Texas Atty. Gen. Ken Paxton has issued an opinion that gender-affirming therapies for Transgender youth — including hormone therapy and puberty blockers — constitute child abuse.

Paxton was asked by state legislator Matt Krause of Fort Worth to render a judgement on the matter. The attorney general's opinions do not have the force of law but are supposed to guide state agencies.

If Paxton's interpretation of existing child abuse laws is implemented, Texas would become the state with the most restrictive rules about access to Trans health care.

"There is no doubt that these procedures are 'abuse' under Texas law, and thus must be halted," Paxton said in a February 21 press release.

"The Texas Department of Family and Protective Services has a responsibility to act accordingly. I'll do everything I can to protect those who take advantage of and harm young Texans."

In the same statement, Paxton said there are limits to parental rights to consent to gender-affirming treatments for their children.

"This general right to consent to certain medically necessary procedures does not extend to elective (not medically necessary) procedures and treatments that infringe upon a minor child's constitutional right to procreate," he said.

Spokespeople for the Department of Family and Protective Services (DFPS) and Texas Health and Human Services said the agencies would be reviewing Paxton's opinion.

Last year, Texas Republicans tried and failed to change state law to ban gender-affirming care for Transgender minors. In August, after pressure from Gov. Greg Abbott, the DFPS changed its definition of abuse to include gender-affirming surgery for minors.

In November 2021, a Dallas-based clinic offering services to Trans minors, Genecis, stopped taking new patients.

Texas is not the only state to limit access to treatment options for Trans youth. Last year, Tennessee passed a law banning hormone treatment for minors who have not yet reached puberty. Arkansas also passed a law barring doctors from referring minors to specialists in gender-affirming therapies.

All major state and national medical groups have opposed limiting access to gender-affirming care, however. The American Medical Association, American Psychiatric Association, and American Academy of Pediatrics all support age-appropriate gender-affirming medical care.

Last August, the Texas Pediatric Society sent the DFPS a letter urging the agency to make future decisions based on medical science.

"Medical care for Transgender children and adolescents is evidence-based and has proven effectiveness," Dr. Seth Kaplan, the society's then-president, wrote to DFPS Commissioner Jaime Masters.