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Texas Supreme Court upholds state’s ban on gender-affirming care for minors

Attorney General Ken Paxton speaks to supporters as he supports Tom Glass in his campaign for Texas State Representative on Jan. 24, 2024.
Attorney General Ken Paxton speaks to supporters as he supports Tom Glass in his campaign for Texas State Representative on Jan. 24, 2024. Photo: Mikala Compton/American-Statesman / USA TODAY NETWORK

The Texas Supreme Court has reversed a lower court’s decision blocking S.B. 14, the state’s gender-affirming care ban for minors. The law will now remain on the books.

The court ruled 8-1 in a sweeping decision that struck down a lower court decision, issued by the 201st Judicial District Court of Travis County, blocking the ban. The district court’s ruling was then appealed to the state’s Supreme Court.

In the state Supreme Court’s ruling, Justice Rebeca Aizpuru Huddle wrote that the judges concluded that the state 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.” Huddle also said the legislature has an “express constitutional authority to regulate the practice of medicine.”

The Justices entirely dismissed appeals from medical organizations about the validity of gender-affirming care, instead claiming that the law is, in fact, constitutional — contrary to the opinion of Justice Debra Lehrmann and the lower court.

“This decision by the Texas Supreme Court allows the suffering caused by S.B. 14 to continue across the state,” said Ash Hall, policy and advocacy strategist for LGBTQIA+ rights with the ACLU of Texas. “Our government shouldn’t deprive trans youth of the health care that they need to survive and thrive — while offering that exact same health care to everyone else.”

The same puberty blockers and hormone replacement therapy used to treat gender dysphoria in trans youth are also used to treat early onset puberty, rare cancers, and other ailments in cisgender children.

“Texas politicians’ obsession with attacking trans kids and their families is needlessly cruel,” Hall added. “We will not back down until our trans youth have the health care they deserve and our state is a welcoming place to all.”

The lawsuit, Loe vs. Texas, was filed by the ACLU on behalf of several Texas families, some medical professionals, and some organizations affected by S.B. 14. The law bans gender-affirming care for minors and threatens to revoke doctors’ medical licenses if they give such care.

S.B. 14 was supported by Texas Attorney General Ken Paxton and Gov. Greg Abbott (R) who signed it in June 2023.

“We are profoundly disappointed by the Texas Supreme Court’s decision to uphold a ban rooted in prejudice and discrimination against trans youth,” said Alex Sheldon, executive director of GLMA, a group of health professionals advancing LGBTQ+ equality. “This ruling not only endangers the lives of these vulnerable individuals but also dismisses significant medical evidence supporting their care.”

“Today, the trans community was abandoned by the very institutions designed to protect them, and health professionals were denied their ability to perform their duties based on the best scientific evidence available, free from political interference,” Sheldon added. “This fight is far from over. We will continue to challenge unjust measures like S.B. 14 and to defend the rights of all trans youth to access the essential care they need and deserve.”

The plaintiffs in the case were represented by Lambda Legal, the American Civil Liberties Union of Texas, ACLU National, Transgender Law Center, and the law firms of Scott Douglass & McConnico LLP, and Arnold & Porter Kaye Scholer, LLP.

The defendants – who appealed the lower court’s ruling – are Attorney General Ken Paxton, the state of Texas, the Texas Medical Board, and the Texas Health and Human Services Commission.

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