AUSTIN, Texas (AP) — Republican Texas Gov. Greg Abbott has ordered the state’s child welfare agency to investigate reports of gender-confirming care for kids as abuse, a directive that opponents say is a first by any governor over GOP efforts to restrict transgender rights.
Abbott’s move is drawing reactions from across the nation, including sharp criticism from advocacy groups.
The immediate impact of the order, which Abbott issued Tuesday, was unclear, and a spokesman for the Texas Department of Family and Protective Services said there were no open cases based on the governor’s directive.
Meanwhile, the Alabama Senate on Wednesday approved legislation that would prohibit transgender minors from being given puberty-blockers, hormones or surgeries to affirm their gender identity — treatments that the legislative sponsor equated to child abuse.
Senators voted 24-6 for the legislation that now moves to the Alabama House of Representatives. The bill would make it a felony, punishable by up to 10 years in prison, for a doctor to prescribe puberty-blockers or hormones or perform surgery to aid in the gender transition of people 18 years old or younger.
Opponents said lawmakers were inserting themselves into decisions that belong with families and their doctors.
“That family has the right to be able to make that decision on behalf of their child, not the state of Alabama, not the Legislature,” Sen. Bobby Singleton said.

Jake Crandall/The Montgomery Advertiser via AP
Protesters in support of transgender rights rally outside the Alabama State House in Montgomery, Ala., on March 30, 2021.
The Texas governor’s letter to state agencies came after Republican Attorney General Ken Paxton this week released a non-binding legal opinion that labeled certain gender-confirming treatments as “child abuse.” That goes against the nation’s largest medical groups, including the American Medical Association, which have opposed Republican-backed restrictions filed in statehouses nationwide.
Both Abbott and Paxton are up for reelection this year, and their actions came a week before they are on the ballot for Republican voters in Texas’s first-in-the-nation primary of 2022.
The uncertainty over the impact is largely due to the fact that attorney general opinions do not carry the weight of law. In Houston, the county office that represents the state in civil child abuse cases said it would not take any actions based on the letter, and Texas’ largest child welfare advocacy group said it was unclear what judges and prosecutors would do with the opinion.
“What is clear is that politicians should not be tearing apart loving families — and sending their kids into the foster care system — when parents provide recommended medical care that they believe is in the best interest of their child,” said Kate Murphy, the senior policy associate for child protection at Texans Care for Children.
The opinion by Paxton is directed at treatments that include puberty blockers and hormone therapy. It comes months after Texas Republican legislators— who filed more anti-LGBTQ proposals last year than in any other statehouse — proposed laws banning such treatments but failed to pass them.

AP Photo/Eric Gay
Texas Gov. Greg Abbott
Arkansas became the first state to pass a law prohibiting gender confirming treatments for minors, and Tennessee approved a similar measure.
Numerous states also have enacted laws banning transgender students from competing in scholastic sports on the basis of their gender identity.
Cathryn Oakley, state legislative director and senior counsel for the Human Rights Campaign, said no other governor has taken the same action as Abbott. She called it a “lawless interpretation” and expressed worry for parents.
“The terror that is being struck into their hearts is very real,” Oakley said. “I’m also thinking about the kids who are relying on that care and how frightened the are.”
The Alabama House Judiciary Committee on Wednesday heard sometimes emotional testimony during a public hearing on a companion bill to the one that cleared the Senate. The committee could vote next week.
Dr. Nola Ernest, a pediatrician and vice president of the Alabama Chapter of the American Academy of Pediatrics, told the committee that the legislation “overrides science.”
“The use of medications to treat gender dysphoria, under a team of medical experts, is evidence-based standard of care and often life-saving,” Ernest said.
Jeff White, the parent of a transgender daughter, urged lawmakers to, “vote no on this extremist bill before it kills someone.”
“This bill is not about compassion or protection. It is a violation and subjugation of who my daughter is,” White said.
White said his daughter is “one of the kindest and most creative people I am privileged to know” and that the gender-affirming treatment she receives allows her to focus on having a normal childhood.
Sydney Wright, who described herself as a former transgender man, said she still struggles with difficult side effects from taking testosterone as a teen after being diagnosed with gender dysphoria.
She urged lawmakers to approve the bill. Wright said, “nobody recommended that you have time to think or time to grow out of it.”
“I’m not putting the blame on medical professionals. These are choices I made in my teenage years, but I wish someone could have stopped me,” Wright, 22, said.
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How to get people’s pronouns right and what to do if you slip up
Phil Velasquez/Chicago Tribune
In 1924 the Society for Human Rights was founded by Henry Gerber in Chicago. It was the first documented gay rights organization in the United States, and meetings were held in his home.
The Henry Gerber House, pictured, is now a National Historic Landmark.
