L. remembers exactly what her son was wearing one winter evening nine years ago. She can still see every detail: the blue Angry Birds T-shirt, the black Bakugan hoodie unzipped down the front, the jeans that had once been bedazzled and that still faintly bore the heart-shaped pattern where the plastic jewels had been, the Dr. Who socks — one still on his foot, the other on his bedspread. And the belt. She remembers the belt most of all. It was white and bore images of M&M characters, green and red candies cavorting across its length. A child’s belt, almost a toy, really. It was with this belt that her son was attempting to hang himself from the ceiling fan in his bedroom. He was nine years old.

That evening kicked off a years-long journey on L.’s part to stabilize her son’s mental health. She immediately got him into counseling. She fretted that her divorce from her husband might have influenced the suicide attempt. Or bullying. Or the possibility that he was gay. “When I asked him why, all he could tell me was that he was broken and there was no way to fix this,” L. says. “He didn’t know how to express what was different.”

It wasn’t until four years later that L.’s son, who was assigned female at birth, came across a YouTube video of a kid his age talking about being trans and, as L. explains it, “he said it was like, ‘Oh, my God, there’s a word for me.’ ” He shared this news with his mother, and was soon peppering her with medical studies and PowerPoint presentations he had made on why she should consent to him going on puberty blockers. “I’m a very science-minded person, so I was like, ‘Show me the studies,’ ” she says. “I had to be educated so that I felt safe doing it.” Some months later, after many tests and consultations with medical and mental health professionals, they went to Whattaburger to celebrate her son’s first puberty blocker shot. What L. didn’t know yet is that they were also celebrating the beginning of the end of his self-harm. “It’s the only reason he’s still alive,” she tells me pointedly.

Her reason for telling me this story, however, is not actually to make that point. It’s to talk about the fact that she’s already made it. And made it. Since 2019, L. (who, like other parents in this article, asked to go by her first initial) and her son have been going to meetings of the Texas Legislature to share their personal experience of what the scientific committee has long known to be true: that gender-affirming care is both necessary and life-saving. They’ve watched with alarm as bills that would ban that care have gotten closer and closer to becoming law, despite the pleas of many families like theirs and the overwhelming advice of the medical community, including the American Academy of Pediatrics, the American Medical Association, and the American Psychological Association. There is not a single medical or mental health organization of repute that does not support gender-affirming care as best practice. 

And yet the past few years have seen conservatives across the country try, in various ways, to ban it. Last month, Texas Attorney General Ken Paxton (who, it should be noted, is both awaiting trial for a securities fraud indictment and under investigation by the FBI for allegations of bribery and abuse of office) released an opinion arguing that gender-affirming care was so abhorrent that it could be considered child abuse under existing Texas law. Four days later, on Feb. 22, Gov. Greg Abbott directed the commissioner of the Department of Family and Protective Services (DFPS) to “conduct a prompt and thorough investigation of any reported instances of these abusive procedures” and called for doctors, nurses, and teachers who did not report “such child abuse” to face criminal penalties. The directive was blocked in court on March 11. As of last week, however, investigations into families were continuing. Paxton tweeted, “This fight will continue to the Supreme Court. I’m ready for it.” (Paxton’s office did not respond to a request for comment.)

L. read the letter from Abbott the day it was released. “I had a panic attack,” she tells me. “I felt shaky, queasy, heart was racing, dry mouth.” She also had Child Protective Services show up at her home on March 1, claiming that there had been “multiple allegations dealing with the genital mutilation and hormone abuse you inflicted on your child.” She knew better than to let the woman inside her house, directing her instead to contact her lawyer. “It’s pretty much been a terrible day ever since.”

Rev. Remington Johnson

Rev. Remington Johnson poses for a portrait in her home in Austin, Texas.

Ilana Panich-Linsman for The New Republic

The first ban on trans medical care was introduced in 2020, providing a definitive solution to a problem that never actually existed. Medical guidelines for the treatment of trans children dictate a clear sequence of best practices that are known to improve mental health. Before puberty, no medical intervention is recommended; parents are advised to love their children and help them “socially transition,” which may mean changing their pronouns and their clothing. Once a child enters puberty, safe and reversible puberty blockers are a way to buy time. If a teenager later decides they want to start hormones to continue the transition, that would happen with the consent of their parents, their psychiatrist, and their medical team. Surgeries are hardly ever done on patients under the age of 18, and only in instances in which there is deemed to be an urgent need. Sometimes there is: Trans children are at a higher risk of suicide than almost any other demographic. Gender-affirming medical care has been shown to bring the risk down so substantially that it becomes comparable to that of their cisgender peers.

