We Owe Transgender Children and Youth Affirmation and Respect

A Statement from the Center for the Study of Social Policy

Children and youth need to be affirmed in their identities in order to be healthy and to thrive. This is a statement of fact and not contested opinion; it is backed by research, and it is supported by the American Medical Association (AMA) and the American Academy of Pediatrics (AAP). In spite of this, Governor Abbott of Texas is using his power to intentionally harm children and youth by doing the exact opposite of what we all know is best. His actions directly endanger the health and well-being of the children of Texas and their families, and the health care professionals that support them by falsely stating that gender-affirming health care is equivalent to child abuse. This is patently wrong, politically motivated, and incredibly dangerous.

For transgender youth—and all youth—to thrive, the environments where they learn and grow, the various systems with which they interact, and the adults who love, care for, and support them must affirm their identities and senses of self. Again, the research is clear: all young people need respect and affirmation of their whole identity—including their gender identity—and without this support, young people suffer detrimental harm to their health and well-being. We know that gender inclusive policies are associated with better mental health outcomes and higher levels of feelings of belonging among transgender youth. Gender-affirming medical care has been linked to lower rates of depression, suicidal thought, and suicide risk. Medical experts including, the AMA, AAP, the American Academy of Child and Adolescent Psychiatry, and the American Psychiatric Association have all been outspoken about the importance of gender-affirming care to ensure the health and well-being of transgender youth.

Governor Abbott’s letter to the state’s Department of Family and Protective Services (DFPS) falsely claims that gender-affirming health care is child abuse. Further, he states that those who support youth in accessing gender-affirming care—including parents, caregivers, medical professionals, and others—should be investigated by DFPS for child abuse. This is a very dangerous attempt to invade, and potentially sever, family relationships. It further traumatizes a young person who is already navigating the natural arc and milestones of identity development. Loving families who affirm their child’s identity and seek gender-affirming care are doing exactly what is in the best interest of their child’s health and well-being. They should be supported at every step, not be subject to an invasive investigation, oversight, and policing by the state.

There is no doubt that Governor Abbott’s letter will cause Texas youth and their families real harm, which will undoubtedly worsen if DFPS follows the letter’s directive. Youth face real trauma when they are separated from their families and are placed in foster care. Already, youth identifying as LGBTQ+1 are overrepresented in child welfare. This overrepresentation is even starker for LGBTQ+ youth of color, who experience the compounding effects of structural racism. Once in the foster care system, LGBTQ+ youth and LGBTQ+ youth of color are at an increased risk of unstable placements, in large part because the system fails to provide the support and affirmation transgender youth, and all youth, need.

Those supporting these efforts in Texas, including Texas Attorney General Paxton, are failing young people, rejecting them based on their identities, and threatening to sever family relationships. Unconscionably, Governor Abbott’s actions are not an isolated effort. This directive from Texas is one of many state level agendas threatening and harming the health and well-being of transgender youth and their families. Lawmakers across the country have supported legislation denying gender-affirming care for youth, excluding transgender athletes from competing and subjecting young people to invasive health care examinations, supporting teachers who intentionally misgender students, requiring school employees to out a child’s identity to their parents, and supporting efforts to discriminate against transgender people more broadly.2

For too long the child welfare system, founded on racist principles and continuing to perpetuate systemic racism, has surveilled, policed, and removed children and youth from their families and communities. It has been funded to primarily support family separation and foster care rather than community supports and has allowed for the discrimination of LGBTQ+ youth and caregivers. A lack of federal protection for LGBTQ+ youth and caregivers and a lack of accountability for child welfare systems have too often allowed for political agendas and harmful state policies to go unchallenged. Abbott’s agenda flies in the face of what we know is best for children and families simply because of his politics—not research, good policy, or human decency. However, there are policymakers, leaders, and advocates taking important steps to protect the rights and dignity of transgender children and youth and their caregivers. Several District Attorneys in Texas have spoken up, calling Governor Abbott and Attorney General Paxton’s efforts “un-American” and a “politically motivated attack,” and national, state, and local organizations have committed to protecting transgender children, youth and their families.

We cannot continue to only defend the dignity, health, and well-being of children and families from attacks. Enough is enough. We must be proactive. We must upend the child welfare system. We must condemn politicians who put their desire for power and political gains over the health and well-being of children and families. We must reorient toward broader protections for children and families, by promoting anti-discrimination efforts and making meaningful investments in communities to provide resources that help caregivers promote the healthy identity of their children, not punish them for doing so. Ensuring access to gender-affirming health care and supporting parents in being champions for their children’s needs is a priority. Transgender youth and their families must be treated as respected, dignified, and affirmed human beings, not as political pawns. This is an essential step in the right direction and the minimum of what we owe.

About CSSP. The Center for the Study of Social Policy is a national, non-profit policy organization that connects community action, public system reform, and policy change to create a fair and just society. We work to achieve a racially, economically, and socially just society in which all children and families thrive by translating ideas into action, promoting public policies grounded in equity, supporting strong and inclusive communities, and advocating with and for all children and families marginalized by public policies and institutional practices. Learn more at www.CSSP.org.


1 An acronym for “lesbian, gay, bisexual, transgender, and queer.” The plus (+) is inclusive of all other expressions of gender identity and sexual orientation. See: “Key Equity Terms and Concepts: A Glossary for Shared Understanding.” Center for the Study of Social Policy, 2019. Available at: https://cssp.org/resource/key-equity-terms-concepts/.
2 Meanwhile there are limited federal level protections to prohibit discrimination on the basis of sexual orientation and gender identity and expression in employment, housing, education, health care, and other settings.