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Texas Republican proposes ban on gender-affirming care in the state — even for some adults

The ‘Texas Millstone Act,’ which would ban people under the age of 26 from receiving puberty blockers or certain procedures, is the latest bill aimed at limiting health care.

By Will Fritz - March 29, 2023
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Demonstrators gather on the steps to the State Capitol to speak against transgender-related legislation bills on May 20, 2021, in Austin, Texas.
FILE - Demonstrators gather on the steps to the State Capitol to speak against transgender-related legislation bills being considered in the Texas Senate and House, May 20, 2021, in Austin, Texas. A federal ruling on Aug. 16, 2022, that gender dysphoria is covered by the Americans with Disabilities Act, could help block conservative political efforts to restrict access to gender-affirming care, advocates and experts say. (AP Photo/Eric Gay, File)

A bill introduced in the Texas Legislature earlier this month would ban gender-affirming care for anyone through the age of 25.

H.B. 4754 was introduced by Republican Texas state Rep. Tony Tinderholt on March 10 and referred to the state House Committee on Public Health on March 22. The bill, dubbed the “Texas Millstone Act” by Tinderholt, would prohibit the provision of gender-transition procedures or treatment “to an individual younger than 26 years of age,” as well as referrals for such treatment.

“Gender transition procedure or treatment” is defined broadly: H.B. 4754 includes not only hormone treatment and surgeries in the definition, but also puberty-blocking drugs.

The bill makes it a felony for a physician or health care professional to provide gender-affirming care to anyone under the age limit, and lists a statute of limitations of 40 years. It also allows health care practitioners who provide gender-affirming care to be sued either by the parents or guardians of a minor who receives such care or by an adult who does.

The Texas Millstone Act appears to be named after a bill proposed in the Oklahoma Senate in January that also would have banned gender-affirming care for anyone under age 26. S.B. 129 was called the Millstone Act, and, according to a press release by state Sen. David Bullard, the Republican who introduced it, it was explicitly named to refer to the biblical verse at Matthew 18:6, which in the version shared by Bullard reads, “But whoever causes one of these little ones who believe in Me to sin, it is better for him that a heavy millstone be hung around his neck, and that he be drowned in the depths of the sea.”

The bills are similar, and Tinderholt echoed Bullard’s reasons for introducing the bill in Oklahoma.

“When I took office, I never could have guessed that Texas’ youth would need protection from legal, sexual mutilation. Yet here we are,” Tinderholt said, according to a story from March 20 on conservative news site Texas Scorecard.

Bullard said in a press release published Jan. 10 on the Oklahoma Senate website, “Four short years ago when I received the honor to serve in the Oklahoma State Senate, I could not have imagined that it would be necessary to file a bill to protect children in our state from being legally sexually mutilated, yet we find ourselves in that very situation.”

S.B. 129 has been amended so that it would only ban the use of public funds or publicly owned health care facilities for gender-affirming care.

The Texas bill is only one of the most recent bills targeting gender-affirming care in the state.

S.B. 1029, introduced in February by Republican state Sen. Bob Hall, would ban public funding for gender-affirming care, prevent insurers from covering such care, and introduce other restrictions that critics have said would make it nearly impossible for transgender Texans of all ages to receive any gender-affirming treatment.

“If this bill passes, insurers will no longer cover gender-affirming care, malpractice insurers will not provide malpractice insurance to providers, and physicians will not assume a personal financial lifetime liability for providing gender affirming care, affecting nearly 100,000 trans people in the state,” Christopher Hamilton, CEO of the LGBTQ+ health care nonprofit Texas Health Action, told CBS News in February after S.B. 1029 was introduced.

S.B. 14, meanwhile, would call for potentially revoking the licenses of doctors who provide puberty blockers and other gender-affirming treatments to those under 18.

Bills in several other states take aim at such care as well, even for adults.

bill under consideration in South Carolina would prohibit gender-affirming care for anyone under age 21. A bill being considered in Kansas would do the same; a similar bill in Mississippi ultimately died in committee.

Tinderholt’s office did not immediately respond to a request for comment from the American Independent Foundation.

Published with permission of The American Independent Foundation.


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