Phil Velasquez/Chicago Tribune
In 1924 the Society for Human Rights was founded by Henry Gerber in Chicago. It was the first documented gay rights organization in the United States, and meetings were held in his home.
The Henry Gerber House, pictured, is now a National Historic Landmark.
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How to get people’s pronouns right and what to do if you slip up
Maurice Seymour/Wikimedia Common
Christine Jorgensen, a former U.S. Army private, made headlines in the 1950s after having sex reassignment surgery and talking widely about her experience, one of the first people in the U.S. to do so. Her gender conversion began with hormone injections in 1950, when she was 24, and was completed in 1952 with surgery at the Danish State Hospital in Copenhagen.
Maurice Seymour/Wikimedia Common
Christine Jorgensen, a former U.S. Army private, made headlines in the 1950s after having sex reassignment surgery and talking widely about her experience, one of the first people in the U.S. to do so. Her gender conversion began with hormone injections in 1950, when she was 24, and was completed in 1952 with surgery at the Danish State Hospital in Copenhagen.
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How to get people’s pronouns right and what to do if you slip up
Kay Tobin Lahusen via Philadelphia Inquirer
Barbara Gittings, pictured at a rally, was a prominent gay and lesbian rights activist who, a decade before the Stonewall rebellion of 1969, was battling for the rights of homosexuals.
In the late 1950s she founded the New York chapter of the Daughters of Bilitis, the first national organization for lesbians, The New York Times reported.
In the early 1970s she helped lobby the American Psychiatric Association to change its stance on homosexuality; in 1973 the association rescinded its definition of homosexuality as a mental disorder.
Kay Tobin Lahusen via Philadelphia Inquirer
Barbara Gittings, pictured at a rally, was a prominent gay and lesbian rights activist who, a decade before the Stonewall rebellion of 1969, was battling for the rights of homosexuals.
In the late 1950s she founded the New York chapter of the Daughters of Bilitis, the first national organization for lesbians, The New York Times reported.
In the early 1970s she helped lobby the American Psychiatric Association to change its stance on homosexuality; in 1973 the association rescinded its definition of homosexuality as a mental disorder.
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How to get people’s pronouns right and what to do if you slip up
Andrew Dolkart, courtesy of the National Park Service
Early on June 28, 1969, New York police raided the Stonewall Inn, a gay club in Greenwich Village. The raid set off a riot among bar patrons and neighborhood residents as police roughed up customers, leading to six days of protests and clashes with police.
The Stonewall riots were a defining moment for the nascent gay rights movement and the reason behind June being chosen as Pride Month.
Andrew Dolkart, courtesy of the National Park Service
Early on June 28, 1969, New York police raided the Stonewall Inn, a gay club in Greenwich Village. The raid set off a riot among bar patrons and neighborhood residents as police roughed up customers, leading to six days of protests and clashes with police.
The Stonewall riots were a defining moment for the nascent gay rights movement and the reason behind June being chosen as Pride Month.
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How to get people’s pronouns right and what to do if you slip up
Darin Oswald/Idaho Statesman
The idea for PFLAG, which originally stood for Parents and Friends of Lesbians and Gays, began in 1972 when Jeanne Manford marched with her son, Morty, in New York's Christopher Street Liberation Day parade, the precursor to today's pride parades. In March 1973 the first meeting of what would become PFLAG was held.
The group went national as Parents, Families and Friends of Lesbians and Gays in 1982. Since 2014, PFLAG is no longer considered an acronym but rather the entire name of the organization.
Darin Oswald/Idaho Statesman
The idea for PFLAG, which originally stood for Parents and Friends of Lesbians and Gays, began in 1972 when Jeanne Manford marched with her son, Morty, in New York's Christopher Street Liberation Day parade, the precursor to today's pride parades. In March 1973 the first meeting of what would become PFLAG was held.
The group went national as Parents, Families and Friends of Lesbians and Gays in 1982. Since 2014, PFLAG is no longer considered an acronym but rather the entire name of the organization.
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How to get people’s pronouns right and what to do if you slip up
Genaro Molina/Los Angeles Times
The first pride parade was held in New York on June 28, 1970, one year after the Stonewall raid on Christopher Street. A few thousand people took to the streets in New York, and gay activist groups on the West Coast held a march in Los Angeles and a march and gay-in in San Francisco. In Chicago people marched the day before New York and marked the Stonewall anniversary with a week of events.
Today, millions around the world march and rally for LGBTQ pride around the world, including in West Hollywood, pictured, which has one of the biggest and best-known pride events in the country.
Genaro Molina/Los Angeles Times
The first pride parade was held in New York on June 28, 1970, one year after the Stonewall raid on Christopher Street. A few thousand people took to the streets in New York, and gay activist groups on the West Coast held a march in Los Angeles and a march and gay-in in San Francisco. In Chicago people marched the day before New York and marked the Stonewall anniversary with a week of events.
