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Texas has taken a major step toward banning transgender minors from getting puberty blockers and hormone therapy — care that medical groups say is vital to their mental health — after the state House gave Senate Bill 14 initial approval Friday.

Trans Texans and LGBTQ advocates consider the bill one of the most consequential pieces of legislation in this year’s legislative session. It would ban trans people younger than 18 from getting certain transition-related care. Kids already accessing treatments would have to be “weaned off” in a “medically appropriate” manner, the bill says. It also bans transition-related surgeries, though those are rarely performed on kids.

The House’s vote to advance the bill followed over five hours of pushback from Democrats, who had successfully delayed the bill on a technicality twice last week. On Friday, Democratic lawmakers once again tried to raise points of order, a parliamentary maneuver aimed at delaying or defeating bills, but their efforts failed this time. Some Democrats, though, defected and voted in favor of the bill.

The initial vote was 92-48, though several Democrats later said they accidentally voted in favor and meant to oppose the bill. State Rep. Charlie Geren of Fort Worth was also listed as voting against the bill — the only Republican to do so — even though he is a joint sponsor of the legislation and tweeted that he was proud of its initial passage. He later told The Dallas Morning News that it was a mistake and he meant to vote in favor. None of those vote changes will change the outcome.

As SB 14 advances, Texas — home to one of the largest trans communities in the country — is moving ever closer to joining over a dozen states in restricting transition-related care for minors. The American Civil Liberties Union and Lambda Legal have already raised legal challenges against several of them. And judges have so far blocked the efforts to limit these treatments for trans youth in Alabama and Arkansas.

Pending one more final vote in the House, SB 14 would return to the Senate, which has already passed a version of the legislation that mandates an abrupt cutoff as opposed to a tapering off process.

Trans Texans, their families and medical groups say transition-related care is critical to supporting the mental health of trans youth, who are already facing higher risks of depression and suicide than their cisgender peers. Getting access to these treatments, they say, is time intensive and requires multiple medical evaluations. Parents are included in decisions about what treatments, if any, are best for individual children.

[“A death sentence”: Trans Texas teen plots his future as proposed ban on hormone therapy progresses]

“The bill in front of us today is banning health care,” said state Rep. Mary González, D-Clint, while advocating for a failed amendment that would have largely foiled the legislation. "Politics shouldn't determine health care, period."

Some Democratic lawmakers, including the nine openly LGBTQ state representatives, stood outside the chamber prior to debate and read letters from trans youth who would be affected by SB 14 and their families. And earlier in the day, LGBTQ Texans and their allies marched to the Capitol to protest the legislation, just over a week after state police forcefully booted scores of them from the Capitol and handcuffed two.

“We’re rising up. The whole LGBTQIA community is fighting back against a group of people who, at their core, don’t want us to exist,” said Danielle Skidmore, a longtime Austin resident and trans woman who came to the Capitol on Friday to protest the bill.

SB 14’s supporters have pushed back against the science and research behind transition-related care. They say the bill is meant to protect parents from health care providers who are taking advantage of a “social contagion” and pushing life-altering treatments on kids who may later regret taking them.

“Let me begin to say that there is no high-quality scientific evidence that puberty blockers, cross-sex hormones and surgeries help children,” Cypress Republican state Rep. Tom Oliverson, the bill’s key sponsor in the lower chamber, said Friday.

Oliverson found support from attendees with red T-shirts that said “save Texas kids.” Some also sang and prayed outside of the gallery Friday morning before the House convened.

Ruth Potts, a grandmother from Fort Worth, was at the Capitol for the fourth time this year to support SB 14. She said trans children should wait until they are 18 years old to undergo medical treatments.

“This is not the time to be making these decisions,” she said. “It’s important that children are allowed to be children.”

[Texas Republicans have filed dozens of bills affecting LGBTQ people. Here’s what they’d do.]

The proposal is a priority for Lt. Gov. Dan Patrick, who presides over the upper chamber, and the Republican Party of Texas, which opposes any efforts to validate transgender identities. The proposed ban is among a slate of Republican bills seeking to restrict the rights and representation of LGBTQ Texans. They are also coming amid a growing acceptance of Christian nationalism on the right, which has prompted some conservative lawmakers to push for legislation that could further infuse Christianity into the public sphere.

“I am beyond angry that we must keep showing up to defend the dignity, privacy and liberty of our neighbors,” said Ricardo Martinez, CEO of Equality Texas. “This is part of a nefarious plan to eliminate us from public life. But it won’t work. We will not stop fighting for our rights. Not now, not ever.”

The House has traditionally acted as a foil on some of the Senate’s most socially conservative endeavors. Many LGBTQ Texans — and conservatives — wondered if the lower chamber would stop SB 14. In April, House Speaker Dade Phelan, R-Beaumont, declined to comment on the legislation. In 2019, when he was a House committee chair, he told The Texas Tribune he was “kind of done talking about bashing on the gay community. It’s completely unacceptable.” On Thursday, he praised SB 14’s advancement.

“In Texas, we will not tolerate bad actors taking advantage of our most vulnerable population, and we will not stand for minors being influenced to make life-altering decisions until they are of legal adult age,” he said in a statement.

According to a recent poll from the University of Texas at Austin, 58% of Texas voters support barring health care providers from offering gender-affirming care to minors. Its February survey also found that 59% of voters don’t personally know an openly trans person.

Democratic lawmakers who voted for the bill, according to the vote record, included state Reps. Harold Dutton of Houston, Tracy King of Batesville, and Shawn Thierry of Houston.

