Texas Senate scales back proposed restrictions on puberty blockers and hormone therapy for transgender kids

People chant during the Trans Kids Call for HELP! rally in front of the Governor's Mansion in Austin on March 13, 2022. (Lauren Witte/The Texas Tribune, Lauren Witte/The Texas Tribune)

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The Texas Senate on Wednesday gave initial approval to a bill that would ban puberty blockers and hormone therapy for transgender youth wanting to gender transition if they are not already receiving such care. Major medical groups approve of such care and say it lessens higher rates of depression and suicide for trans youth.

Senate Bill 14 author Sen. Donna Campbell, R-New Braunfels, made a last-minute change on the chamber floor Wednesday that limited the scope of the legislation. The bill previously would have banned several transition-related treatments outright. On Wednesday, Campbell amended the legislation to allow children who are currently receiving puberty blockers and hormone therapies to continue such treatments if the bill is signed into law and takes effect.

That means SB 14 would ban puberty blockers and hormone therapies only for children who are not receiving it by early June.

The bill also bans transition-related surgeries, though they very rarely happen for trans youth. Health care providers also would not be eligible for financial reimbursement through Medicaid and the child health program for such treatments.

Johnathan Gooch, communications director for Equality Texas, said LGBTQ advocates and Texans are “deeply grieved” that SB 14 is advancing. He said it was “prudent” to allow kids already receiving puberty blockers and hormone therapy to continue such treatment but still considered the bill harmful.

“Trans kids of the next generation should not be disadvantaged because fear-mongering politicians decided to listen to their demons rather than their doctors,” he said in a statement to The Texas Tribune.

Campbell painted doctors providing transition-related care as opportunists capitalizing on a “social contagion” with treatments that lack sufficient scientific data that could determine whether the care is safe and effective.

But in an hourslong Senate committee hearing about the bill, medical groups testified about the wealth of scientific evidence backing mental health benefits of transition-related care for transgender youth. Trans youth who take puberty blockers are significantly less likely to experience lifelong suicidal ideation than those who want the care and don’t get it, according to recent studies.

Over the objections of hundreds of doctors, medical groups and LGBTQ Texans, Republican lawmakers have said the legislation is needed to protect children and that medical studies don’t support the benefits of such care.

“This is not science-based practice,” Campbell said Wednesday.

During the chamber debate, Democratic Sen. José Menéndez of San Antonio also introduced two floor amendments, including one that sought to ban conversion therapy, which aims to change someone's sexuality. Both measures failed. The Senate voted 19-12 along party lines for SB 14, which is one of Lt. Gov. Dan Patrick’s priorities this session.

Under the amended bill, families have a shrinking window to begin this treatment before June 3.

Landon Richie, policy associate with the Transgender Education Network of Texas, said if the bill is “increasing the burden on families who may be in line for appointments to receive this care, but if time runs out before they receive it, they’re not going to get care in this state.”

Richie said many families don’t have the resources to leave the state to get this care, which will significantly restrict what treatment is available to address the mental health challenges trans youth experience.

The bill will make its way to the lower chamber after a final vote in the Senate. In 2021, a bill similar to SB 14 was passed in the Senate but died in the Texas House. But this year, a majority of House members — all of them Republican — have signed on as authors or co-authors to House Bill 1686, which is more restrictive than the new version of SB 14. HB 1686 amounts to an outright ban on transition-related care for kids. HB 1686 was debated Monday, but has not yet been approved by the House Public Health Committee, which includes three openly LGBTQ lawmakers, all of them Democrats.

The House legislation saw overwhelming public opposition, as more than 2,800 people registered against the bill while just under 100 people expressed support. The bill’s opponents criticized Rep. Stephanie Klick, a Fort Worth Republican who chairs the committee, for cutting off testimony before hundreds of people could testify against it in person. Though several trans youths and their parents were able to make their case to the lawmakers.

Sunny Bryant, a nine-year-old trans girl from Houston who testified late in the night, said she had to miss school to wait for her chance to speak.

“If you pass this bill and we stay in Texas, I’d grow up looking like my dad and that’s a scary thought,” she said to laughter in the room. “I want to grow up looking like me — nobody else, just Sunny.”

Some parents also spoke through tears about how this legislation, if enacted, would push them out of a state that they have deep ties to so that their kids could continue accessing hormone therapy and puberty blockers.

“I’d have no choice but to leave this state,” said Lisa Stanton, mother to Maya Stanton, a 12-year-old trans girl from Houston.

She has a job that could allow her to relocate, but her husband’s work is in Texas.

“We have literally been having conversations about whether we will have to separate and move somewhere else and have him just visit us on the weekends,” Lisa Stanton said. “This is ruining our lives.”

And for some older trans youth, the legislation is already making them rethink where they want to build their future. On the same day as the House committee hearing, Topher Malone, a trans high school senior from Round Rock, received Rice University’s notice about whether or not the Houston college had accepted her. But she didn’t bother checking to see if she was admitted.

“I don’t want to stay here for college anymore, because of what this state government is doing to trans people like me and I can’t stand it anymore,” Malone testified.

Sen. John Whitmire, D-Houston, arguing against SB 14, said he’s built relationships with families of trans youth and urged the Senate to leave decisions about gender-affirming care up to parents. He noted he’s been a lawmaker for 50 years, but this issue was only recently debated at the Capitol.

“I would pray that it’s not just politics but it’s genuine concern for the health and welfare of the transgender children,” Whitmire said. “Let’s remember that the transgender children are God’s creations and we love them.”

The bills restricting transition-related health care are among a slew of legislation Republican lawmakers are pushing that could upend several facets of LGBTQ Texans’ lives. During this month’s hearing on SB 14, GOP activist Steven Hotze went on an anti-trans tirade, calling doctors who provide this type of health care “pedophiles.” Menéndez asked Hotze not to lob baseless and incendiary attacks. Menéndez said trans people are “living their true selves.”

A new research brief by the Trevor Project, a national LGBTQ youth suicide-prevention organization, found that trans kids who come out before age 13 experience higher rates of discrimination, physical harm and suicide attempts than those who come out after that age.

“Right now, transgender and nonbinary young people in the U.S. are dealing with an impossible duality: visibility and understanding of trans people are at an all-time high, and yet, at the same time, they are witnessing a historic wave of anti-trans political attacks all across the country,” Dr. Jonah DeChants, senior research scientist at The Trevor Project said in a statement to the Tribune.

The study found that those whose gender identity is met with a high amount of family support have significantly better mental health outcomes.

“Taking even small steps to support the trans young people in our lives can be, quite literally, life-saving.”

Disclosure: Equality Texas and Rice University have been financial supporters of The Texas Tribune, a nonprofit, nonpartisan news organization that is funded in part by donations from members, foundations and corporate sponsors. Financial supporters play no role in the Tribune's journalism. Find a complete list of them here.


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