Today, millions around the world march and rally for LGBTQ pride around the world, including in West Hollywood, pictured, which has one of the biggest and best-known pride events in the country.
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How to get people’s pronouns right and what to do if you slip up
Justin Sullivan/Getty Images/TNS
Gays and lesbians also made strides in the 1970s by running for office. Kathy Kozachenko became the first openly LGBT American elected to public office when she won a seat on the Ann Arbor, Mich., City Council in 1974. Elaine Noble was the first openly gay candidate elected to a state office when she was elected to the Massachusetts legislature, also in 1974.
And Harvey Milk won a seat on the San Francisco Board of Supervisors in 1977. Milk was loud and unapologetic about his sexuality, earning widespread attention. His remarkable career was cut short when he was gunned down about a year after taking office.
Justin Sullivan/Getty Images/TNS
Gays and lesbians also made strides in the 1970s by running for office. Kathy Kozachenko became the first openly LGBT American elected to public office when she won a seat on the Ann Arbor, Mich., City Council in 1974. Elaine Noble was the first openly gay candidate elected to a state office when she was elected to the Massachusetts legislature, also in 1974.
And Harvey Milk won a seat on the San Francisco Board of Supervisors in 1977. Milk was loud and unapologetic about his sexuality, earning widespread attention. His remarkable career was cut short when he was gunned down about a year after taking office.
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How to get people’s pronouns right and what to do if you slip up
Jebb Harris/Orange County Register
Billy Crystal, pictured in 1998, played one of the first openly gay characters in a recurring role on a prime-time television show on "Soap," which ran from 1977 to 1981.
Jebb Harris/Orange County Register
Billy Crystal, pictured in 1998, played one of the first openly gay characters in a recurring role on a prime-time television show on "Soap," which ran from 1977 to 1981.
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How to get people’s pronouns right and what to do if you slip up
Stephen Dunn/Hartford Courant
Writer and AIDS activist Larry Kramer's work with ACT UP and the Gay Men’s Health Crisis brought attention to the AIDS crisis at a time when many people preferred ignorance. He loudly demanded attention for the disease that was felling thousands of gay men, and his writing, including the play "The Normal Heart," captured the ordinary lives caught up in the ordeal of AIDS.
Stephen Dunn/Hartford Courant
Writer and AIDS activist Larry Kramer's work with ACT UP and the Gay Men’s Health Crisis brought attention to the AIDS crisis at a time when many people preferred ignorance. He loudly demanded attention for the disease that was felling thousands of gay men, and his writing, including the play "The Normal Heart," captured the ordinary lives caught up in the ordeal of AIDS.
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How to get people’s pronouns right and what to do if you slip up
Arnie Sachs/CNP/Zuma Press
The Democratic Party added “sexual orientation” to its platform’s anti-discrimination protections at the 1980 convention in New York. It was the first American political party to officially incorporate such a plank. Jimmy Carter and his running mate, Walter Mondale, along with their wives, are pictured at the convention.
Arnie Sachs/CNP/Zuma Press
The Democratic Party added “sexual orientation” to its platform’s anti-discrimination protections at the 1980 convention in New York. It was the first American political party to officially incorporate such a plank. Jimmy Carter and his running mate, Walter Mondale, along with their wives, are pictured at the convention.
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How to get people’s pronouns right and what to do if you slip up
Richard Messina/Hartford Courant
In 2004 Massachusetts became the first state to make it legal for same-sex couples to wed. It followed a controversial decision from the Massachusetts Supreme Judicial Court.
Nooni and Alicia Hammarlund, pictured, were among the couples securing a license on May 17, 2004, the first day for legal marriages.
Richard Messina/Hartford Courant
In 2004 Massachusetts became the first state to make it legal for same-sex couples to wed. It followed a controversial decision from the Massachusetts Supreme Judicial Court.
Nooni and Alicia Hammarlund, pictured, were among the couples securing a license on May 17, 2004, the first day for legal marriages.
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How to get people’s pronouns right and what to do if you slip up
Kent Nishimura/Los Angeles Times
On June 26, 2015, the U.S. Supreme Court ruled by a 5-to-4 vote that the Constitution guarantees a person's right to same-sex marriage.
“No longer may this liberty be denied,” Justice Anthony M. Kennedy wrote for the majority in the historic decision.
Kent Nishimura/Los Angeles Times
On June 26, 2015, the U.S. Supreme Court ruled by a 5-to-4 vote that the Constitution guarantees a person's right to same-sex marriage.
“No longer may this liberty be denied,” Justice Anthony M. Kennedy wrote for the majority in the historic decision.