lawmakers advanced, state Rep. Cole Hefner, R-Mt. Pleasant, authored the lower chamber’s version of the bill.

Perry declined to comment on what inspired his bill to make some transition-related health care, like puberty blockers, child abuse and did not respond to a request for comment about his bill about limiting transgender children's sports participation. Krause, Hefner and Hall also did not respond to requests for comment.

Different fates in Texas Senate and House

At the beginning of the session, the various anti-trans bills seemingly had strong momentum. They easily soared through the Senate’s Republican-dominated committees and the full upper chamber, which split on party lines each time.

The House, however, has been a different story. Speaker Dade Phelan, R-Beaumont, has not responded to multiple requests for comment on the current legislation, but in 2019 told The Texas Tribune in a podcast interview that he didn’t want to pass bills “bashing” on the LGBTQ community.

Only one of the anti-trans bills originating in the lower chamber ever made it out of committee: Krause’s bill banning gender-affirming health care for transgender children. But the bill was never brought to the floor.

The Senate’s bill limiting school sports teams that transgender children can join also made it out of a House committee — after it got ensnared in a fight between Democrats.

In its first House Public Education Committee vote, Senate Bill 29 did not receive enough votes to pass, with Democratic Chair Harold Dutton of Houston declining to vote for or against the bill.

But after another House Democrat killed one of Dutton’s unrelated bills on a procedural technicality, he brought SB 29 back up for a vote, and an amended version passed out of his committee. Dutton claims SB 29’s revival wasn’t retaliatory, though representatives say he indicated to them it was.

The bill was among several Tuesday that House Democrats used delay tactics to keep from meeting another vital deadline. Democratic lawmakers waved transgender pride flags alongside members of the House LGBTQ Caucus as the deadline passed without SB 29 advancing.

Phelan didn’t assign SB 1311, which would revoke the medical licenses of physicians who perform or prescribe medical care for gender transitioning, to the House Public Health committee until early Monday morning. That was past the deadline for committees to advance bills to the full House floor. SB 1646, which would make it child abuse to allow kids to receive transition-related health care, was previously assigned to that committee, chaired by Fort Worth Republican state Rep. Stephanie Klick, but never received a hearing.

While those legislative results likely spell doom for some of the bills that have worried transgender Texans for months, lawmakers could try to revive the measures as amendments on other bills. Thursday afternoon, state Rep. Bryan Slaton, R-Royse City, proposed an amendment that would have kept a bill about student athletes’ compensation for their likeness from applying to transgender athletes. The amendment was withdrawn after a procedural objection.

It wasn’t Slaton’s first attempt to make an amendment that could affect transgender youth. Earlier this month, he proposed another amendment that would have required student ID cards to include peoples’ sex and name assigned at birth.

That, too, was killed by a procedural objection on the basis that Slaton had written “mail” instead of “male” into the amendment’s language.

Passion and community

Despite the apparent lack of success this session, LGBTQ advocates say transgender youth have already been hurt by the bills.

After the Texas Legislature considered the bathroom bill in 2017, The Trevor Project reported a dramatic increase in the number of transgender children calling its mental health hotline. That effect appears to be occurring again.

Earlier this year, Arkansas passed its own ban on gender affirming health care — the first state to do so. Dr. Michele Hutchison, who works at the state’s biggest provider of medical care for transgender youth, told The Associated Press that the ban has caused some of her patients to attempt suicide and others to consider turning to the black market for treatment.

“My families are in a state of panic, asking what state should they move to, saying their child is threatening to kill themselves,” she said. “They want to know what they should do next and we don’t have a clear answer for them.”

Lisa Stanton, the Houston mother of a 10-year-old transgender girl, said her family has already had to start looking at houses and jobs in other states, worried that if some of the Texas measures pass they’ll have to leave or be labeled child abusers.

Others, like Indigo Giles, may leave either way. At 19, Indigo wasn’t at risk of being affected by the bills this session, which applied to Texans under the age of 18. But after listening to legislators, they said they and other transgender Texans no longer feel like Texas is safe for them.

“There’s always the fear of what bills come next,” they said. “Who will be the next target? It might be me.”

Giles described testifying at the Capitol this year as “exhausting and upsetting” and said they felt “unbearably frustrated” to have to oppose so many bills. Long hearings forced them to miss class and do poorly on exams, they said, and some other students had to attend Zoom classes from overflow legislative hearing rooms while they waited for their turn to testify.

Yet, moments of connection and growth have sprouted up amid the battle. Those moments helped Giles find both a passion and a community.

Late one night, Indigo approached a group of mothers they had met earlier and asked for a “mom hug.” The women immediately stood up and obliged, Giles said.

“Even though we didn’t know each other that well, we knew each other’s stories. We knew we were there for the same reason, fighting for the same things,” Giles said. “That brought us really close.”

Other adults complimented Giles’ public speaking and offered them career advice, they said, and for the first time they began to consider a career in law or politics.

Maya Stanton, on the other hand, is far from making any career decisions. But even at her young age, Lisa Stanton said testifying inspired Maya to stand up for herself and realize her own voice.

“In a weird way, it helped her realize her own strengths,” Lisa Stanton said.

In a committee hearing, Maya Stanton recounted the difficulties she encountered feeling like she had been put into the wrong body. After socially transitioning, she told legislators, those difficulties disappeared.

“Since I’ve been able to grow my hair long, change my name and pronouns and dress like a girl, I finally fit right in my body,” Maya said. “I’m a girl in my head and my heart.”

Cassandra Pollock and Jordan Vonderhaar contributed to this story.