Democrat U.S. Senate candidate James Talarico now says he does not support gender mutilation surgery for minors—but when Texas lawmakers voted to prohibit the procedures, Talarico voted no.
The 2023 vote is receiving renewed scrutiny as the Trump administration moves to cut off Medicaid funding for sex-rejecting procedures on children and conservative groups make Talarico’s record on the issue a focus of the U.S. Senate race.
Talarico voted against Senate Bill 14, legislation prohibiting physicians from performing gender-mutilation surgeries on minors as well as prescribing sterilizing puberty blockers and cross-sex hormones for the purpose of changing a child’s biological sex.
The measure was ultimately approved by the Legislature and signed into law by Gov. Greg Abbott.
Now, the issue is emerging as a major fault line in the Texas Senate race.
A new ad, produced by American Principles Project PAC, is an AI-generated remake of Lyndon B. Johnson’s famous 1964 “Daisy” advertisement and is part of a $10 million campaign targeting Talarico.
The original “Daisy” ad, aired during Johnson’s presidential campaign against Republican Barry Goldwater, depicted a young girl counting the petals of a flower before transitioning into a nuclear countdown and explosion.
In the new version targeting Talarico, the girl is instead depicted preparing to undergo a gender-mutilation procedure, with Talarico portrayed as the doctor.
Talarico’s campaign has responded by saying he does not support gender reassignment surgery for minors.
That position, however, comes only three years after his vote against the Texas legislation that prohibited those surgeries on children.
Meanwhile, the policy debate over taxpayer funding of sex-rejecting procedures has returned to the national stage.
This week, the Centers for Medicare & Medicaid Services announced that Medicaid and the Children’s Health Insurance Program will no longer fund gender-transition hormones or surgeries for minors.
CMS Administrator Mehmet Oz said the move is consistent with the Trump administration’s commitment to protecting children from what he described as “experimental and life-altering sex-rejecting procedures” carrying serious long-term health risks without sufficiently reliable evidence of clinical benefit.
Talarico’s legislative record also includes another vote involving insurance coverage for gender-mutilation procedures and the consequences of those treatments.
In 2025, Talarico voted against Senate Bill 1257, which requires health plans that cover gender-mutilation procedures to also cover adverse effects and follow-up care.
That includes short- and long-term side effects, health monitoring, and treatment necessary to “manage, reverse, reconstruct from, or recover from” a gender-mutilation procedure.
Talarico’s vote against the legislation is receiving new relevance following his Republican opponent Attorney General Ken Paxton’s landmark settlement with Texas Children’s Hospital over allegations involving gender-transition treatments and Medicaid.
The case originated from allegations that Texas Children’s knowingly submitted false claims to Medicaid by prescribing puberty blockers, cross-sex hormones, and other gender-transition treatments to minors despite Texas Medicaid policies excluding the procedures from coverage.
Under the settlement, Texas Children’s will pay $10 million, with more than $8.5 million going to the state of Texas.
The hospital is also required to establish the nation’s first free, full-service detransition clinic.
Additionally, Texas Children’s must permanently terminate the privileges of several physicians and amend its bylaws to provide for the loss of clinical privileges for staff who perform gender-mutilation procedures.
“This historic settlement is a resounding defeat for the radical gender ideology that has preyed on Texas children under the guise of ‘care,’” said Paxton.
The settlement provides a new backdrop for Talarico’s 2025 vote against requiring health plans that cover gender-transition procedures to also cover the consequences of those procedures and care for individuals seeking to reverse them.
Paxton’s campaign has contrasted the two candidates’ records on the issue.
“James Talarico has refused to take responsibility for his record. He supported and voted for the mutilation of children, then voted against requiring insurance companies to cover procedures that reverse the damage done by rogue doctors,” Paxton campaign Spokeswoman Madison Cercy told Texas Scorecard.
“Meanwhile, Attorney General Ken Paxton has delivered historic protections, including a groundbreaking settlement that creates the first-ever detransition clinic in America and holds the radical transgender movement accountable for their actions against children.”
Texas Scorecard asked Talarico’s campaign how he reconciles his current position that he does not support gender reassignment surgery for minors with his vote against Senate Bill 14 in 2023.
The campaign was also asked why Talarico voted against SB 1257, whether he still stands by that vote, and whether he believes insurers that cover gender-transition procedures should be required to cover adverse effects and detransition care.
No response was received before publication.
