AUSTIN -- After more than five hours of debate, much of it with a heavy police presence and full gallery looking on, the Texas House on Friday evening approved a bill that would ban gender affirming medical treatments for minors and urge doctors to wean current patients off this care.
The legislation -- which contradicts the recommendations of major U.S. medical organizations -- is now just a few steps from becoming law.
A cheer went up from supporters upon passage of the bill, the chamber's last official task before lawmakers go home for Mother's Day weekend.
Bill sponsor Tom Oliverson, an anesthesiologist, described parents as "manipulated" into affirming their transgender children and questioned the efficacy of peer-reviewed studies as lacking in rigor. Mental health care should be the only treatment allowed for Texas youth experiencing gender dysphoria, he said.
"We don't treat mental health disorders with surgery. We treat mental health disorders with mental health care," said Oliverson, R-Cypress.
The bill still needs the approval of the House one more time, more or less a fait accompli now that it has passed once.
The Senate, where Republicans also enjoy a majority, must sign off on the House's changes before it heads to the governor's desk. Gov. Greg Abbott, a Republican, has not publicly commented on the legislation. Last year he directed child protective services to investigate parents of transgender children for abuse, a policy on hold while it's litigated.
The passage represented a promise kept for some conservatives in the Legislature, who ran on the ban or promised not to go home this session until it became law. Transgender rights activists made killing the bill one of their top goals.
Ricardo Martinez, head of the LGBTQ rights group Equality Texas, struck a defiant tone after the vote was taken.
"This is part of a nefarious plan to eliminate us from public life. But it won't work. We will not stop fighting for our rights. Not now, not ever," he said in a statement.
The legislation would require the state to revoke the medical licenses of doctors who provide treatments like puberty blockers, hormone therapy or surgery to minors in order "to transition a child's biological sex." It would also ban taxpayer money from going to individuals and entities, including public colleges and universities, that provide such care to minors.
Existing patients could continue along their treatment path, without switching medications or beginning a new course of care, if they attended 12 or more sessions with a mental health counselor or psychotherapist in the six months prior to bill's effective date of June 1. But doctors would be required to "wean" them off this care in a "safe and medically appropriate" manner.
Nontransgender minors experiencing issues like precocious puberty are not barred from receiving this care. Surgeries on intersex youth would also not be restricted.
Democrats in the House successfully delayed debate on the controversial bill twice this month, sending it back to committee through procedural tactics that revealed flaws in its drafting.
After failing to do so for a third time on Friday, they spent their time laying the groundwork to challenge the bill in court if it becomes law. Democrats raised concerns that the measure violates the U.S. Constitution's equal protection clause by banning treatments only for transgender youth.
"This bill is totally unconstitutional and violates the rights of a targeted group of people from accessing healthcare. Today we set the record of how this bill adversely affects a certain segment of families," said Rep. Julie Johnson, D-Farmers Branch.
According to the pro-LGBTQ rights website Movement Equality Map, 17 other states have passed similar bans. Laws in at least two states are on hold as they're litigated.
Democrats also tried and failed to amend the bill 19 times.
They unsuccessfully attempted to change the age restrictions in the bill or outlaw only surgeries. They asked to track suicide rates in transgender youth. In one of their most sweeping amendments, they proposed creating a commission that could approve treatments if recommended by four doctors. It also failed.
The only change approved was one Oliverson proposed to sever any portion of the measure if it is held "invalid."
There are an estimated 29,800 transgender Texans between the ages 13 and 17, according to a recent statistical analysis by the Williams Institute at the University of California at Los Angeles. Only about one-third of Texans know a transgender person, and even fewer among Republicans, according to the Texas Politics Project.
Before debate began, more than 100 LGBTQ rights activists gathered in a somber protest. A half dozen lawmakers, some of them openly queer themselves, read aloud letters from transgender youth and their families.
The bill is one of several pieces of legislation that target LGBTQ, and specifically, transgender rights. In addition to the care ban, Republicans are advancing bills to restrict transgender athletes, regulate the discussion of LGBTQ issues in schools and one initially pitched as a way to ban minors from attending drag shows.
A recent surgery of Texas transgender youth completed by the LGBTQ group the Trevor Project found 62% of those polled said recent politics negatively impacted their wellbeing.
The American Medical Association, American Psychological Association and other national physicians' groups all support age-appropriate and individualized medical treatments for minors experiencing gender dysphoria, including puberty blockers and hormone therapy.
Oliverson said suicidal ideation has been incorrectly linked to lack of care and rejected the support of national physicians groups, saying they were not necessarily representative of the entire medical field and shied away from taking a hard look at these treatments.
"I am not interested in what they have to say," Oliverson said of the American Academy of Pediatrics. "They have more or less discredited themselves by being unwilling to actually engage in rigorous scientific debate."
He also brought up European countries that once embraced gender affirming care that have now stepped away or are taking another look at those practices, and likened gender dysphoria to anorexia.
Despite the divisive nature of the bill, debate was largely calm.
After about four hours, Arlington GOP Rep. Tony Tinderholt accused Democrats of wanting to physically hurt children by providing them gender affirming treatment.
"It's despicable," Tinderholt said. "It's child abuse."
There were scattered cheers and clapping from supporters. They were warned not to speak out.
The gallery had emptied out significantly as debate stretched into hour four. Unlike in previous weeks, when LGBTQ rights activists disrupted proceedings with pro-transgender chants, there were no protests from the public. Around four dozen state police officers manned the area around the gallery on Friday.
Just before the vote was taken, Thierry gave a tearful speech in which she said years of research, discussion with advocates and soul-searching led her to support the legislation.
"I know what it's like to feel unseen, unheard and devalued," Thierry said. "I believe this debate was never about embracing transgender children. For me this discussion is about how best to protect and care for these children."
After the bill passed, LGBTQ activists marched to a nearby park to find solace in each other.
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