Then again, the introduction of the first medical ban did provide the solution to a different problem: the need to continually mobilize the right-wing base and the sense that LBGTQ issues would be a good way to do it. In 2015, when the Obergefell v. Hodges case was before the Supreme Court, legislation opposing marriage equality proved to be unpopular with voters. Signing a bill that allowed businesses to refuse service to LGBTQ people on religious grounds caused such an uproar that it threatened to end Mike Pence’s political career in Indiana (though it probably also put him on Trump’s radar). The blowback over North Carolina’s 2016 bathroom bill was swift and definitive. It seemed that Americans as a whole just didn’t hate LGBTQ people as much as conservative operatives wished they did.

Then in 2019, the right-wing think tank American Principles Project came up with a winning variation on the theme when they invented the wedge issue of trans kids playing school sports. Suddently, cis children could be spun to be at a disadvantage and so, predictably, the idea took off. “2020 set a record number of anti-trans bills filed in the U.S.,” says Kate Oakley, the Human Rights Campaign’s state legislative director and senior counsel. “That number more than doubled in 2021, and we are on track to surpass it in 2022.” 

The anti-trans medical bans were a new development fed to legislators by the far-right Heritage Foundation and the Alliance Defending Freedom, which the Southern Poverty Law Center has designated an anti-LGBTQ hate group. Already this year, at least 38 of these bans have been introduced in legislatures across the country. Alabama’s includes a provision that would mandate that teachers out their students and has such vague language that it could be interpreted to mean that even the children themselves would face up to 10 years in prison for receiving gender-affirming care. Idaho’s bill would send medical providers to prison for life. Arkansas’, which passed in 2021 despite being vetoed by the governor, would revoke the medical license of anyone practicing gender-affirming care and prohibit doctors from even referring patients for it. The week before the law was set to go into effect, it was blocked by an ACLU lawsuit.

“I mean, these bills are patently unconstitutional in just about every possible way you could think of,” says Kaitlin Welborn, an attorney for ACLU in Alabama. “It’s almost as if they tried to be as unconstitutional as possible.” Sydney Duncan, an attorney for Birmingham’s Magic City Legal Center, agrees: “The Supreme Court that we have right now is basically the same court that broadened the scope of sexual discrimination to include sexual orientation and gender identity. So it would be very strange for the same court to go back and say, ‘Well, we didn’t mean what we meant two years ago on this definition.’ ”

Yet the unlikelihood that these bills will ever be enacted is part of what makes them particularly pernicious. It exposes them for what they are: a political ploy that uses the lives of children as pawns. “This is an insane amount of government overreach,” one Texas mom of a trans child told me. “This is literally a state government telling community members to report children to the state and asking the state to come into their homes and round them up. It’s fascism, and it’s starting with trans kids now because they are vulnerable and there are so few of them, but who knows what the next form of this will be? Whatever the next polling data of extremist politics tells them to do, that’s what they’ll go for next. We need community members to hold the line with us.” 

The other side is certainly holding theirs. It is no mystery why Paxton and Abbott both released their directives immediately before their primaries. And it is also clear that, thanks to redistricting, the state has become so gerrymandered that the primaries are the only part of the election that really matters; whoever wins those has won the general election by default, which means that the tempering of views that is generally required in a contested general election is happening less and less frequently. “Primaries tend to be the focus of extremists in both parties,” points out Neil Giles, a Houston lawyer and father of two non-binary children. “So you end up with wilder and frankly stupider people in government office. You end up with people like Ken Paxton. They’re throwing red meat. That’s all these politicians are doing.” 

There is also, as L. pointed out, very little effort to even feign otherwise. Paxton’s opinion was so flawed that it drew rebukes from numerous sources he cited, some of whom said that he was distorting their research to arrive at a conclusion entirely at odds with what their data actually shows. Notably, the opinion drew parallels between gender-affirming care and our country’s history of forcibly sterilizing minority populations; implied that parents that consent to this care could be suffering from Munchausen syndrome by proxy; and referred repeatedly to “genital mutilation” as if affirming care fell into that category, reminding readers that “female genital mutilation” had been made a “state jail felony” (leaving a carve-out for male circumcisions, of course).

