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These parents didn't embrace gender-affirming care. Texas investigated them

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Morgan had always been exceedingly bright, curious and outgoing. She was an extraordinarily hard worker and excelled at art. But in third grade, when her period arrived so early, she became anxious and withdrawn from her schoolmates. She started cutting her forearms. Her parents, who live in Spring, Texas, sent her to a small, private school and to a therapist, and she improved. She made friends. She stopped cutting. She was still navigating ADHD and social anxiety, and they suspected she was on the autism spectrum, but she was stable.

In sixth grade, she got into Discord, Reddit and TikTok. Her mental health seemed to be deteriorating again. Her friends started coming out as pansexual and trans. At age 13, Morgan announced that she, too, had gender dysphoria. She needed a new name and pronouns. Her parents took her to a gender specialist.

"The doctor was agreeing with everything she said and telling her we could give her puberty blockers," said Morgan's mother. "There was never any talk about medical history, mental history, family history."

Wary of their daughter's emotional fragility, and appalled both at the lack of curiosity about anything else that could be at play, and the insistence that the parents affirm with no questions asked, the family never returned. The parents felt she needed real help for the source of her struggles, not a fad cure for depression and anxiety discovered on social media.

Less than a month later, after they'd informed the school and the doctor that they wouldn't be allowing their daughter to socially or medically transition, a social worker from the Department of Family and Protective Services showed up at their door to tell them they were being investigated for abuse and neglect.

Texas policy around trans kids has caused quite a kerfuffle in the past few months, whipping people into a frenzy whatever side of the debate they're on. Attorney General Ken Paxton and Gov. Greg Abbott have declared medical interventions for gender dysphoria to be child abuse and authorized child protection agencies to investigate parents for engaging it, despite the fact that multiple medical organizations endorse puberty blockers, cross-sex hormones and sometimes surgeries like double mastectomies for children under 18. Many families believe what advocacy organizations like the ACLU state: that these interventions are literally "life-saving."

News organizations like The New York Times have reported on families with affirmed trans kids being subject to DFPS investigations, and the terror they feel not just at the prospect of not having access to puberty blockers or hormones, but of being forcibly separated from children during a difficult time. Such actions are truly cruel, and counterproductive to a child's mental health.

But families in multiple states, including Texas, have also been investigated when they refuse to socially or medically transition their children. The heat is turned all the way up on both sides, and families are getting burned. But there's no scientific reason for this madness. Despite what groups like the American Academy of Pediatrics or the Trevor Project — or even Assistant Secretary for Health Rachel Levine — say, there is no solid evidence that these interventions should be categorized as life-saving.

To understand why requires a deeper look at the science. There are indeed studies that show short-term improvement in mental health after kids receive puberty blockers and/or cross-sex hormones. One study, a retroactive survey of adults, asserted that those who got puberty blockers when younger had fewer suicidal thoughts and attempts. But a published critique noted that puberty blockers weren't even available in the U.S. when some respondents said they'd taken them, and some were over 18 (they are generally prescribed under the age of 16), which means respondents didn't understand or answer truthfully.

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There are similar problems with studies about suicidality — flawed and biased survey science that doesn't help us know how best to respond to the 4000 to 5000 percent increase in gender dysphoric youth seen in much of the Western world. The high rate of suicidal ideation or attempts among kids with gender dysphoria is similar to the rates of kids with other mental health conditions, especially autism, and there is overlap between autism and gender dysphoria. We may be looking at the wrong thing, assuming dysphoria is the source of the problem instead of a symptom.

Many parents have heard that they can either have a dead cisgender or a living trans child. But in one long-term prospective study, the suicide rate increased after transition. There is no solid evidence that transition is the panacea so many prominent people and groups in the U.S. are making it out to be.

Multiple evidence reviews in other countries have determined that these studies are deeply problematic and of such low quality and low certainty that they shouldn't be extrapolated from. They exhibit too much bias and flawed methodology to apply to the larger population.

"There are no definite conclusions about the effect and safety of the treatments," reported Sweden's National Board of Health and Welfare, the same week Paxton and Abbott made their declarations. (Sweden, of course, didn't go after parents for partaking of the treatments; rather, they simply shifted policy and recommendations).

Meanwhile, though there are not robust, long-term data to consult, it does appear that this protocol may lead to infertility, and causing infertility in children satisfies the definition of child abuse in Texas. That is, the science on which Paxton based his opinion seems accurate, even if the policy and opinion created from it is wrong.

Should you persecute parents for partaking of these medical interventions? No. They're doing what they think is best. They can't be faulted if they don't have the skills to navigate the science on their own, and instead follow the instructions of many trusted sources.

Should parents be separated from their children if they refuse these interventions? No, because the science doesn't support that they are life-saving or that they're endangering their children for choosing a different therapeutic path.

We should take the focus off the parents and put it on the professional organizations, the practitioners, the government officials, demanding evidence reviews and the best evidence-based care for our kids. And we should stop making unsupported and unscientific claims about gender-affirming care for minors.

Morgan's parents were cleared of all wrongdoing, but the investigation did turn up a lot of information. It was discovered that Morgan had been sexually assaulted by a boy in her school, leaving her with serious PTSD. That's why she was so tight-lipped. The boy was eventually convicted. Morgan will need therapy, time, attention and, most of all, her parents' love and support, to heal. But being investigated and accused causes trauma to a family.

"There was a lot of shock and a lot of concern that our family was about to fall apart on us," Morgan's father said. Morgan still won't talk about gender issues. "When she's ready," her mother said, "we're here for her."

Lisa Selin Davis is author of Tomboy: The Surprising History and Future of Girls Who Dare to Be Different. Her work has appeared in The New York Times, The Washington Post, and The Wall Street Journal. She wrote this for The Dallas Morning News. Morgan's name has been changed.

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