The lone justice to dissent called the Texas Supreme Court ruling to uphold the ban on gender-affirming care for minors "cruel" and "unconstitutional" Friday.
The Texas Supreme Court, currently made up of all Republican justices, decided 8-1 to uphold a ban on providing gender-affirming care, including puberty blockers, to transgender people under the age of 18. The Court said that it did "not attempt to identify the most appropriate treatment for a child suffering from gender dysphoria," claiming it to be a "complicated question" for doctors and legislators.
The Court ruled that even though "fit parents have a fundamental interest in directing the care, custody, and control of their children free from government interference," that interest is bound by "the Legislature’s authority to regulate the practice of medicine."
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"[W]e conclude the 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 and the Legislature’s express constitutional authority to regulate the practice of medicine," Justice Rebeca Aizpuru Huddle wrote.
Justice Debra Lehrmann, the only justice to dissent, was clear in her disagreement. She wrote that the decision means "the State can usurp parental authority to follow a physician’s advice regarding their own children’s medical needs." Lehrmann identified that gender-affirming care can be "lifesaving."
She also mocked the idea that the Court's ruling didn't "deprive children diagnosed with gender dysphoria of appropriate treatment." Lehrmann pointed out that by upholding the law, it "effectively forecloses all medical treatment options that are currently available to these children ... under the guise that depriving parents of access to these treatments is no different than prohibiting parents from allowing their children to get tattoos."
"The law is not only cruel—it is unconstitutional," she wrote, calling the ban a "hatchet, not a scalpel."
Lehrmann also put the lie to the claims by anti-LGBTQ activists that surgery is common for transgender minors.
"Indeed, the leading medical associations in this field do not recommend surgical intervention before adulthood. Without a doubt, the removal of a young child’s genitalia is something that neither the conventional medical community nor conscientious parents would condone," she wrote. "Moreover, medical experts do not recommend that any medical intervention ... be undertaken before the onset of puberty."
Lehrmann is correct. Prior to puberty, transgender care is basically limited to social changes. For example, wearing gender-affirming clothing and using appropriate pronouns, according to Advocates for Trans Equality.
Puberty blockers can be prescribed for those who are starting puberty. Puberty blockers are safe, according to Cedars-Sinai, and are not only used for transgender youth. A common purpose is to stop precocious puberty, which affects 1 in 5,000 children, including children as young as 6. For both transgender youth and kids going through precocious puberty, puberty blockers are known to improve patients' mental health, according to the Mayo Clinic.
Puberty blockers are also fully reversible. However, in terms of trans youth, a study published in The Lancet found that 98% of those on puberty blockers went on hormone replacement therapy upon turning 18. But even for those few teens who realize after being on puberty blockers that they aren't trans, all they have to do is stop taking them, and their puberty will progress as normal.
