Austin doctors who treated trans kids leaving Dell Children’s clinic after AG Paxton announces investigation

People line the railing on all three levels of the outdoor rotunda of the Texas Capitol in Austin, waving signs during the "Fight for our Lives" rally in opposition of bills affecting LGBTQ people in March. (Evan L'Roy/The Texas Tribune, Evan L'Roy/The Texas Tribune)

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Dell Children’s Medical Center in Austin has stopped providing transition-related care to transgender teenagers, according to several parents who were told they would need to find new providers.

Dell Children’s said in a statement Saturday that while its adolescent medicine clinic remains open, “the physicians who previously staffed the clinic will be departing.”

Parents said they were told about the doctors’ departures just hours after Attorney General Ken Paxton announced an investigation into “potentially illegal” activity at Dell Children’s. The investigation seems to be in response to a video report from the conservative Project Veritas, a far-right activist group that engages in deceptive practices to do hidden camera-style investigations.

The video allegedly shows a Dell Children’s social worker saying the Austin-based hospital provides certain gender-affirming treatment for patients “as young as eight, nine” and sometimes after only one consultation.

In response to the video, Dell Children’s released a statement on April 28 that says it does not provide hormone therapy or gender-affirming surgery to children, and the hospital system was looking into the allegations.

This investigation comes as the Texas Legislature looks poised to bar trans minors from receiving puberty blockers and hormone therapy. Those already receiving these treatments would also have to be “weaned off” of them, which some trans Texans and their parents have called forced detransitioning. The ban would take effect on September 1, if Senate Bill 14 becomes law.

Gender-affirming care is an umbrella term for the treatment of gender dysphoria, the discomfort that comes when one’s gender identity does not align with the sex they were assigned at birth. Gender-affirming care ranges from social transitioning — using different pronouns or dressing differently — to puberty blockers, hormone therapy and surgical interventions. Surgeries are not commonly performed on trans minors, especially those on sex organs.

News of the staffing changes at Dell Children’s left parents scrambling. One mother, who agreed to speak with The Texas Tribune only if her name isn’t used because she fears for her family’s safety, said her 12-year-old daughter received her first puberty blocker shot earlier this year, after over a year of medical monitoring and tests.

Her child is due for another shot later this month, but last Friday got the call that her doctor had left Dell Children’s and the appointment was canceled.

“It happened so quickly,” the mother said. “I was under the impression that we still had this appointment and that we at least had that one guaranteed shot.”

Following the call, the clinic sent her a list of resources, including out-of-state providers, according to a message reviewed by the Tribune. Since then, she has been trying to figure out how to get her daughter, who is about to turn 13, her next round of medication.

She’s heard many of the closest places are already booked up for months, and she’s grappling with the financial impact of routinely traveling outside of Texas.

“The last couple days have been going through the feelings of not wanting to leave a home and a community and schools that we love,” she said Sunday. “But then how much stress would be lifted and what a relief it would be to be in a place where this wasn't a question — that part, I think, can't be underestimated.”

It is already extremely difficult to get transition-related care in Texas. Providers are few and far between, and often have long waitlists. Several families told the Tribune they waited months to be seen at Dell Children’s.

Another Austin-area mom, who spoke with the Tribune on condition of anonymity because she also fears for her family’s safety, said her trans daughter has presented as a girl ever since she was a young child. After years of therapy and social transitioning, her daughter eventually got on puberty blockers under the guidance of the doctors at Dell Children’s.

“She was thrilled,” the mom said. “Things like, when she would get recognized for a girl at the store in the checkout line, her face would just light up.”

Her daughter formed a close relationship with the doctors. They were the first ones to notice that she was struggling with an eating disorder, which the mom says even her pediatrician had missed.

“These kids develop relationships with these doctors that they trust and that’s ripped away from them,” she said. “We’re left with a child with an eating disorder that no one is watching.”

In the days since she got the news, the mom has called several out-of-state clinics, eventually finding one that would put them on a nine- to 12-month waitlist for care.

As of now, gender-affirming care remains legal in Texas, which is why these mothers say they can’t understand Dell Children’s decision to part ways with their providers. A similar clinic, The GENder Education and Care, Interdisciplinary Support (GENECIS) program, which is housed at Children’s Medical Center in Dallas and is run jointly by UT Southwestern Medical Center, shut down last November after a political pressure campaign. The clinic began accepting patients again after the program director filed a lawsuit and a judge granted an injunction.

Many parents of trans kids who have the resources are throwing in the towel on Texas. Nichole, who also asked that her name not be used out of fear for her family's saftey, hasn’t gotten the call yet from Dell Children’s about whether her child’s June appointment is canceled, but she’s proactively looking for a new pediatric endocrinologist.

When she first learned her 11-year-old identifies as nonbinary, meaning neither male or female, Nichole said she had “a lot of learning to do.” Their first appointment at Dell Children’s was the education the family was desperately looking for.

“That first appointment we just had conversations about what gender-affirming care is, really broadly, and what medical interventions we could consider and the implications of that,” she said. “It feels radical, honestly, to have a doctor’s undivided attention, just to answer questions, but that’s what it was.”

She said the providers made sure her child had a voice in the conversation, while still respecting the role of the parents in any medical decisions. They didn’t feel pressured into any particular course of action and their next appointment was going to be a very similar open-ended learning format, Nichole said.

“To me, it felt like what medical care ought to be,” she said.

Since she heard the news about Dell Children’s, she’s been calling around to other states, and found a potential provider in New Mexico. This doctor used to work in Arkansas, but relocated as that state cracked down on gender-affirming care for minors.

For Nichole, the most important thing is making sure her child doesn’t have to worry about any of this — interruption to their health care, the cost, the burden.

“My kid’s job is to be a kid,” she said.

Disclosure: Dell and UT Southwestern Medical Center have been financial supporters of The Texas Tribune, a nonprofit, nonpartisan news organization that is funded in part by donations from members, foundations and corporate sponsors. Financial supporters play no role in the Tribune's journalism. Find a complete list of them here.

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