What Was Lost: The End of Transgender Pediatric Treatment in Texas


Oklahoma City is now the closest place for patients in North Texas to receive transgender pediatric treatment. That could mean more than six hours in the car per trip for Dallas children. For children in other parts of the state, it can take a full day to get proper care.

In December, Children’s Health quietly removed the branding from its website about the once-announced GENECIS clinic, which offered gender-based care to transgender children. The clinic was closed after a conservative group organized a protest against GENECIS services in the homes of some of the children’s directors. It was the only one of its kind in Texas.

These services are not completely gone yet. Existing patients are offered similar services, but new patients are not admitted to hormone therapy, an essential part of gender-equitable care. As these patients drop out of the program, they have no other place to go. Texas children are being forced to leave the state to receive treatment recognized as best practice by the American Academy of Pediatrics.

But what exactly is gender-equitable care and why is it important that these services are brought together in one clinic? Dr. Shauna Lawlis, an adolescent medicine doctor at OU Children’s Physicians Adolescent Medicine Clinic in Oklahoma City, says the evidence lies in the patients.

“It’s amazing to see these children change in a positive way,” she says. “They are often so happy that there is a doctor who understands, listens, and supports them, and we can take steps to improve their dysphoria. You see leaps and bounds. “

The Oklahoma clinic includes a social worker who connects the family with resources and an adolescent doctor to attend to their specific needs. The patients are between 10 and 25 years old. Doctors working in the clinic have experience dealing with puberty, relationships, independence, and mental illnesses that develop during this time. The clinic also has a nutritionist, as gender dysphoria is often accompanied by eating disorders. It also has gynecological services.

The clinic offers endocrinological services for puberty blockers and hormone therapy. There are mental health providers who care for a population that is often bullied, marginalized, and isolated. According to the Trevor Project’s Third Annual National Survey of LGBTQ Youth Mental Health, 52 percent of transgender and non-binary youth in the US thought of suicide in 2020. The clinic also has gynecological services.

Because these services are in one clinic, multiple providers can treat the patient in one day, which is particularly important because there are so few clinics. Patients come from all over the region to seek care. The clinic also works with a network of therapists who care for patients near where they live so that they do not have to drive to the clinic for more frequent therapy sessions.

After all, patient comfort is paramount. They need to feel welcomed, validated, and supported, which is often the opposite of what they experience outside of the clinic.

“They know that they are being addressed correctly, that they are not of the wrong gender, and that they are not being called dead (they will be given their names before the transition),” said Amy Barrier, a nurse and head of Prism’s Transgender Care Task Force Health North Texas treating transgender adults in Dallas. “They are treated with respect and this lack of discrimination is the best we can offer besides helping them get to the body they belong in.”

While many of these patients suffer from mental illness, according to Lawlis, gender dysphoria is not a symptom of mental health problems. The differences are biological; Patients with gender dysphoria have brains that look more like the brains of those they identify with. “A diagnosis of mental illness is actually caused by the stress on your body and brain that are mismatched,” she says.

In the past few years Lawlis has seen the clinic grow from 100 to over 1,300 patients. When I asked her if she had seen an influx of Texan patients since GENECIS closed, she told me she did not know because they were still working to schedule appointments for inquiries that came in prior to the announcement. It is a service that is in high demand, but also threatened.

The Texas 2021 legislature featured dozen of bills threatening the transgender community, including denying transgender children access to puberty blockers, hormone therapy, or sex-confirmation surgery. House Bill 25 was signed by Governor Greg Abbott last year and requires public school students to participate in athletic competitions based solely on their gender at birth.

This type of care is also being attacked in Oklahoma. Last year the Oklahoma legislature tabled bill that would make it a crime to offer gender-affirming medical treatment other than counseling to anyone under the age of 21. “I just expect it to get worse, which is of course annoying,” she says. “We are all concerned about these children and where they will be cared for when we are all closed.”

Such legislation forces some families to leave the state. I spoke to the Tran family, who uprooted themselves and moved from Dallas to Seattle when their kid came out transgender. “We wanted to bring them to a place where there were already local safeguards and a much more positive culture. It’s not an easy step, but we thought we needed him, ”she told me. “Some of our friends and family thought we were paranoid for doing this. I wish I was wrong, but when I heard about the GENECIS closure, I didn’t know what the mental health of my daughter or family would have been if we had stayed in Texas. “

Despite opposition at home and across the country, Lawlis is on a mission to help people who need them. This patient list now includes every new patient in Texas.

“We attach great importance to providing care in a place where there are not many care options. I could go to California and be one of 200 vendors, but I can do more here, ”she says. There is a lot at stake. “For these children it is literally a matter of life or death. They are so unhappy in their bodies that closing these clinics could lead to an increase in suicide rates. “

author

Will is the editor-in-chief of D CEO Magazine and the editor of D CEO Healthcare. He wrote about healthcare …


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