Texas’ Anti-Trans Attorney General Declares Psychologists Must Impose Conversion Therapy on Trans Kids

In a new opinion released Friday, Texas AG Ken Paxton has effectively prohibited therapists from treating trans kids—unless they try to convert them.

Texas AG Ken Paxton has decided supporting trans kids is “child abuse” | Image: Wikimedia Commons

On Friday, Texas Attorney General Ken Paxton released an opinion announcing that under Texas’ gender-affirming care ban for minors, therapists will no longer be allowed to treat trans kids. The opinion, created in response to an inquiry by the Texas Behavioral Health Executive Council—which issues therapy licenses in the state—asserts that any “health care professional” who “facilitates [gender-affirming care]” or fails “to stop a doctor or another parent from conducting these treatments” is engaging in child abuse.

And, according to Paxton, the term “health care professional” includes psychologists. As such, he specifically makes clear that under the provisions of Texas Senate Bill 14 (2023), they too can be held criminally liable for affirming a trans kid’s identity or not reporting someone who is willing to. Moreover, he claims that this interpretation is necessary because “the multidisciplinary path to medically transitioning children often starts with mental ‘health care.’”

Paxton asserts that any who treat trans kids are subject to criminal penalties.

However, he goes even further. In the opinion, Paxton states that therapists have a responsibility to “assist with ‘stabilizing,’ ‘alleviating,’ or ‘overcoming’ a child’s [gender dysphoria],” but in the same breath, he disavows the medical consensus on gender-affirming care. Thus, he leaves them only one option: conversion therapy.

Simply put, psychologists that continue to help trans minors will be forced to adhere to Paxton’s belief that gender dysphoria can be ‘overcome.’ Even if they want to, they can no longer affirm a trans kid’s identity, offer alternatives in another state, or encourage parents to accept their kids for who they are. Under Paxton’s opinion, doing anything other than push a child to accept being their assigned sex at birth will result in providers losing their license and/or being imprisoned. This is conversion therapy, which is recognized by the United Nations as being tantamount to torture.

Furthermore, as previously established, psychologists must also report parents and doctors who are supportive of their kids for child abuse—potentially robbing trans kids of crucial support networks. In doing so, Paxton is essentially creating a vigilante system with the aim of snuffing out any semblance of support for trans kids.

Because Paxton has complete enforcement power over the law, this interpretation of it effectively binds providers unless found illegal by a court. Until then, therapists can only opt out of this by refusing to treat trans kids altogether, something that will have devastating consequences on a population already suffering under a harmful gender-affirming care ban.

Paxton emphasized ‘medical responsibility’ in Friday’s opinion.

This isn’t the first time that Paxton has targeted trans people in his state, either. In 2022, he began investigating parents who were supporting their trans kids for “child abuse,” a move that was eventually blocked in court. Around the same time, Paxton requested a list of trans people who had changed their IDs from the Texas Department of Public Safety, but this task was found impossible by the agency.

Then, at his behest, both the DPS and Department of Health and Human Services suddenly announced they were banning gender marker amendments in mid-2024, with the DPS additionally making a list of those that have asked about changing their marker. The following March, Paxton released a formal opinion declaring any and all gender marker changes to be invalid.

That said, this is by far his most sweeping attack yet. Even before Paxton’s opinion, because of the law’s vagueness, therapists in Texas have long been afraid to treat trans kids. I myself experienced this shortly after SB 14’s passage, with multiple therapists citing the law as the reason why they were unable to treat me at a time when I desperately needed help.

But now, those that were willing to take the risk are being frozen out. Even worse, Paxton is emboldening conversion therapists to take their place, forcing trans kids to either seek help from those that actively look to harm them or suffer alone.

Already, Texas bans doctors from providing evidence-based gender-affirming care to trans minors and bans schools from supporting trans kids in any way. These two alone have had a tremendous impact on trans kids’ mental health, and those consequences are something that therapy has worked to mitigate.

Except today, the state has now banned struggling trans kids from seeking help—unless it’s the help Republicans want them to seek. It’s hard to overstate just how much suffering this will cause. For the sake of Texas’ trans kids, courts must not allow Paxton to enforce his opinion. Their lives quite literally depend on it.