Transgender surgery for children constitutes child abuse, Texas commissioner rules

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Transgender surgery on the genitals of a child constitutes child abuse under Texas law, according to the head of the Texas Department of Family and Protective Services (DFPS).

“Genital mutilation of a child through reassignment surgery is child abuse, subject to all rules and procedures pertaining to child abuse,” DFPS Commissioner Jaime Masters wrote in a letter to Governor Greg Abbott on Wednesday. Earlier this month, Abbott had requested clarification on the issue from DFPS, which is responsible for investigating charges of abuse, neglect, or exploitation of children, elderly adults, and adults with disabilities.

In the letter, Masters noted that altering a child’s genitals in pursuit of transgender identity “may cause a ‘genuine threat of substantial harm from physical injury to the child'” under Texas family code. “This surgical procedure physically alters a child’s genitalia for non-medical purposes potentially inflicting irreversible harm to children’s bodies. Generally, children in the care and custody of a parent lack the legal capacity to consent to surgical treatments, making them more vulnerable.”

Masters laid out a few situations where genital surgery may not constitute abuse because it might be medically necessary. Such cases include children whose body parts have been affected by illness or trauma; children who are “born with a medically verifiable genetic disorder of sex development, such as the presence of both ovarian and testicular tissue”; and children who do not “have the normal sex chromosome structure for male or female as determined through genetic testing.”

Under Texas Family Code, a professional who has “cause to believe” that child abuse has occurred or is occurring must report to DFPS within 48 hours. Professionals may not delegate this reporting duty and failure to report constitutes a Class A misdemeanor punishable by up to one year in jail, a fine of up to $4,000, or both.

Even the pro-transgender World Professional Association for Transgender Health (WPATH) does not recommend genital surgery for children. “Genital surgery should not be carried out until (i) patients reach the legal age of majority in a given country, and (ii) patients have lived continuously for at least 12 months in the gender role that is congruent with their gender identity,” the WPATH Standards of Care document states.

“Puberty-blocking” drugs and cross-sex hormones for children and adolescents are more controversial, however. WPATH and other pro-transgender organizations recommend such interventions, often claiming that they are reversible. 

Rachel Levine, now assistant secretary of health at the Department of Health and Human Services, has publicly supported such interventions for children and adolescents. 

Yet Dr. Michael Laidlaw, an endocrinologist in Rocklin, Calif., said that such hormonal drugs are “actually causing a disease,” namely hypogonadotropic hypogonadism, which occurs when the brain fails to send the right signal to the gonads to make the hormones necessary for development. Last year, Britain’s High Court ruled that children under age 16 lack the ability to consent to “puberty-blocking” drugs and cross-sex hormones. 

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