Heights resident Anna Eastman, a former Houston ISD trustee and former state representative, said she cannot remember a time when there were so many proposed state laws that would negatively impact the transgender community. The so-called “bathroom bill” was in the 2017 Texas Legislature session and did not pass.
This year, however, Equality Texas – a political advocacy organization that advocates for LGBTQ+ rights – has identified more than 10 bills it says target transgender youth and families. In the past few weeks, bills that would ban gender-affirming healthcare for youth and prohibit youth participation in sports that align with a transgender person’s preferred identity have been moving through the House and Senate.
And Eastman – whose daughter Helen has since come out as a transgender female – is now in the position of testifying against them. While she is opposed to all the bills that restrict the rights of transgender Texans, she said the ones that would penalize families, classifying gender-affirming healthcare as child abuse and criminalizing doctors who provide it, are most frightening to her.
“We were really lucky,” Eastman said. “When my own kid came out to me there were highly regarded professionals who made the journey a lot easier. I cannot fathom the levels of stress added if our support was classified as child abuse. Even having the debate in the House and Senate makes kids a target.”
Or as Helen said in her testimony against the healthcare bills: “The idea that my parents could have been punished for accepting me and allowing me to be the person I need to be is frightening.”
On the other side of the issue is State Sen. Paul Bettencourt, who represents Senate District 7 in west Harris County. Bettencourt is a sponsor of Senate Bill 1646, which would classify transition care for those under 18 — including puberty-suppression drugs, cross-sex hormones and surgery or other medical procedures for the purpose of gender transitioning or gender reassignment — as child abuse.
The bill initially passed in the Texas Senate this week by a vote of 18-13 and was expected to go to a final Senate vote after press time Wednesday. The proposed legislation would need to also pass in the House to become law.
Intersex children with reproductive or sexual anatomy that doesn’t fit the typical definitions of female or male, estimated by a 2019 study in the Journal of the Endocrine Society to be 1 in 1,000 births, would not be denied treatment under the proposed law.
Bettencourt’s office did not respond to requests for comment and does not have any statements about the bill on his official Facebook page.
According to the Mayo Clinic, the American Psychiatric Association recognizes gender dysphoria. It is defined as the feeling of discomfort or distress that might occur in people whose gender identity differs from their sex assigned at birth or sex-related physical characteristics.
Texas Catholic Conference of Bishops issued a public statement in support of SB 1646, saying the church “cares for those who experience gender dysphoria. They must be accepted with respect, compassion and sensitivity. Every sign of unjust discrimination toward them should be avoided.”
However, the statement also said the bill protects children because “so-called ‘gender-affirming’ therapies do not help children to harmonize such inclinations and attractions within the broader context of integral personal development.”
Alison Mohr Boleware, a representative with the Texas chapter of the National Association of Social Workers, said her organization is concerned the bill and its redefinition of child abuse would negatively impact the mental health of children and the ability of professionals to provide care.
“If we are fearful that a conversation could be considered gender-affirming care and must be considered child abuse, this would really harm a therapeutic relationship between a social worker and their client,” Boleware said. “We are also worried about what this symbolizes for LGBTQ Texans. We want them to feel safe talking to a mental health professional about anything.”
Local residents become advocates
A local resident who has made multiple trips to Austin this session is Mandy Giles, a Garden Oaks mother with two children who identify as non-binary, defined as a gender identity that is neither male nor female.
Many non-binary people use the pronouns they/them instead of she/her or he/him. Giles’ child, Indigo, is one of them.
“I like to think of it as there are more than two genders,” Giles said. “Gender is not along a straight line, (but) more of a 3D infinite universe.”
Still, when Indigo became the first of her children to come out to her and husband Neil, it was an ongoing process of understanding.
“When Indigo was 14, they realized they were not a girl, but it was a while before they found the language that felt right,” Giles said. “The misconception is that it is a fad. My husband and I thought the same thing. We didn’t know any transgender people, but as we talked to our child more, talked to transgender adults, and learned more, we found that this was very real.”
