GAC and My Duty to Report

GAC and My Duty to Report | Association for Mental Health Professionals

Last year SB 14 was passed outlawing transgender conversion therapy for minors in TX. Kathleen became aware of a local, N. TX counseling group that publicly offers to write the GAC letters required by the WPATH conversion protocol before any medication or surgery may be applied. This particular counseling group also sees children which raised the question, when do I have a duty to report another counselor for this activity?

At the Feb 2, 2024 LPC Board meeting the following comments were read into the record during the Public Comments segment. At AMHP we are aware that SB 14 is currently being tested in the TX higher courts, and that any clarifications of official opinions, extant code, or recently passed bills will (probably) first need to take place in the TX legislature. This is not currently an issue the licensing boards can do anything about. We simply wanted to go on record with our concerns and we have done just that.

Opening Statement on GAC and My Duty to Report

I'm Kathleen Mills, LPC-S and co-founder of AMHP. At AMHP we stand firmly against the entire "gender affirming care", or GAC movement, and we believe the immense harm being done to our children will mark our generation of academics, parents, counselors, and medical professionals as one of the most egregiously delinquent in modern history if not longer.

On Feb 18, '22 the TX Office of the Attorney General (the OAG) issued a legal opinion classifying certain gender affirming care services as "child abuse" based on the TX Family Code 261. The OAG qualified such treatment as CHILD ABUSE on the basis that it causes "mental or emotional injury" to a child. That would appear to bring this issue into the sphere of mental healthcare under the auspices of the Do No Harm ethic.

In light of the passage of the TX Senate Bill 14 last year which went into effect on Sept 1,'23 and outlaws gender affirming care for the under 18 demographic, I think clarification is needed, specifically about the part that licensed mental health providers are ethically and legally allowed to play for the under 18 crowd. Glaringly absent from SB 14 is the specific mention of mental health licensees in the affirming care process.

We are fully aware that these matters are being litigated as we speak in the higher courts nevertheless there are questions that need to be considered and answered, ultimately in our rulebooks:

Questions About SB 14

1. Pertaining to SB 14, do the generic terms, "physicians" or "medical professional", include the licensees of the 4 BHEC Boards?

2. Is the omission of "mental health practitioners" from SB 14 a purposeful omission or something the legislature needs to revisit and add to the list of covered entities?

3. Was SB 14 intended to cover the entire GAC protocol/process or just the portion that begins with medication or a scalpel? Does it cover the writing of treatment letters by counselors?

Child Abuse and the OAG Opinion

4. Does the OAG's legal opinion classifying certain gender affirming care services as "child abuse" apply to the 4 boards under BHEC's authority, or not?

5. In light of the OAG opinion and the entire GAC protocol, at what point in the process is the process considered child abuse? At what point does "child abuse" legally begin?

Specifically, is the authoring of a greenlighting letter for gender affirming care medication and surgery for a minor "child abuse", or not?

6. If so, are we aiding and abetting in the "child abuse" and is a counselor potentially legally liable, and to what degree?

BHEC/Board Recognition of Hours

7. An organization called WPATH is currently the loudest voice in training new GAC adherents in the protocols for transitioning those dealing with gender confusion, including children.

a. How are the Licensing Boards going to view certification of a process which has been largely outlawed in the State of TX? Will that certification be recognized?

b. Will training/certification hours through outfits like count towards renewal?

Do I Have a Duty to Report?

8. If participation in any part of the gender affirming care process is suspected by a licensed mental health counselor who advertises general counseling services for minors, or is observed or reported to me, including the drafting of affirming care approval letters, do I have a duty to report? Under what parameters do I have a duty to report?

9. If a licensed TX counselor is suspected of having written an affirming letter while practicing in TX, for a minor even though subsequent treatment may take place in another state, do I still have a duty to report? Must I be able to prove my suspicion or is suspicion adequate?

Answers to these questions need to be determined and clearly stated in our rulebooks.

Invitation to Professional Organizations

We openly invite the other professional organizations to publicly denounce Gender Affirming Care as a non-science-based treatment protocol, and recognize the OAG's legal opinion, the definition of child abuse in the Family Code Pt 261, and SB 14 which outlaws GAC in minors under 18. We further encourage them to condemn the writing of GAC letters in compliance with the OAG's opinion of GAC as child abuse for minors regardless of which state any further treatment may occur.

It's past time to do the right thing and have this discussion. Thank you.


We'll keep an eye on this issue and let you know how things develop. Then we'll let you know how you can get involved and make your voice heard.

We got this.

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About the Author

GAC and My Duty to Report | Association for Mental Health ProfessionalsPhillip's background has blessed him with a variety of interests, skills, and tools to get things done. He spent 25 years in the printing and marketing industry before meeting Kathleen Mills in 2015. They quickly figured out that they made a pretty good business team and, owing to Kathleen's story, embarked upon a mission that would see the creation of and eventually the Association for Mental Health Professionals.

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