Protesters outside the Katy Independent School District's central office on August 31
Protesters outside the Katy Independent School District's central office on August 31 (Reginald Mathalone/NurPhoto via AP)

‘Heartbreaking’: Anti-Trans Healthcare Law Takes Effect in Texas

Despite ACLU win in lower court, an appeal by the state means transgender kids and their families will feel the devastating effects of the ban.


Kit O'Connell is a white person with a broad forehead and large nose and shoulder length, wavy brown hair. They are wearing a green metal wayfarer glasses, blue velvet coat, white button down with red accents and a red scarf wrapped loosely around their neck like a tie.

Editor’s Note: This piece discusses suicide and suicidal ideation. If you or someone you know is suicidal, call the National Suicide Prevention Lifeline at 800-273-TALK (8255) or the Trevor Project at (866) 488-7386.

Texas’ anti-trans healthcare law is already having a “direct, measurable negative effect on children and families,” said Michele Hutchison, chief of pediatric endocrinology at the University of New Mexico in Albuquerque. 

Hutchison, whose career began in Texas, now frequently consults with families who are considering leaving the state to maintain their children’s healthcare.

Senate Bill 14, which prohibits doctors from providing safe, evidence-backed, and often life-saving forms of healthcare to transgender children, takes effect today after a lawsuit by the ACLU of Texas failed to stop it. Last week, a Travis County District Court issued a temporary injunction that blocked implementation of the law, but Attorney General Ken Paxton immediately appealed the case to the Texas Supreme Court, which automatically overrules a lower-court injunction. The Texas Supreme Court has so far refused, without comment, to issue a similar injunction. Five Texas families, with trans kids between the ages of nine and sixteen, are plaintiffs in the suit. 

Ash Hall, a policy and advocacy strategist at the ACLU of Texas said the law is unconstitutional and forces medical professionals to violate their code of ethics. 

“Doctors are being forced to violate their oath to ‘do no harm’ by not providing medical care … that improves mental health and lowers their risk of suicide,” they told us.

Hutchison said that even the debate around the bill—part of a nationwide, Republican-led attack on abortion rights and healthcare for trans youth—has had dire effects on the mental health of the trans kids she sees. 

“I had several patients admitted to ICUs or hospitals for suicide attempts,” Hutchison told the Texas Observer. “It was heartbreaking.” 

Her account is consistent with reports finding that thoughts of self-harm are trending up and LGBTQ+ kids. According to a poll from the Trevor Project, which tries to prevent queer suicide, 86 percent of trans and nonbinary youth say political debates about trans people have negatively affected their mental health. 

“I had several patients admitted to ICUs or hospitals for suicide attempts.”

An ad with the text: When Texas is at its worst, the Texas Observer must be at its best. We need your support to do it. A button reads: JOIN NOW

Every major advisory board, from the American Medical Association to the American Academy of Pediatrics, has agreed that these forms of medical care are appropriate for young trans people and dramatically improve their mental health. Children begin these forms of treatment with great care, after months of consultations between parents, mental health professionals, and experts like Hutchinson. 

Nationwide, the GOP introduced hundreds of bills in 2023 targeting the rights of queer people, especially young folks. Texas is one of 20 states that currently bans or will soon ban certain forms of healthcare for trans kids. Now, with SB 14 going into effect, Hutchison said families are scrambling to find alternatives, often looking to travel out of state for healthcare if they can afford the frequent trips. Since the state has also threatened to use Child Protective Services to investigate parents for providing healthcare to trans kids—a directive from Paxton’s office that’s sent the department into turmoil and is the subject of an ongoing lawsuit—she said she is forced to tell parents to act with caution, even though their children’s lives may be on the line. 

“There’s a lot of legal implications for these families to consider,” Hutchinson said. “And I’m not an attorney, so it’s difficult for me to advise them.”

Currently, an injunction won by the ACLU and Lambda Legal last September protects members of the pro-LGBTQ+ nonprofit PFLAG from investigation by Child Protective Services. Those who are not members are not covered by the injunction. 

Under the law, a medical provider who is found to be offering one of the banned medical treatments could lose their license. But Hall emphasized that these forms of care are—contrary to misinformation spread by the state’s lawyers—not only scientifically proven to be safe and effective, they are also essentially identical to forms of medical care offered to cisgender (non-trans) young people. For example, puberty blockers, which temporarily halt the advance of adolescence, are commonly prescribed to young cisgender girls undergoing “precocious” puberty. These same drugs also allow trans kids to make more deliberate choices about their bodies as they age into adulthood. According to Hall, this violates the Equal Protection Clause of the Texas Constitution.

“It discriminates against trans adolescents on the basis of sex and violates the rights of healthcare providers by interfering with their licensure and their ability to practice medicine,” Hall said.

Hutchinson, who got her start as an endocrinologist decades ago in Texas, said she recently allowed her license to practice medicine in the Lone Star State to lapse for the first time in order to continue safely providing medical care to patients in New Mexico without complications. She called the situation “strange” and “sad.” 

“I can’t even count how many families I know that have ripped up their lives to move to New Mexico so that their children can be taken care of without fear of reprisal,” Hutchinson said.

Although she said it’s “just horrible” that they’ve been forced to leave their homes, Hutchinson said, “It speaks to how much these parents love their children and believe in them that they would do that. It’s pretty amazing.”