Texas appeals court blocks state from investigating families seeking gender-affirming care for trans youth

By Emma Tucker and Rebekah Riess, CNN

(CNN) — A Texas appeals court upheld two injunctions in a pair of legal cases Friday, in an order blocking the state’s Department of Family and Protective Services from investigating families of transgender youth who are seeking gender-affirming medical care for their children.

The legal battle began after Texas Gov. Greg Abbott, a Republican, ordered the state agency in February 2022 to launch investigations into parents who provide their children with the treatment, which has been deemed safe, effective and potentially lifesaving by many major medical groups but was banned in September by state law.

The governor’s order came shortly after Texas Attorney General Ken Paxton declared gender-affirming surgical procedures in children and prescribing drugs affecting puberty should be considered child abuse. Abbott ordered the Department of Family and Protective Services commissioner “to conduct a prompt and thorough investigation of any reported instances of these abusive procedures in the State of Texas.” Within two weeks of the directive, the state had opened at least nine investigations of families, according to the department.

The court of appeals upheld a trial court decision in the Friday order, ruling in favor of LGBTQ+ advocates and families in two related Texas lawsuits asking a state court to block the agency from investigating parents who provide their children with gender-affirming care.

The court order freezes the state’s enforcement of a department rule which expands the definition of “child abuse” and mandates child abuse investigations into every report of a transgender child receiving gender-affirming medical care until a trial can be held to determine whether the policy is unlawful.

The trial court concluded families of transgender minors and teens would be harmed by being “subjected to an unlawful and unwarranted child abuse investigation; intrusion and interference with parental decision-making.” One of the lawsuits was filed by the so-called “Doe” family in March after the family said they were investigated by the Department of Family and Protective Services for seeking care for their trans teen.

The judge also said families would be harmed by the “deprivation or disruption of medically necessary care for the parents’ adolescent children” and “the chilling of the exercise of the right of Texas parents to make medical decisions for their children relying upon the advice and recommendation of their health care providers acting consistent with prevailing medical guidelines.”

‘Dangerous abuse of state power,’ advocacy group says

After the governor’s directive to the Department of Family and Protective Services last February, a district court judge in Travis County ordered the state in March 2022 to temporarily stop investigating families, saying the order was “beyond the scope of his authority and unconstitutional,” and a trial was set for July.

Paxton appealed the district court injunction in March and declared investigations could continue during the appeal process under the law. Later in the month, Lambda Legal and the ACLU filed a request with the appellate court, arguing emergency relief and a reinstatement of the temporary injunction were needed to “prevent imminent and irreparable harm.”

The state’s Third Court of Appeals then ruled in favor of the civil rights groups, writing in an opinion, “to follow the Governor’s directive pending the outcome of this litigation would result in irreparable harm” and a temporary injunction is necessary to “preserve the rights of all parties” while the appeals process plays out.

In a ruling in May, the Texas Supreme Court also argued Abbott’s directive “cites no legal authority” and does not legally bind the department to follow his directive, unlike some of his other executive orders. The court, in its opinion, also affirmed Paxton’s opinion does not alter preexisting law or legal obligations of the department.

CNN has reached out to Gov. Abbott’s office and the Department of Family and Protective Services for comment.

Abbott’s directive to the agency was seen by many as an attack on transgender children and their families. Gender-affirming care is endorsed by the American Medical Association, the American Psychiatric Association and the American Academy of Pediatrics, among other major medical groups, as clinically appropriate for children and adults with gender dysphoria, a psychological distress which may result when a person’s gender identity and sex assigned at birth do not align.

Some critics of the therapies suggest children should wait until adulthood to transition. But the American Academy of Pediatrics says it is an outdated approach which assumes gender identity is fixed at a certain age. Research shows it is healthier to value a child for who they are rather than for what they will become. And some therapies, such as puberty blockers, are reversible, while related surgeries are rare, according to an analysis of health insurance claims from 2017 to 2021.

The new state law, Senate Bill 14, bars health care providers from giving gender-transition surgeries, puberty-blocking medication or hormone therapies to those under 18, with violators at risk of losing their licenses. Measures like it have been pushed in recent years – along with a record number of anti-LGBTQ bills – across US states, largely by Republicans, including some who’ve argued bans on such care protect against “irreversible” biological changes facilitated by parents.

“We are grateful the court saw through this dangerous and transparently discriminatory action by Texas officials,” said Chase Strangio, deputy director for transgender justice at the ACLU’s LGBTQ & HIV Project, after the ruling.

“Our clients and countless families like theirs are guided by love and compassion for their transgender youth, following the guidance of their doctors and fighting for the futures their family deserves,” the statement continued. “These baseless and invasive investigations are a dangerous abuse of the state’s power and one we’re thankful the Texas courts have consistently ruled against.”

CNN’s Amir Vera and Ashley Killough contributed to this report.

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