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Gender-Affirming Care of Minors Investigations Overwhelm State Workers

Texas' family services are 'on the brink of collapse' after requiring child abuse investigations of gender-affirming care for minors.

LGBTQ rights supporters gather at the Texas State Capitol to protest state Republican-led efforts to pass legislation that would restrict the participation of transgender student athletes on the first day of the 87th Legislature’s third special session on September 20, 2021 in Austin, Texas. (Photo by Tamir Kalifa/Getty Images)

(CNN) — A court filing from 16 current and former employees of the Texas Department of Family and Protective Services, along with the Texas State Employees Union, says the agency is “on the brink of collapse” following the state’s decision to investigate the gender-affirming care of minors as potential child abuse.

The brief cites a “string of departures” within the agency since the directive was put in place in February, arguing remaining workers will be spread dangerously thin.

The amicus curiae (Friend of the Court) brief was filed with the state’s Third District Court of Appeals, which is considering whether the policy, prompted by an opinion from Attorney General Ken Paxton and ordered by Gov. Greg Abbott, was implemented legally. The governor and DFPS are appealing the March decision of a district court judge in Austin that put enforcement of the policy on hold. In May, the Texas Supreme Court ruled that DFPS could continue investigating families suspected of seeking out gender-affirming care while the case is appealed. At the time, DFPS confirmed that some nine families were under investigation.

As DFPS caseworkers quit, those remaining are forced to do more work, the court filing says. They further allege that the agency has been unable to meet its “baseline of care” for years, and that the state’s policy on transgender children has “driven it to a new nadir.” The filing also argues the directive was enacted illegally because the state did not go through the required formal process to create a new policy. The state has argued it did not need to do so because the directive is an interpretation of existing policies, not a new rule.

In the brief, a former DFPS worker alleges that they were ordered to do a full investigation of all gender-affirming care cases, even when that treatment was ordered by a medical professional.

Gender-affirming care is medically necessary, evidence-based care that uses multiple approaches to help a person transition from their assigned gender — the one that corresponds with the sex the person was designated at birth — to the gender by which they want to be known.

Major medical associations have agreed that gender-affirming care is clinically appropriate for children and adults with gender dysphoria, which according to the American Psychiatric Association is psychological distress that may result when a person’s gender identity and sex assigned at birth do not align.

“Prior to February 22, 2022, never in DFPS’s history was investigating parents who merely followed medically recommended care prescribed by a doctor and with the consent of the child considered ‘child abuse,'” the filing states.

Half of the DFPS employees who signed on to the court filing are no longer with the agency, with some of them having resigned in protest of the policy. Most of those who are still employed by DFPS filed anonymously “to minimize the risk of retaliation,” according to the brief. One of the Child Protective Services investigators who resigned is a transgender man, the document says.

The brief urges the appeals court to affirm the lower court’s decision temporarily barring enforcement of the policy, despite the appeal brought by DFPS. The Court of Appeals has not yet set a date for oral arguments in the case.

A DFPS spokesperson declined to comment on the brief from DFPS workers Wednesday.

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