A recent directive from Texas Governor Greg Abbott has some group psychotherapists wondering if their licenses could be challenged and if their careers could be tainted by accusations of child abuse. In addition, the directive also leaves some members of the transgender community and their supporters feeling attacked, anxious, and angry.
The new measure classifies medical treatments for transgender adolescents as child abuse under current Texas law. Under the law, services would include puberty blockers and hormone injections. The mandate also requires the Texas Department of Family and Protective Services to investigate parents and licensed medical facilities who help children receive these treatments
Additionally, the Governor’s mandate imposes penalties to mandatory reporters such as teachers, doctors, and psychotherapists, as well as the members of the public, if they fail to report services helping a transgender youth.
One HGPS group psychotherapist says the new mandate raises fears for trans youth, their families, and therapists who are counseling them. “No matter where you stand on the issue, this legislation affects all of us. First, pause to imagine a child you hold dear finds out they could be taken from their family for wearing the “wrong” outfit to school. What do you imagine they would feel? My guess is terrified and unsafe,” says the therapist.
While Abbott likens the transgender medical treatments to sterilization, some group psychotherapists say under current medical guidelines people should not undergo genital reassignment surgery until they are at least 18 years old. While the individual is still a minor, psychotherapists have focused on helping trans youth and their families socially transition by choosing a new name and style of dress. Therapy, both in a group or individual setting, has focused on mental health and structural support at schools and other organizations.
The new directive may undo this emotional reinforcement and put schools and therapists in a position where they question the care they would normally give. Some therapists proffer this scenario: Imagine that you are that child’s therapist. They show up to group and, while they have been expressing their transgender identity, they are not today. You are curious so you ask. As the question leaves your mouth, you realize that you are among the people who are not safe. Because for one, no adult is; and two, because you are a mandated reporter and can now be implicated in “child abuse.”
The American Medical Association and other groups such as the American Psychological Association and the American Counseling Association have issued statements opposing the order. A spokesperson for the Texas State Teachers Association said, “Our members don’t want to be the transgender police for Greg Abbott.”
In March, a Texas judge issued a statewide injunction blocking any investigations under the governor’s order. However, some therapists may believe the Governor’s order may put them in a fundamental conflict between their role as a mandatory reporter and violating professional standards of ethics that would inflict serious harm to patients. Some clinicians may ask this question: “Who are we as therapists if we cannot help our clients feel safe being who they are?”