Attorney General Ken Paxton has issued a formal legal opinion concluding that mental health professionals licensed by the Texas Behavioral Health Executive Council qualify as “health care providers” under state law.
The interpretation means they may face consequences if they help facilitate sex-rejecting procedures for minors.
The opinion interprets Senate Bill 14, the 2023 law banning certain sex-rejecting treatments for children, and clarifies that its restrictions extend beyond doctors and surgeons. According to the opinion, the statute’s definition of “health care provider” encompasses licensed professionals who provide mental or behavioral health services.
Under that interpretation, providers who help “facilitate” prohibited treatments may be barred from receiving public funds and could risk losing their licenses, even if they do not directly perform them.
“Any radical facilitating the ‘transitioning’ of our kids is committing child abuse,” Paxton said. “The law is clear that these radical procedures are illegal and in no world should Texans’ tax dollars be used to permanently harm children.”
“This opinion should send a clear warning there will be consequences for any medical professional, whether a doctor or a therapist, who is illegally ‘transitioning’ Texas kids,” he added.
Supporters of the move say the opinion shuts down what they describe as an enforcement gray area.
Vanessa Sivadge, founder of Protecting Texas Children, said she “strongly applaud[s] Attorney General Paxton’s Opinion affirming that mental health professionals are health care providers under Texas law and are therefore accountable under Senate Bill 14.”
“As a nurse and gender medicine whistleblower, this opinion closes dangerous loopholes and reinforces critical safeguards to protect children from psychological and social transition practices that can set them on a path toward irreversible medical interventions,” she said.
Sivadge added that “at a time when approximately 68% of mental health professionals identify as liberal or very liberal, compared to only about 6% as conservative … it is especially important to ensure that ideology does not override evidence, parental rights, or child welfare,” calling the opinion “clear and decisive guidance” that prioritizes “the well-being of vulnerable minors.”
While attorney general opinions do not create new law, they guide state agencies and licensing boards in enforcement decisions.
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