Citing a “troubling surge” of gender-related psychological issues and unnecessary interventions among minors, Texas and 14 other states are lending “hearty” support to an Alabama law that prohibits the use of puberty blockers, cross-sex hormones, and surgery to medically “transition” children and adolescents.

Texas Attorney General Paxton announced Friday his office has joined an amicus brief backing Alabama’s appeal of a lower court ruling that blocked the state from enforcing its Vulnerable Child Compassion and Protection Act.

The Alabama law was set to take effect in May but was challenged by multiple plaintiffs, including minors who identify as transgender and their parents, an openly gay pastor, and the U.S. government.

Two other lawsuits were filed against the VCCPA by what Alabama Attorney General Steve Marshall called “a fleet of activist groups that collectively control billions of dollars,” including the ACLU, Southern Poverty Law Center, Lambda Legal, GLAAD, Transgender Law Center, and other leftist organizations, but those suits were dropped.

At issue in the appeal is whether Alabama “may act to protect its young people and regulate the medical profession by prohibiting life-altering gender-transition procedures, for which there is medical and scientific uncertainty.”

According to the amicus brief, filed in the U.S. Court of Appeals for the 11th Circuit:

The Amici States, like Alabama, are concerned by the surge of gender-related psychological issues among adolescents (especially girls) and the rush by practitioners to supply vulnerable young people with life-altering drugs and procedures.


Indeed, at many facilities, hormones are provided on demand to children who say they are transgender, without any psychological assessment. Alabama’s legislation is a commonsense response to this troubling surge in unnecessary intervention.

The brief details “a raging controversy in the international medical community concerning the safety and effectiveness of using pharmaceuticals and surgeries to address gender-related psychological issues in still-maturing adolescents,” adding that “even clinicians at the center of efforts to provide pharmaceuticals and surgeries for gender-related psychiatric issues have begun sounding the alarm.”

Multiple medical professionals are cited who are “deeply concerned” about fast-tracking kids into medical treatment and the “abject failure” to evaluate their mental health or prepare them for making such a life-changing decision.

Also noted are doctors’ concerns about the “rising numbers of detransitioners” who regret receiving pharmaceutical and surgical treatments as adolescents, and who later discovered their dysphoria was caused by underlying trauma, abuse, or a mental-health condition for which they did not receive adequate psychiatric treatment.

“Medicalizing adolescents’ gender-related psychological issues invests these young people in a treatment pathway that leads to more consequential interventions over time,” the brief adds.

Another doctor suggests social contagion is contributing to the surge.

“In my over 40 years as a psychologist, I’ve seen psychotherapeutic phenomena come and go,” Dr. Erica Anderson, who identifies as trans and counsels “gender creative” kids, is quoted in the brief. “Eating disorders, multiple personality disorders and repressed memory syndrome have in retrospect spread through subgroups of adolescents and the professionals who have treated them.”

This spread is like wildfire through vulnerable underbrush, clearly borne in an environment of contagion. Why is this phenomenon distinctly different than previous ones?

The brief also cites several systematic reviews of medical evidence that show the safety and effectiveness claims made by the plaintiffs are unsupported by the scientific literature.

Because the use of pharmaceuticals and surgeries to address adolescents’ gender-related psychological issues is not evidence-based, practitioners lack a proper basis for believing that they will provide these young people more benefit than harm. And that is precisely where the State of Alabama’s important—even compelling—interests in protecting children and regulating the practice of medicine becomes all-important.

Professional groups like the American Medical Association are skewered in the brief for supporting plaintiffs’ claims that life-altering “gender transition-related care” is appropriate for kids based on their self-identification as “transgender,” when the groups have argued in the past that minors are not capable of making the same mature judgments as adults.

The brief attributes this inconsistency to the groups’ political and financial interests.

The plaintiffs argue the benefits of subjecting kids to transitioning treatments outweigh the risks. They also say such treatments reduce suicides in dysphoric minors—a claim refuted in the brief.

The brief concludes that when “there is medical and scientific uncertainty,” courts have given states—not medical practitioners or professional and advocacy organizations—“wide discretion” to regulate the practice of medicine.

Texas Republicans want their lawmakers to pass a similar ban.

The Texas GOP made the issue a priority in 2021, but the Republican-controlled Legislature failed to pass any bills protecting kids.

Banning gender modification of children is now on the GOP’s list of legislative priorities for 2023:

Texas must ban chemical castration, puberty blockers, cross-sex hormones, genital mutilation, bodily alteration surgery, psychological/social transitioning, and any other methods applied to or performed on children.

Paxton concluded in a February opinion that the kinds of procedures Alabama’s law seeks to prohibit can constitute “abuse” under the Texas Family Code.

The full amicus brief can be read here.

Erin Anderson

Erin Anderson is a Senior Journalist for Texas Scorecard, reporting on state and local issues, events, and government actions that impact people in communities throughout Texas and the DFW Metroplex. A native Texan, Erin grew up in the Houston area and now lives in Collin County.