Physicians as Political Pawns — The Texas Directive on Gender-Affirming Care and Other Moves

This perspective article examines the Texas directive issued by Governor Greg Abbott in February 2022, which classified parents seeking gender-affirming care for transgender children as child abusers. The directive, though temporarily blocked by a court injunction, reflects a broader trend of state-level efforts to criminalize gender-affirming care for minors, as seen in Arkansas, Tennessee, and Alabama. The article highlights the ethical and legal conflicts faced by physicians, who are caught between adhering to professional standards of care (such as those outlined by the World Professional Association for Transgender Health) and complying with politically motivated mandates. Federal protections, including Section 1557 of the Affordable Care Act and HIPAA, complicate compliance, as they prohibit discrimination based on gender identity. The piece argues that these measures erode trust in medical providers and politicize health care, disproportionately affecting vulnerable populations. It calls for coordinated responses from hospital ethics committees, legal counsel, and medical professionals to navigate these challenges.

This perspective article examines the Texas directive issued by Governor Greg Abbott in February 2022, which classified parents seeking gender-affirming care for transgender children as child abusers. The directive, though temporarily blocked by a court injunction, reflects a broader trend of state-level efforts to criminalize gender-affirming care for minors, as seen in Arkansas, Tennessee, and Alabama. The article highlights the ethical and legal conflicts faced by physicians, who are caught between adhering to professional standards of care (such as those outlined by the World Professional Association for Transgender Health) and complying with politically motivated mandates. Federal protections, including Section 1557 of the Affordable Care Act and HIPAA, complicate compliance, as they prohibit discrimination based on gender identity. The piece argues that these measures erode trust in medical providers and politicize health care, disproportionately affecting vulnerable populations. It calls for coordinated responses from hospital ethics committees, legal counsel, and medical professionals to navigate these challenges.