The Texas Supreme Court upheld a statutory ban on gender-affirming care for minors on Friday.
The plaintiffs are parents whose children are taking or intend to take gender-affirming care, licensed Texas physicians, and LGBTQ+ rights advocate groups. The defendants were various Texas officials and governmental bodies. The trial court granted the plaintiffs a temporary injunction against the defendants from enforcing Texas Senate Bill 14 (SB 14) because it was likely to violate the Texas Constitution on the following grounds:
(1) it infringes on the fundamental rights of parents to make decisions concerning the care of their children in violation of Article I, Section 19 (the Due Course of Law Clause); (2) it deprives Texas physicians of a vested property interest in their medical licenses and infringes on the occupational freedoms of Texas healthcare providers in violation of the Due Course of Law Clause; and (3) it discriminates against transgender children and their parents because of sex and transgender status in violation of Article I, Section 3 (the Equal Protection Clause) and Article I, Section 3a (the Equal Rights Amendment).
The Texas Supreme Court found that SB 14 does not infringe on the parental right to make medical care decisions for their children because that right competes with the interest of protecting children from harm. Furthermore, the Texas Legislature has the constitutional authority to regulate medical practice, and parents can choose only among legal medical procedures. The court reasoned that since SB 14 does not violate a constitutionally protected interest, it can be found unconstitutional only if it is not rationally related to a legitimate government interest. The court found that “the Legislature had a rational basis for concluding that the risk of providing these treatments to children solely for the purpose of physically transitioning from their sex at birth was not outweighed by the benefits.”
The court also found that the bill did not infringe on Texas physicians’ alleged vested property interests or occupational freedoms. In assuming the physicians’ medical licenses were property interests, the court found that it is not absolute since the Texas Constitution authorizes the Legislature to regulate medical practices. Having found the bill itself to pass the “rationally related” test, the court looked to whether the “real-world effects” of the bill make it fail the “rationally related” test or too burdensome on physicians. The court did not find either situation to be the case because “[t]he statute does not prevent medical providers from treating children with gender dysphoria with [alternative treatments], nor does it prohibit them from providing those medical procedures to adults.”
The court did not find SB 14 to violate the two “Equal Rights Clauses” because it does not have sex-based preferential treatment and the transgender status is not a constitutionally protected class.
The Supreme Court said last week that it will review the legality of state efforts to ban gender-affirming medical care for minors. At present, half the states in the nation have passed laws barring transgender youth from obtaining gender-affirming care — with state policies diverging on the expansiveness of the definition of such treatments. A handful of states — Alabama, Florida, Idaho, North Dakota, Oklahoma, and South Carolina, according to the advocacy group MAP — make it a felony to provide gender-affirming care to youths.
