Texas sues to prevent losing federal funds over its investigations of trans children’s families

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Texas is worried it could lose over a billion dollars in federal funding over Gov. Greg Abbott’s directive requiring medical professionals to report transgender children receiving gender-affirming health care as potential child abuse.

Texas Attorney General Ken Paxton amended an existing lawsuit suing the Biden administration Wednesday, attempting to void guidance issued by the U.S. Health and Human Services on March 2 that said restricting someone’s ability to receive medical care solely on the basis of their sex assigned at birth or gender identity is likely a violation of the Affordable Care Act for federally funded entities. That federal guidance came in response to Abbott’s directive issued late last month to treat certain medical treatments for trans children as possible crimes to be investigated by the Department of Family and Protective Services.

The federal guidance stated that health care providers do not need to disclose private patient information regarding gender-affirming care and that it is illegal to deny health care based on gender identity.

Paxton, in the lawsuit, said that guidance is based on “erroneous interpretation of sex discrimination.” The lawsuit says Texas does not aim to deny health care based on gender identity. Instead, the state argues its investigations disregard gender entirely, barring all children from “unnecessary medical interventions.”

In 2020, $1.36 billion in federal funds went to Texas’ Department of State Health Services, Paxton said in the lawsuit. More than $26 billion went to the State’s Health and Human Services Commission.

Before Abbott issued his directive essentially equating gender-affirming care to child abuse, Paxton issued a nonbinding legal opinion stating that health care treatments such as puberty blockers, prescription medicines whose effects are entirely reversible, constitute child abuse as well. These statements elicited intense criticism from the White House, doctors, lawmakers and advocacy organizations.

So far, the state has begun five investigations into parents of trans children since Abbott issued his directive Feb. 22. However, there may be more cases as the state declined to disclose active investigations amid pending litigation.

Paxton attempted to stop a ruling temporarily blocking the state from investigating the family of a trans child. But a Texas appeal court denied him Wednesday. On Friday, lawyers for the American Civil Liberties Union and Lambda Legal will ask a lower court judge to stop state investigations against parents who obtain gender-reaffirming care for their children.