The depression Indigo experienced was serious and abated as they were able to affirm their gender identity.
At 17, Indigo had gender-affirming surgery.
“With each step, we saw a different person,” Giles said. “Indigo was more confident. There was a light in their eyes.”
As Indigo, now a freshman in college, said during their testimony against SB 1646 and Senate Bill 1311, which would criminalize doctors for transition care, “I finally recognized the person in the mirror.”
As Giles notes, every transgender child is different as is their experience. Not all involve surgery. But for those that do, she said it is an integral part of the journey.
“For a lot of kids these are not elective procedures,” she said.
Giles, her husband and Indigo have already testified against a number of these bills.
“Anyone can testify,” she said. “It is very empowering.”
'Let them get to 18'
During testimony at an April committee meeting, State Sen. Bob Hall, the author of SB 1311, said the matter is a religious and moral issue for him.
“Every single child is created in the image of God, (and) altering a healthy, completely natural part of His creation in such a mutilating way is morally and ethically wrong as it carries dire consequences for the children involved,” he said.
Hall’s assertion that “there is a natural cure for real or perceived gender dysphoria, and it is called puberty,” is something that was echoed by the four people who testified to the committee on behalf of SB 1646 and SB 1311.
They cited the same report referred to by the Texas Catholic Conference of Bishops – a study by the 500-member American College of Pediatricians (ACP), formed in 2002 by a group of doctors who branched off from the 60,000-plus member American Association of Pediatrics after it endorsed same-sex adoption. The ACP study claims that when gender dysphoria occurs in a pre-pubertal child, it resolves in 80-95 percent of patients by late adolescence.
Areana Quiñones, the executive director of Houston-based Doctors for Change, said there are a few studies that get cited with this statistic.
“Most clinicians will reply that the studies were flawed because they did not ask the right questions and they made conclusions based on a limited understanding of gender dysphoria versus social gender,” Quiñones said.
State Sen. Charles Perry, who authored SB 1646, said he recognized the medical issue is personal and sensitive for families.
“(Medical intervention) limits all options going forward where (children) would be better served, better informed and understand and make those decisions,” Perry said in committee.
Perry and Hall reiterated that once an individual reaches the legal age of adulthood, they could pursue gender reassignment.
“Let them get to 18,” Hall said.
Parents want tolerance, autonomy
While both sides of the issue presented evidence that transgender children experienced higher rates of depression and suicide, they differ on their opinions as to why. Proponents of the bills prohibiting any kind of gender reassignment say therapy alone is enough to improve mental health outcomes, while hormones and therapy make things worse.
“It is not a question that these kids are suffering, but what is an appropriate treatment?” asked Kevin E. Stuart, executive director of the Austin Institute for the Study of Family & Culture, who supports both bills.
Quiñones counters that mental health for transgender individuals is strongly influenced by access to social and medical transitioning and says hormone therapy and surgery reduces rates of suicide by 40 percent in trans individuals. She also cited a study by the National Institutes of Health that found suicide rates for trans individuals did not increase after surgery.
“The American Psychiatric Association has condemned policies that limit access to these services that lead to improved mental health for transgender individuals,” Quiñones said.
Dr. Marjan Linnell, who testified against both bills as a representative of the Texas Medical Association, said “organized medicine stands strongly united against both bills” and that no medical or surgical treatment is used until after the onset of puberty.
Linnell said puberty-suppression treatments have been used safely for decades to delay early puberty and are reversible. She said that while hormones may cause some permanent changes, there is consultation about this step between a doctor and family.
“Gender dysphoria is a medical diagnosis, and it is up to the provider, patient and parents/guardians to do what is in the best interest of the individual based on their medical, psychological and social needs,” Quiñones said.
In her testimony, Anna Eastman told the Senate she and her family were the lucky ones as they had the opportunity to open their minds and hearts. She urged lawmakers to do the same.
“But if you will not, please just stay out of our business and allow us to make decisions in the best interest of our children,” she said.