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Texas doctors are worried for their patients losing access to gender-affirming care


To Texas now, where the battle over gender-affirming care for minors continues. Texas' governor and attorney general have attacked such medical care as child abuse. As NPR's Wade Goodwyn reports, doctors have begun to speak out for their patients.

WADE GOODWYN, BYLINE: It's 5:00 on a weekday afternoon at UT Southwestern Hospital in Dallas. About 100, 120 are holding a protest rally here on the front lawn.


UNIDENTIFIED PROTESTER: Hey, hey. Ho, ho. Transphobia's got to go. Hey, hey. Ho, ho...

GOODWYN: There's doctors and nurses and staff. And then there's just regular folks like Angel Martinez, who's in the fencing business. He's also transgender. Martinez is angry about the governor and attorney general's declaration that transgender treatment is child abuse.

ANGEL MARTINEZ: I think it's ludicrous. I think keeping the proper treatment away from these kids is abuse, so the abuse is actually coming from the government, not from the parents.

GOODWYN: Martinez is sitting in the hospital's thick green grass, wrestling with his young goddaughter, enjoying the spring afternoon. But he's full of worry about what the future will be like for transgender teens if medical treatment evaporates in Texas.

MARTINEZ: Well, I can tell you from personal experience, there's going to be a lot of suicide. There's going to be a lot of hate crimes, a lot of bullying, a lot of people beating people up, hurting people. I've been through it.

GOODWYN: A few steps away is a tall doctor in his lab coat, Nathan Chertack, a senior urology resident at the hospital.

NATHAN CHERTACK: As a urologist, we take care of people's sexual health, reproductive health, urinary health. So transgender care is a big part of that. How can I not be here to support my patients?

GOODWYN: Chertack is dismayed by what he feels is interference in medical treatment by Texas politicians.

CHERTACK: Numerous medical groups have come out in support of transgender care and gender-affirming care. And to ignore all the advice and input from medical professional groups is, frankly, sad and disappointing.

GOODWYN: UT Southwestern Hospital had a respected seven-year-old transgender treatment program called Genesis, but the hospital suspended medical treatments for new transgender patients in November, reacting to the political pressure out of the governor and attorney general's offices. Texas Children's Hospital in Houston followed in UT Southwestern's footsteps in March but went further, stopping hormone treatment for current patients, too. Last month, a Texas judge temporarily stopped the state's Department of Family and Protective Services from investigating families solely because they have a transgender child who's being treated.

DANY HANNA: What makes Texas so attractive is the general approach to life - small government, less regulation, individual responsibility and action. You know what's best for yourself and your family. And what's happening here is the exact opposite.

GOODWYN: Dany Hanna is a urologist and surgeon who treats trans patients. Hormone therapy often starts at the beginning of puberty, with puberty blockers. For those who eventually decide to have surgery as adults, they've usually been in treatment for years, including psychiatric evaluation. Hanna says once they enter his treatment, they undergo an average of 15 appointments before surgery.

HANNA: If there's ever a question, any suspicion that this individual's not ready to undergo therapy, we can and we have slammed the brakes to stop the process.

GOODWYN: Hanna believes if Texas successfully stops transgender adolescents from receiving gender-affirming medical treatment, it will threaten their well-being, not protect it.

HANNA: With a broad stroke of the brush, they've created this kind of one-size-fits-all policy for an issue that's exceptionally nuanced. I think in the future, moving forward, if patients are only able to receive care once they reach 18 years old, you're going to see a lot more mental health crises in these patients.

GOODWYN: The list of medical associations that approve of transgender treatment is extensive - 29 major medical groups, including the American Academy of Pediatrics, the American Psychiatric Association and the American Medical Association. The AMA's argument is simple - quote, "trans and non-binary gender identities are normal variations of human identity." But political leaders in Texas and more than a dozen other states are taking aim at the right to treatment.

Wade Goodwyn, NPR News, Dallas. Transcript provided by NPR, Copyright NPR.

NPR transcripts are created on a rush deadline by an NPR contractor. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.

Wade Goodwyn is an NPR National Desk Correspondent covering Texas and the surrounding states.