Paxton Opinion KP-0401 Reviewed (Child Abuse)

I. The Executive Summary

a. All enumerated treatments and procedures in the Requestors original letter can legally constitute child abuse.

b. Several provisions in the TX Family Code relating to "mental or emotional injury", "physical injury", and failure to make a reasonable effort to prevent an action by another party" provide grounds for child abuse.

II. Nature and Context of the Question

a. These elective surgeries have the effect of permanently sterilizing minors.

b. These procedures can cause side-effects and harms beyond permanent infertility.

c. The courts have determined a human right to procreate.

d. The denial of a minor's right to future procreation without their legal consent constitutes child abuse.

e. A minor cannot legally consent to medical treatments.

f. Parents cannot legally consent to medical procedures that might result in the minor's inability to procreate at some future point.

g. There is no scientific consensus that these sterilizing procedures and treatments serve to benefit minor children dealing with gender dysphoria.

h. There is no evidence that long-term mental health outcomes are improved or that rates of suicide are reduced by hormonal or surgical intervention.

i. One of few relevant studies....found high rates of post-transition suicide.

j. WPATH states that with respect to irreversible procedures, genital surgery should not be carried out until patients reach the legal age of majority to give consent.

k. Legal and ethical scholars have suggested that it is particularly unethical to radically intervene in the normal physical development of a child to "affirm" a "gender identity" that is at odds with bodily [biological] sex.

l. In areas of medical and scientific uncertainty, State and Federal governments have "wide discretion" to regulate such activity through legislation and this duty is "at its zenith" when it comes to protecting our children.

III. Right to Procreate; Consent

a. The enumerated surgical procedures can and do cause sterilization.

b. Chemical or surgically removing a minor's reproductive organs without consent (sterilization) supports a finding of child abuse.

c. Minors cannot consent to procedures and treatments that result in their sterilization.

d. There is insufficient evidence that the effects of puberty blockers are reversible.

e. The US Constitution (14th Amend) protects a fundamental right to procreation. (Skinner vs Oklahoma)

f. A parent's right to consent to medical procedures does not extend to elective (not medically necessary) procedures and treatments that infringe upon the minor's right to procreate. Doing so would constitute child abuse as well.

g. There is no legal or judicial path to parental consent for GAC treatments or procedures for GAC.

h. IF one of the enumerated treatments or procedure did not result in sterilization the courts would have to analyze the facts on a case-by-case basis to make a child abuse determination.

IV. Questioned Treatments and Procedures Equate to Child Abuse

a. TEX FAMILY CODE Chapter 261 and TEX PENAL CODE define abuse and provide outcomes for the offense and injury to a child.

b. The Texas Department of Family and Protective services defines "genuine threat of substantial harm from physical injury" to include the...

..."declaring or exhibiting the intent or determination to inflict real and significant physical injury or damage to a child. The declaration or exhibition does not require actual physical contact or injury."

Note: This statement seemingly applies to the social transitioning or "facilitation" phase of the GAC process.

c. A parallel is drawn between extant laws banning "female genital mutilation" and analogous procedures that include genital mutilation--potentially including gender reassignment surgeries--that could constitute abuse.

d. Unnecessary medical treatment inflicted on a child by a parent can constitute child abuse under the FAMILY CODE.

e. Even where the procedure or treatment does not involve the physical removal or alteration of a child's reproductive organs (i.e. puberty blockers) these procedures and treatments.....a court could find these procedures to be child abuse.

f. "Anyone who has a reasonable cause to believe that a child's physical or mental health or welfare has been adversely affected by abuse or neglect by any person SHALL immediately make a report" TEX FAM CODE 261.101(a).

g. If a professional has reasonable cause to believe....that a child has been abused or neglected...that professional shall make a report no later than 48 hours from the point the professional first has reasonable cause. A failure to report is a criminal offense.

Now You Know

Practitioners of the GAC process in TX are traversing a very slippery road. The facilitation of minors is illegal. Referring minor patients to other counselors for GAC services is now illegal. The physical transitioning of minors in TX and a handful of other states is without question, illegal.

But the point of this article is that all of those activities may also be very easily classified as child abuse since 2022. Practice any segment of the GAC process and you're looking at the probable loss of your license, prison time, and the loss, through criminal and/or civil court, of everything you own.