In numerous visits to the Alabama state capital to sit in on committee hearings for these bills, Vanessa Tate Finney, the mother of a trans 13-year-old, has witnessed firsthand the lack of rigor that’s gone into their introduction in the state legislature. “I don’t think they have a personal vested interest in the bill because even the bill’s sponsors don’t know what’s in the bill,” she says, pointing out that it is typical for far-right think tanks to simply supply the language of a bill to a legislator who agrees to sponsor it. Most have misleading names like the “Alabama Vulnerable Child Compassion and Protection Act,” which has been making its way through the legislature this season. In support of this bill, Tate Finney says that its sponsors seem unable to tell the difference between legitimate medical experts and associations like the American College of Pediatrics, an anti-LGBTQ hate group named specifically so as to be mistaken for the apolitical American Academy of Pediatrics. “I have yet to hear anything in testimony from the side that is supporting the bill and is actually factually true,” she tells me. “They see ‘MD’ behind someone’s name and don’t understand that there is a tremendous difference between a doctor who is a plastic surgeon and a doctor who is a primary-care physician to children who identify as transgender, who live with gender dysphoria, a child like my own who at 13 is at the prime age to be really, truly affected by the long-term legal outcomes of this. They have no experience with these children. In fact, their star witness is a plastic surgeon.”

Last year, she says, one of the sponsors of an affirming-care medical ban bill was asked if he’d ever met a transgender or non-binary minor, and not only did he admit that to the best of his knowledge he had not, but, she says, the committee had to ask for clarification of what “non-binary” meant. “It’s very, very heartbreaking,” says Tate Finney, “to have to tell your child, ‘The hope that you had of becoming the person that you know that you are has been taken away by a bunch of people who don’t know what they’re doing.’ ”

Meanwhile, kids who can’t yet vote are watching from the sidelines as their futures are decided by such people. “A lot of our young people are really spiraling,“ says Amanda Keller, the director of the Magic City Acceptance Center, a safe space for LGBTQ kids in the Birmingham area. “They’ll go through the process of being angry and grieving and panicking and trying to figure out what to do and what comes next. The word ‘hopeless’ comes up a lot.” And the hopelessness is there whether or not these bills ever make it to law. “We know that there were multiple children who attempted or did die by suicide because the bill passed in Arkansas, even though the ACLU got an injunction very quickly,” says ACLU’s Welborn. “Just the fact of passing it will make some children feel like they have no way out.”


Texas State Capitol Rally

Activist Indigo Giles speaks on the steps of the Texas State Capitol during a rally on March 1.

Mandy Giles

Texas is now giving the country a chance to see exactly what that looks like for trans children and their families. And it doesn’t look good. The day after Abbott issued his directive, a employee of the Department of Family and Protective Services was “placed on leave from her employment because she has a transgender daughter with a medical need for treatment of gender dysphoria,” according to a lawsuit filed on behalf of the family by the ACLU, Lambda Legal, and Houston firm Baker Botts LLP. Since then, multiple families have been contacted by DFPS, and numerous providers, including Texas Children’s Hospital in Houston, have “paused” certain gender-affirming services. This leaves some families scrambling to figure out how to continue their child’s care, and doctors and medical professionals torn between their fear of legal action and the Hippocratic oath they took to follow what they know are best practices. “It’s creating massive confusion,” one parent told me. “And I think that’s the point. Doctors are like, ‘Could I lose my license? Could I be targeted for not reporting’? I’m hearing panic in the therapist community, like, ‘Can I still talk to my patients? Can I talk to their families?’ ” 

Which means that overnight there has essentially been a dismantling of the support systems put in place to protect a vulnerable group of children even as they find themselves under a political and cultural spotlight. “It’s one thing for a random man at the grocery store to say a hurtful comment in passing about what you look like, because I don’t have to deal with that after I leave this grocery store, right?” says Indigo Giles, a non-binary 19-year-old Texan. “But you can’t run away from the governor of the state. It’s so frightening for the person in charge to be saying that.” And even kids who were not yet receiving affirming medical care feel the effects. In cases of actual abuse, the license DFPS has to seek out a child — to go to their school, to talk to them without their parents’ permission — is a necessary safeguard. Yet in this case, it has meant that parents who have worked incredibly hard to surround their children with support and acceptance have had to sit their children down and prepare them for the possibility of having that bubble burst. “Parents are having to have that very first conversation with their child,” says the Rev. Remington Olivia Johnson, an Austin-based activist and health care professional who recently led a rally against Abbott’s directive outside the governor’s mansion. “No one has put transphobia into the minds of these children. No one has hung that on them. And now we have Abbott ripping apart this protective shield over these children and saying, ‘I know who you are is wrong, and I will destroy any sort of childhood innocent innocence that you had around this.’ ”

