Texas Supreme Court upholds ban on gender transition care for minors

The Texas Supreme Court on Friday upheld a state law banning medical treatments for gender reassignment in minors. This overturned a lower court ruling that had temporarily blocked the law. This is a blow to parents of transgender people.

The court, whose nine elected members are all Republicans, voted 8-1 in favor of allowing the law, which was passed last year, to remain in effect. It prohibits doctors from prescribing certain medications to minors, such as hormones and puberty blockers, and prohibits them from performing certain surgical procedures, such as mastectomies, on minors.

Parents of transgender youth, along with gay and transgender advocacy groups, argued that the ban should be blocked because it violates the Texas Constitution, in part by preventing parents from making what they believe are the best medical decisions for their children.

This argument is powerful in Texas, where protecting parents’ rights from government intervention has been a major goal, especially for conservatives. But the court ruled that this argument was incorrect.

“We have never held that the interest of a fit parent to care for her child without government interference, no matter how compelling, justifies stricter scrutiny of every provision of the law,” wrote Judge Rebeca A. Huddle. in the opinion of the court.

She wrote that the Legislature “made a permissible, rational policy choice to limit the types of medical procedures available to children, particularly in light of the relative onset of both gender dysphoria and its various treatments.”

The court compared the law to restrictions on child labor and laws that prohibit minors from getting tattoos.

In the lonely dissentJudge Debra Lehrmann wrote that the law, which bans treatments accepted by major medical groups, was “cruel,” “unconstitutional” and squandered the court’s years-long efforts to enshrine “a robust conceptualization of parental autonomy.”

“This particular parental right — to make potentially life-saving medical decisions for your children — certainly does not fall into the same category as tattooing, tobacco use, or even child labor,” she wrote.

The Texas bill, known as Senate Bill 14, is part of a wave of legislation passed by Republican-controlled states that targets transgender rights, including restrictions on bathroom use and sports participation and a ban on gender transition care for minors. About two dozen states have passed bans or severe restrictions. Under the Texas bill, doctors who provide the treatments could have their medical licenses revoked.

Texas Attorney General Ken Paxton, who defended the law on behalf of the state, has sought access to documents held by PFLAG National, an LGBTQ advocacy group, regarding transgender minors and their medical care. The organization, which is fighting in court to keep the documents from being released, was among the plaintiffs in the lawsuit seeking to overturn the ban.

“The Texas Supreme Court got it wrong today by ruling against families, against doctors and against the future of Texas,” Brian K. Bond, the CEO of PFLAG National, said in a statement. “Every Texan, transgender or not, deserves the freedom to access the health care they need when they need it.”

The plaintiffs also included doctors who provide gender transition care and the parents of several transgender children. They challenged SB 14 before it was set to take effect last year and obtained a preliminary injunction from a lower court. The Texas Supreme Court allowed the law to take effect in September, while Mr. Paxton appealed the lower court’s ruling.

On Friday, the Supreme Court said the district court erred in issuing its order and declined to reinstate it. That was not a final decision on the merits of the challenge to the law, but it made clear where the Supreme Court justices would stand on the matter.

A spokesperson for Lambda Legal, an LGBTQ advocacy group whose attorneys represented the plaintiffs, said the group is considering how to proceed with the case.

The Supreme Court ruled that the law did not deprive parents of “any constitutionally protected right, nor undermine a custom embedded in our history or traditions,” nor amount to unconstitutional sex discrimination.

To illustrate how much the majority justices struggled with the question of how to balance parental rights with the actions of the state legislature, there were three concurring opinions.

Judge Jimmy Blacklock, in his agreementpresented the issues raised in the case as a fundamental moral conflict between what he called the “traditional view” and the “transgender view” when it comes to issues of sex and gender.

“The divergence is unbridgeable,” he wrote, adding: “By and large, those who adhere to the traditional view operate from the sincere belief that the transgender view is ultimately only an appearance.”

In her dissent, Judge Lehrmann discussed the positive impact that gender treatments had on the child plaintiffs in the case, and took umbrage that the majority dismissed the treatments as “new” merely because they had only recently been developed.

“The court fails to recognize the unfortunate reality that relatively new medical procedures and treatments are often the only options available to loving parents desperately trying to help their children,” she wrote.

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