Democratic state Reps. Alma Allen of Houston, Rhetta Bowers of Rowlett, Jessica González of Dallas, Suleman Lalani of Sugar Land, Christian Manuel of Beaumont, Armando Martinez of Weslaco, Penny Morales Shaw of Houston and Mary Ann Perez of Houston initially voted for the bill, according to a record of the vote, but later said on twitter or told reporters that those were accidents and that they meant to vote against it.

Thierry, the lone Democrat to publicly speak in favor of SB 14 during Friday’s debate, said she voted for it with “an open heart and clear mind.”

“As a thoughtful legislator, mother, woman of faith and child advocate, I have made a decision to place the safety and well-being of all young people over the comfort of political expediency,” she said.

During the Friday debate, other Democrats took aim at how a committee hearing on the legislation limited the number of people who could testify and how it appeared the number of supporters and opponents were about equal when there were actually fewer than 100 people in favor of the bill and more than 2,400 against it. In addition, they raised questions about whether SB 14 would prevent trans minors from receiving medical treatments still available to other children, which could be aimed at helping any potential future legal challenge based on the Fourteenth Amendment’s Equal Protection clause.

Openly LGBTQ state representatives also spoke against the bill while referencing their own lived experiences and communities.

“This is today's [Defense of Marriage Act],” said state Rep. Ann Johnson, a lesbian Houston Democrat.

Oliverson, who faced a barrage of questions from Democrats, largely stayed focused on his criticism of the science and research behind transition-related treatments.

“??The science on gender dysphoria lacks sufficient high-quality evidence documented, and there's a growing list of harms, established side effects that accompany patients,” he said.

And throughout the debate, Democrats tried to shut down or soften SB 14’s proposed restrictions by proposing 18 amendments, but saw no success.

In particular, one failed proposal from state Rep. Joe Moody of El Paso would have allowed trans minors receiving transition-related medical treatments before June 1 to continue getting that care. This amendment was similar to what the Senate approved — but then backtracked on — last month. Oliverson had initially expressed support for the exemption when the upper chamber first voted for it, but he disapproved of Moody’s proposal Friday.

Republicans also shot down a proposal from state Rep. Vikki Goodwin, D-Austin, that sought to study for five years the rates of suicide among trans kids, who would be affected if SB 14 becomes law. Oliverson said he takes this issue seriously, but cautioned against pushing a narrative that the risk of suicide is high or guaranteed if trans kids don’t receive transition-related care.

Earlier Friday, Democratic lawmakers stood outside the House chamber and read letters from trans youth and their families detailing the harm the state government has already inflicted on their lives. House members shared stories of Texas families who left their home state and children wrestling with thoughts of suicide.

State Rep. Julie Johnson read a letter from a family that fled Texas after Attorney General Ken Paxton issued a nonbinding legal opinion that families providing gender-affirming care to their kids should be investigated for child abuse.

“We are the ones protecting children. It is the state Legislature that has decided to hurt them,” the Farmers Branch Democrat read.

Last week, Mary González successfully cut short the House debate on the legislation twice by raising points of order. These roadblocks had visibly frustrated GOP lawmakers, who quickly vowed to put the bill back on track after the second delay. The Republican Party of Texas had also publicly urged its legislators to appeal any decision by Phelan that would allow for more delays.

Since the 2021 legislative session and over the past few months, the looming prospect of losing this health care has already spurred some families with trans kids to start planning for ways to get treatments outside of the state or flee Texas entirely. But traveling or moving is cost-prohibitive for some families. Many parents of trans kids have also testified about having been in Texas for generations and not wanting to uproot themselves from the communities that they love.

Skidmore, one of the bill protesters at the Capitol on Friday, said animosity from the Texas Republicans directed at transgender people has felt increasingly aggressive and violent.

“Seeing all the energy, all the hate directed against children breaks my heart,” she said.

And at least one Dallas mother, who has been a vocal advocate for her trans daughter, is not planning to leave the state at this point.

“There are a lot of families that are leaving, but I refuse to let my government force me out of my home,” Rachel Gonzales said on the eve of the Friday vote.

“I fully recognize that if we’re able to find a way to stay here safely, that is a point of privilege because so many people are going to be so deeply impacted,” she added. “But trans kids have always existed. Trans adults have always existed. And no matter how hard [lawmakers] try, they’re not going to be able to eliminate their existence from this state and it’s disgusting that they keep trying.”

Following Friday’s vote, dozens of other LGBTQ advocates walked away from the Capitol to the nearby Waterloo Park to show their solidarity with the queer community. Marti Bier, the vice president for programs for Texas Freedom Network, an advocacy group that works on LGBTQ issues, dreaded the conservations parents will have to face since gender-affirming care for their children could soon illegal in Texas.

“Even though you can expect something like this to happen, it still feels really overwhelming, the consequences for real kids and real families,” said Bier, wiping away tears as they left the Capitol Friday evening.

Zach Despart and Karen Brooks Harper contributed to this story.

Disclosure: Equality Texas, Texas Freedom Network and the University of Texas at Austin have been financial supporters of The Texas Tribune, a nonprofit, nonpartisan news organization that is funded in part by donations from members, foundations and corporate sponsors. Financial supporters play no role in the Tribune’s journalism. Find a complete list of them here.

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This article originally appeared in The Texas Tribune at https://www.texastribune.org/2023/05/12/texas-trans-kids-health-care-ban/.

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