Metro Weekly

Biden administration releases trans-supportive guidance to child welfare agencies

HHS warns child welfare agencies against prosecuting parents for allowing trans children to access gender-affirming health care.

biden, trans, guidance
HHS Secretary Xavier Becerra – Photo: U.S. Department of Health and Human Services.

The Biden administration has released transgender-supportive guidance to state child welfare agencies that reaffirms President Biden’s commitment to protecting transgender youth and their families, pushing back against a recent order by Texas Gov. Greg Abbott (R) demanding that parents of transgender youth be investigated for “child abuse” if they affirm their child’s gender identity.

Abbott issued a directive instructing the Texas Department of Family and Protective Services to investigate parents who have allowed their transgender-identifying children to access gender-affirming medical treatments, such as puberty blockers and hormones. Abbott based his order on an opinion by Texas Attorney General Ken Paxton (R), who opined that gender-affirming care renders patients infertile and should be considered “abuse” because it allegedly irreversibly impacts a child’s ability to procreate.

In response, the White House condemned Texas Republicans’ actions, calling them “government overreach at its worst” and charging that such actions are politically-motivated. Echoing remarks he made during his State of the Union address on Tuesday, President Joe Biden reiterated his pledge to support transgender youth and allow them to “reach [their] God-given potential.”

“In the United States of America, we respect the rights and dignity of all families,” Biden said in a statement. “Transgender children bring fulfillment to their parents, joy to their friends, and are made in the image of God. Affirming a transgender child’s identity is one of the best things a parent, teacher, or doctor can do to help keep children from harm, and parents who love and affirm their children should be applauded and supported, not threatened, investigated, or stigmatized. … Jill and I are standing with the incredibly brave transgender children, their parents, and families throughout Texas and around the country, and we will continue to fight for a future where all children can thrive.”

In addition to condemnation from the president, the U.S. Department of Health and Human Services announced several actions to keep transgender children safe and discourage state child welfare agencies from “weaponizing child protective services against loving families,” as Biden put it. 

Health and Human Services Secretary Xavier Becerra issued an “information memorandum” urging states to use their child welfare systems to protect and support LGBTQI+ youth, and informing child welfare agencies that allowing children to gender-affirming care is a valid part of supporting trans-identifying youth and may be medically necessary for some patients.

“The Department of Health and Human Services and all leading national medical and pediatric associations confirm that providing gender-affirming medical care is in the best interest of children and youth who need it,” the memorandum reads. “Such children, youth, and their families can require specific support in order to ensure that a child or youth can remain at home in an emotionally and physically safe environment. As such, each title IV-B and IV-E agency should consider how best to provide services and supports to each LGBTQI+ child and youth who is at risk of entering or is in foster care. These services and supports should be tailored to their individual needs, including those related to their sexual orientation, gender identity, or gender expression.”

Becerra also released guidance on patient privacy, clarifying that health care providers are not required to disclose private patient information related to gender-affirming care, and additional guidance making clear that denials of medically necessary health care based on a person’s gender identity are illegal under Section 1557 of the Affordable Care Act, as is restricting doctors from providing such care or prescribing gender-affirming treatments for youth struggling with gender dysphoria.

Becerra promised HHS would use “every tool at our disposal” to protect transgender youth, parents, and caretakers from malicious prosecution, and pledged to ensure that families and medical providers are aware of resources available to them if Texas attempts to enforce Abbott’s order, urging them to contact HHS’s Office for Civil Rights or file a complaint through HHS’s online portal if they find themselves targeted. 

“The Texas government’s attacks against transgender youth and those who love and care for them are discriminatory and unconscionable,” Becerra said in a statement. “These actions are clearly dangerous to the health of transgender youth in Texas. At HHS, we listen to medical experts and doctors, and they agree with us, that access to affirming care for transgender youth is essential and can be life-saving.” 

On Wednesday, a Texas state judge issued an injunction blocking the Department of Family and Protective Services from investigating and harassing one of its own employees who has been placed on administrative leave and threatened with the loss of health care benefits — not to mention the potential loss of custody over her 16-year-old transgender daughter — for allegedly allowing her daughter to receive puberty blockers to assist in a gender transition. But the injunction was specific to only the DFPS employee’s family, referred to in a lawsuit filed against the state as the “Doe” family.

The judge in that case, Amy Clark Meachum, will consider whether to issue a statewide injunction blocking investigations into all parents of trans children on March 11.

“President Biden’s commitment to defending trans youth against the shameless, monstrous attacks being engineered by malicious and unscrupulous politicians is one of the most powerful demonstrations of why leadership matters for LGBTQ+ people. Following the president’s powerful declaration this week that he has the backs of trans youth, he put his words into action — wielding the power of the federal government to put every state in the Union, including Texas, on notice that discriminating against trans youth and preventing them from accessing lifesaving medical care isn’t only wrong, it is a violation of civil rights, and it won’t be tolerated,” said Kevin Jennings, the CEO of Lambda Legal, which, along with the national and Texas chapters of the American Civil Liberties Union, is representing the Doe family in their lawsuit.

“We are proud President Biden is helping us to further amplify that message of support, and Lambda Legal praises both the President and Health and Human Services Secretary Xavier Becerra for taking historic action to shield trans youth from having the child welfare system weaponized against them by leaders who have shown that they care nothing about their welfare; to emphasize the critical need to affirm and support all LGBTQ+ youth in state care; and to promote family acceptance programs that allow young people to remain safely with their parents and never enter the child protection system,” Jennings added in his statement.

LGBTQ advocates have noted that major medical organizations have found that access to gender-affirming care for transgender children can benefit their mental health, lower suicide rates, and improve other health outcomes. Groups like the American Academy of Pediatrics, the Endocrine Society, and the Pediatric Endocrine Society have all issued statements opposing Abbott’s actions.

The National Center for Transgender Equality praised HHS’s actions.

“President Biden and his administration are standing up for transgender kids in Texas and around the country and we grateful for their leadership,” Rodrigo Heng-Lehtinen, the executive director of the National Center for Transgender Equality, said in a statement. “We know that gender-affirming health care saves lives, can improve mental health and reduce depression and anxiety. And yet, Gov. Abbott has put a target on transgender youth and their families. The Biden administration is making clear that this assault is discriminatory and will not stand.”

Support Metro Weekly’s Journalism

These are challenging times for news organizations. And yet it’s crucial we stay active and provide vital resources and information to both our local readers and the world. So won’t you please take a moment and consider supporting Metro Weekly with a membership? For as little as $5 a month, you can help ensure Metro Weekly magazine and remain free, viable resources as we provide the best, most diverse, culturally-resonant LGBTQ coverage in both the D.C. region and around the world. Memberships come with exclusive perks and discounts, your own personal digital delivery of each week’s magazine (and an archive), access to our Member's Lounge when it launches this fall, and exclusive members-only items like Metro Weekly Membership Mugs and Tote Bags! Check out all our membership levels here and please join us today!