That has certainly been what it’s felt like for K., whose 10-year-old daughter is trans and who spent a recent Saturday having her two young children meet with a lawyer to discuss what to do if DFPS shows up at their school, and to read through a letter each child now carries with them at all times — one copy in their backpack, one in their pocket. “It says, ‘I do not consent to speak with you. Talk to my lawyer. Here is his information,’ ” K. said during a tearful conversation last week. “I mean, my kids are in elementary school, and this is what we’re doing on a Saturday.” 

K. and her husband both grew up in Texas. Their parents and much of their family is there. They live in an affirming community in Austin, where their kids love their school and their friends, in a house in which they had planned to grow old. In fact, up until the past few weeks, K. had always told herself, almost hyperbolically, that she would stick it out in Texas until they tried to take away her children. “And that’s what’s happening now,” she says. “I was resolved to stay and fight, especially for those who can’t leave. But now lawyers are telling us to leave, to get out while we can.” 

Within four days of Abbott releasing his letter, K. and her family had decided to move, and she was making plans to fly out to Portland to look at real estate. When she told her parents, her Fox-watching, Republican father sobbed, saying that he was relieved that she was doing what she had to do to keep her family safe. Friends have told her that Portland will provide a soft landing, but she’s still nervous. “I am so conditioned to trauma now, even hearing that, I don’t believe them. I don’t feel safe,” she says. “I don’t know that I ever will.” She also doesn’t know how she will explain herself to friends she has made in the trans community who don’t have the privilege and the resources to get out (in fact, there are now numerous GoFundMe pages devoted to helping the families of trans kids leave Texas).

“I’m like, ‘I’m such an asshole,’ ” she says, bursting into tears again. “But, I mean, I’m crying every two seconds. I’m not eating and sleeping. I’m at a point where I can no longer take care of my family’s daily life here, and so I need to take some steps back and then fight from a safe distance.” She’d like to think that she can postpone the move long enough to let her kids finish out the year at school, but she’s not sure. A few days back, her daughter had come to her wondering, “Am I going to die?” K. asked her why she would think such a thing. “Because everybody hates me,” was her daughter’s reply.


Last Thursday, almost a week after the judge blocked Abbott’s directive, S. walked into the family room of his central Texas house to find two CPS agents standing there. They had been let in by an older child, but they were there to investigate reports about his eight-year-old. “I about freaked,” he told me. “I’m like, ‘Whoa, what are you doing in my house?’ ”

As S. learned, someone at his workplace had reported that his child, who was assigned male at birth, had been seen using the women’s bathroom. “They said abuse charges were being alleged against me, gender abuse charges. The person that made the report was saying that because I’m trans, I’m forcing my kids to be trans.”

But actually, S. isn’t trans; he’s Two-Spirit, a gender recognized in Native American cultures and used for people who have both male and female spirits within them (though he tells Rolling Stone that he prefers he/him pronouns). His child is Two-Spirit as well. “So as Natives, we’re abusing our children by our culture?” he asks incredulously. “That’s not right.”

Still, the agents were in his home. He knew it would be best to cooperate. He gave them a “safe folder” he had made in fear of just such a moment — a packet of information about the family, including counselors’ letters affirming the child. He let them inspect his house, look in his fridge, talk to his children. He soon realized that the agents were really just going through the motions. At one point, the woman commented that the fact that they were there at all was “just stupid.” The man told him that he could tell his kids were loved and felt safe and that they would be closing the case.

After the agents left, his family gathered for a dinner of chicken nuggets, broccoli, and mac ‘n’ cheese. He let the kids eat Oreos in bed, a consulation prize for surviving what could have been a traumatic night. The kids seemed fine, but S. wasn’t. “I was so shaky,” he says. “It ain’t over until you get the letter in the mail.” Even when he gets the letter from CPS confirming that his case really is closed, he knows it could always be reopened. “I am grateful for the workers doing the right thing and pushing back, but then again wondering if and when they might come over again,” he tells me. “It’s a witch hunt.”