Texas Supreme Court upholds law prohibiting sex changes for minors

The Texas Supreme Court has upheld a state law prohibiting doctors from performing sex changes on minors, coming after parents and medical professionals raised a challenge to the law. 

Delivering the opinion of the court, Justice Rebeca Huddle wrote that the plaintiffs in the case "failed to meet the burden" of whether they had established a "probable right to relief on their claims that the Legislature’s prohibition of certain treatments for children suffering from gender dysphoria violates the Texas Constitution." 

"We have said—and we reaffirm today—that fit parents have a fundamental interest in directing the care, custody, and control of their children free from government interference. But we have never defined the source or precise scope of this interest, and our precedents make clear that this interest is not absolute." 

Huddle added, "When developments in our society raise new and previously unconsidered questions about the appropriate line between parental autonomy on the one hand and the Legislature’s authority to regulate the practice of medicine on the other, our Constitution does not render the Legislature powerless to provide answers." 

The court concluded that the state Legislature "made a permissible, rational policy choice to limit the types of available medical procedures for children, particularly in light of the relative nascency of both gender dysphoria and its various modes of treatment and the Legislature’s express constitutional authority to regulate the practice of medicine." 

"We therefore conclude the statute does not unconstitutionally deprive parents of their rights or physicians or health care providers of an alleged property right in their medical licenses or claimed right to occupational freedom. We also conclude the law does not unconstitutionally deny or abridge equality under the law because of sex or any other characteristic asserted by plaintiffs. We therefore reverse and vacate the trial court’s order." 

The Texas law, SB 14, was passed in June of 2023. It states that healthcare providers are prohibited from performing, as part of affirming a child’s self-declared gender identity, procedures such as castration, hysterectomies, phalloplasty, and mastectomies, and were blocked from prescribing puberty blockers and cross-sex hormones. 

Exceptions were made for healthcare providers doing these things to treat a child with precocious puberty, genetic disorders of sex development, or if the child had begun the drug treatment before June 2023 and attended 12 or more sessions of mental health counseling before starting the course of treatment. Children who are included under the exceptions are ordered to wean off the drug over a period of time "that minimizes the risk of complications" and may not switch course of treatment. 

The ruling comes as the Department of Justice has indicted a Texas doctor on four felony counts after he spoke out against child sex changes that were still occurring at Texas Children's Hospital.