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Texas officials faced a federal backlash this week after the state's governor, Greg Abbott, signed a letter stating that a number of gender-affirming procedures in children are considered to be child abuse under Texas law.
In a letter signed on Tuesday, Abbott told Jaime Masters, commissioner of the Texas Department of Family and Protective Services, that the state's Office of the Attorney General held the opinion that "a number of so-called 'sex change' procedures constitute child abuse under existing Texas law."
Abbott then directed the department to "conduct a prompt and thorough investigation of any reported instances of these abusive procedures in the State of Texas."
The White House criticized the move, with a spokesperson describing it as an "attack on loving parents who seek medical care for their transgender children," according to a statement to ABC News.
The Texas Family Code defines a "child" as a person under the age of 18.
Gender-affirming care is a wide umbrella term referring to medical or social care designed to help affirm someone's gender identity—their internal experience of gender as a male, female, both, neither, or anywhere along the gender spectrum. This gender identity may be different to someone's biological sex, which can cause distress.
A number of interventions may be deemed gender-affirming care, including hormone therapy, which typically begins at age 16 and involves the use of feminizing or masculizing hormones like estrogen or testosterone, respectively, which allow the body to develop physical changes to align people to their gender identity.
Other steps may not involve medical intervention at all, but rather social interventions that might aim to educate or encourage certain activities or the use of different clothing and pronouns.
Gender-affirming care also encompasses surgery designed to match people's bodies to their gender—though not all patients take that route. It could involve surgery to replace the penis with a vagina or the vagina with a penis. It could also involve breast augmentation.
Procedures Restricted to Adults
It should be noted that such procedures are widely restricted to adults over the age of 18. Some may be performed on older adolescents, the University of Columbia states. These decisions are made by a team of medical experts in conjunction with the adolescent and their parents, according to the University of Columbia.
In his letter this week, Abbott wrote that it is "already against the law to subject Texas children to a wide variety of elective procedures for gender transitioning, including reassignment surgeries that can cause sterilization, mastectomies, removals of otherwise healthy body parts, and administration of puberty-blocking drugs or supraphysiologic doses of testosterone or estrogen."
It's not the first time recently that LGBT law has come to the fore in Texas. Last September, the Texas Attorney General's Office filed a complaint seeking to strike down federal guidance that included a rule requiring employers to allow workers to use bathrooms that match their gender identity.
That same month, dozens of students in Temple, Texas, protested at Temple High School in support of a transgender student who was allegedly denied use of female bathrooms and locker rooms.
