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Gender-affirming care is not relatively new to healthcare and medical professionals; yet, in the world of politics and law, legislation restricting access to gender-affirming care, specifically for minors, has skyrocketed over the past few years. Whether it be hormone therapy or surgical intervention, in over 20 states, there is legislation restricting the ability of minors with parental consent to access gender-affirming care. There is empirical evidence that states that legislation restricting access to gender-affirming care is harmful to LGBTQ+ youth. While gender-affirming care has long been a part of healthcare, this new spike in legislation, specifically for minors, provides concern regarding the impact on the well-being of LGBTQ+ individuals, further emphasizing the national need for policymaking to re-evaluate the extent to which it can infringe upon the 1st and 14th amendments. 

There is concern over why legislation restricting gender-affirming care for minors is being introduced and passed, as many argue it is to promote a political agenda. In contrast, others claim it’s a parental rights and child abuse issue. Politicians who promote and advance legislation restricting gender-affirming care, specifically for minors, argue that their legislation is protecting parental rights, and gender-affirming care for minors is a form of child abuse because the child is not yet old enough to make their own decisions. Therefore, healthcare providers are working without proper consent. Since parental rights and child abuse are defined differently in each state’s laws and legislation, there isn’t a national standard for what “parental rights” actually look like. Therefore, there is a lot of room for politicians to interpret the legislation and apply it to other issues. That is to say, the legislation being so broad in language and so widely supported makes it easier for politicians to claim any matter vaguely related to children or matters concerning children as an issue of parental rights or child abuse/neglect. As Naomi Cahn says, in “The Political Language of Parental Rights: Abortion, Gender-Affirming Care and Critical Race Theory”, the framing of gender-affirming care as a parental rights/child abuse issue acts as a “trojan horse for political goals.” Legislation such as “The Parental Rights Amendment,” which is currently attempting to be passed as a national amendment to the constitution, is presented as an issue of parental oversight. Ultimately, they claim that parents should have the right to “direct the upbringing, education, and care of their children.” Therefore, no child should have the right to use pronouns unknown to the parent and should not be allowed to make any decisions over their body without parental consent. The trojan horse, being widely supported sentiments such as giving parents the rights over their children or preventing abuse, allows for the unspecific, vague, and broad language of laws regarding parental rights and child abuse or neglect. This, in turn, provides an opportunity for wide and varied interpretations, allowing politicians to extend their influences regarding this matter beyond the probable intended scope. 

Over 20 states have implemented or considered legislation that restricts access to gender-affirming care; however, Texas specifically has a large variety of anti-trans legislation. “The Texas Legislature considered a measure that would criminalize doctors providing or guardians consenting to gender-affirming care for transgender minors, classifying it as child abuse…The bill did not pass,” Donald L Hudson Jr. wrote in his journal article, Trans Legislation: States Drive A Wave of Bills Affecting Transgender Youth. While this bill did not pass, many like it continue to be introduced nationwide. This bill in Texas was one of the first to call for criminalization openly for individuals who provide gender-affirming care to minors, and many more are being introduced. This trend has shocked the world of healthcare as even many conservative policymakers find the criminalization of doctors for providing care to be well beyond the scope of any legislation. However, Republicans persistent in passing this legislation were determined for it to be implemented somehow. The Republicans in the Texas Legislature re-wrote the bill, re-introduced it to the floor, and in June 2023, Governor Greg Abbott signed the bill, which, as of September 1st, 2023, bars any minor in the state of Texas from receiving transition-related care such as puberty blockers and hormone therapies. Since 2021, Texas has been considering the largest amount of anti-LGBTQ+ bills in the country. GLAAD, a non-profit organization with a mission of culture change and LGBTQ+ advocacy work, had long reported that over 30 anti-LGBTQ+ bills were circulating in the Texas legislature when the bill to restrict minors from accessing transition-related care was passed in 2023. These anti-LGBTQ+ bills ranged in purpose from sports restrictions to HIV criminalization, and while some were dismissed due to their unconstitutionality, many, such as the bill Governor Abbott signed in June 2023, were passed and implemented swiftly. Ultimately, the anti-trans legislation passed in Texas exemplifies an ongoing nationwide trend of criminalization of gender-affirming care, specifically for minors. 

Legislation restricting gender-affirming care for minors has raised concerns over government infringement on the 1st and 14th Amendments. As stated by Morgan Watkins, the primary method used to block such legislation from passing through the courts is the 14th Amendment’s equal protection clause. Since gender-affirming care is considered a form of medical care, denying a parent’s right, or anyone’s right, to proper medical treatment violates the 14th Amendment. Under this argument, several district courts have blocked such legislation from passing as judges have found reasonable cause that restricting access to medical care, such as gender-affirming care, violates the 14th Amendment. Additionally, many opposing legislation restricting gender-affirming care argue that gender-affirming care is a form of self-expression protected under the 1st amendment. However, the issue, specifically with this argument’s ability to withstand in a court of law, is that it has never been questioned or challenged in court before–simply stated, there is no precedent for how it should be ruled upon. Therefore, it is up to the discretion of judges. Abigail Moncrieff, the co-director of the Cleveland State University’s Center for Health Law and Policy, argues that this is when politics come into play as judges will use the opportunity of no precedent to create new constitutional rights of restriction that aline with their political goals or ambitions, as seen in the 6th District Court of Appeals. 

The rise in anti-trans legislation, legislation restricting access to gender-affirming care specifically for minors, is concerning as it signifies a trend, ultimately raising questions about the intersection of politics and parental rights. The vague and broad language of anti-trans legislation, continuously framed as an issue of protecting parental rights and deterring child abuse, provides a “Trojan horse” for political agendas, at length allowing for a wide range of implications and interpretations. The legislation presented in Texas is an example of such a trend, as it is now a crime for minors to receive gender-affirming care in that state. The impact of anti-trans legislation, as passed in Texas, is statistically shown to have an alarming effect on the mental health of LGBTQ+ youth. As politicians, parents, and LGBTQ+ individuals deal with these complicated issues, it is essential to prioritize the rights and overall well-being of LGBTQ+ youth and individuals while creating a more supportive society through comprehensive legislation and evidence-based policymaking.