Survey : 57% of Texans support classifying gender-affirming care for minors as child abuse

More than half of Texans support legislation that would classify any gender-affirming care sought by parents for minors from medical or mental health professionals as child abuse, a survey by the Hobby School of Public Affairs at the University of Houston found.

Fifty-seven percent of Texans would support such legislation, with 73% backing from Republicans and 36% from Democrats, the survey found.

Gender-affirming care is patient-centered care ranging from medical, surgical and mental health care to nonmedical services for transgender and nonbinary people to align their outward, physical traits with their gender identity, according to the U.S. Health and Human Services Department.

Most major medical associations have strongly opposed state legislatures' attempts to block gender-affirming care and have come out in favor of physicians' and families' rights to consider all health care options when making decisions for gender-diverse pediatric patients.

The American Medical Association "opposes the dangerous intrusion of government into the practice of medicine and the criminalization of health care decision-making,” AMA board memberDr. Michael Suk said in a 2021 announcement of the association's opposition to restrictions on transgender medical care. “Gender-affirming care is medically-necessary, evidence-based care that improves the physical and mental health of transgender and gender-diverse people.”

More:Trevor Project: Nearly half of Texas' LGBTQ youths considered suicide in past year

In Texas, 47% of LGBTQ youths seriously contemplated suicide in 2021, and 16% attempted it, according to the Trevor Project, a national LGBTQ mental health nonprofit that conducted a survey of 34,000 LGBTQ youths ages 13-24 across the U.S. The percentages for LGBTQ youths across the country who had considered or attempted suicide, or who had reported having symptoms of anxiety or depression, were all notably higher among respondents who identified as transgender or nonbinary, according to the nonprofit.

Last year, Gov. Greg Abbott and Attorney General Ken Paxton directed the Department of Family and Protective Services to investigate cases of transgender children receiving certain gender-affirming services as child abuse. Several lawsuits over the directive are still wrapped up in the court system.

At the Legislature, however, anti-LGBTQ proposals are heating up as conservative lawmakers take on "culture war" issues at the GOP-controlled Capitol.

Last week, Lt. Gov. Dan Patrick, R-Houston, announced 30 priority proposals, including banning "children's exposure to drag shows," targeting "obscene" books in school libraries and prohibiting children from having gender-modifying surgeries.

As of Patrick's announcement, House and Senate lawmakers had filed 17 bills addressing the access to and legality of gender-affirming care for transgender youths, according to Equality Texas, an LGBTQ advocacy organization. Patrick's priority bills had yet to be filed Friday.

More:Lt. Gov. Patrick releases 30 Texas legislative priorities. Here's what he hopes to pass in 2023.

'Surgery is never the first step'

Gender-affirming surgeries for minors are uncommon, medical experts maintain. At Boston Children's Hospital, which is home to the nation's first pediatric and adolescent transgender health program and has cared for more than 1,000 families, patients who want to pursue chest surgery must be at least 15, and those seeking vaginoplasty, phalloplasty or metoidioplasty must be 18 or older, along with having fulfilled other requirements.

"Surgery is never the first step in a gender transition. It is something that happens after you have already explored social and medical transition options," the hospital's Center for Gender Surgery says on its website. "People who choose to undergo surgery usually do so after taking other steps in the gender affirmation process, such as taking supplemental hormones."

When it comes to changing the sex on a minor’s birth certificate, 65% of Texans support legislation that would prohibit the change unless there was a clerical error or the minor had atypical or ambiguous sex organs, according to the Hobby survey, which was conducted online Jan. 9-19 and polled 1,200 voting-age Texans who answered questions on “culture war” topics expected to come before the Legislature.

Sen. Charles Perry, R-Lubbock, has already filed a bill to prohibit changing the gender markers on minors' birth certificates.

“These survey results will give support to those in the Legislature who really want to strike back against what they see as the push towards transgenderism,” said Matthew Wilson, a political science professor at Southern Methodist University.

More:Texas lawmakers seek review of school board association's guidance on trans student issues

Education, Confederate Heroes Day, ethnic studies

A majority of respondents were in favor of increasing parental rights in educational settings. More than 70% of respondents support requiring a content rating system for books sold to Texas public schools. Sixty-nine percent were in favor of legislation requiring parental approval for any sexuality instruction in public schools.

Fifty-two percent of respondents support legislation that would strip public university faculty members of tenure if they teach critical race theory.

Fifty-five percent support legislation to remove Confederate Heroes Day from the list of official state holidays, though 71% of Republicans oppose the removal.

Fewer than half of Republican respondents support repealing the provision of the Texas Constitution that states marriage consists only of the union of one man and one woman. Sixty-seven percent of independents and 74% of Democrats support repealing the provision.

Texas Legislature:What Austin-area senators hope to pass in the 88th session

Republicans are also alone in their opposition to mandating that every Texas school district offer ethnic studies as a required curriculum, including Mexican American or African American studies. Ninety percent of Democrats support the proposal, compared with 65% of independents and 41% of Republicans. Eighty-six percent of Black Texans and 79% of Latino Texans support requiring ethnic classes, while 54% of white Texans responded in support.

State Rep. Christina Morales, D-Houston, reintroduced a bill to require ethnic studies courses in public schools. Morales introduced an identical bill in the last legislative session, and it passed in the House but not the Senate.

Although 67% of Texans support legislation requiring ethnic studies, the Republican-controlled Legislature might not address it, Wilson said.

“Republicans are much more likely to move on something like the transgender issues than they are to move on something like requiring ethnic studies,” Wilson said, “regardless of what the polling shows on those questions.”

Texas Legislature: What Austin-area House representatives want to pass in the 88th session

This article originally appeared on Austin American-Statesman: Gender-affirming care in Texas? 57% say it's child abuse, survey finds