What HB 1686 Means for Texas Health Care

By Ivy Fowler

Reporting Texas TV

AUSTIN, Texas – Fifteen-year-old Max Oliver told his mom he was a boy when he was four.

Max is transgender, and officially changed his pronouns to he/him a few years ago. His mom, Julie Oliver, said “he’s always been one of the dudes.”

“He just started introducing himself to everybody as Max, and that’s who I know. I know Max,” she said. “He’s been the same kid that he’s always been, you know, he’s a nerd. A loveable nerd.”

Texas legislators proposed several pieces of legislation this session to limit the care transgender people can receive. Julie Oliver opposes this legislation through her role as the executive director of the non-profit advocacy group Ground Game Texas.

Rep. Tom Oliverson, a Republican from Cypress who represents House District 130, sponsored House Bill 1686 to prevent transgender young people from receiving any form of gender transitioning health care.

Health care options currently available for transgender minors include mental health counseling, puberty blockers, and–once they turn 16–hormone therapy. Treatments for minors require the consent of a parent and licensed physician. A consultation and a diagnosis with a medical professional is required before any treatment can begin, and no two treatment plans are the same.

Dr. Sandra Guerra, the Chief Medical Officer of Texas Health Action, said surgical options are almost always reserved for adulthood. There are limited exceptions after extensive counseling, therapy, and exploring other options for minors.

“Gender-affirming care has been demonstrated to be safe, effective, and part of clinical practice the same way that if you needed to get any other kind of health care,” Guerra said. “You go to a clinician’s place of work and go through the exact same process that you would to receive any other kind of healthcare from a trained certified physician.”

Guerra said physicians follow a multi-step process to make sure an adolescent seeking gender-affirming care is particularly for an adolescent in order to make sure that they are fully informed, that their family is fully informed, and that everything is a long-term, gradual approach.

The Texas House of Representatives Public Health Committee, which includes Rep. Oliverson, put House Bill 1686 on the agenda for its March 28 committee hearing.

Protesters gathered in and around the Capitol to rally against the bill. Nearly 3,000 people signed up to testify or register their stance on the bill, with fewer than 100 in support.

Committee chair Stephanie Klick, a Republican from Forth Worth, opened the floor for public testimony at 2 p.m. The committee alternated hearing from critics and supporters for the duration of the discussion. At midnight, after hearing from only about 50 people, the committee ended the public comment portion of the hearing.

Supporters of the bill say they are concerned for minors’ safety the safety of minors and argue that parents are being manipulated to believe that their child will harm themselves if they don’t receive gender-affirming care. They claim such care is child abuse.

“In what world has it become okay to block puberty for children and then as they get older permanently disfigure … and we’re gonna hear from people today who were permanently disfigured as children,” said Rep. Tony Tinderholt, a Republican from Arlington.

Guerra argued that the bill proposes a double standard, as many of the care options available are used on young people for reasons other than being transgender. [She expressed concerns] for the future of Texas health care and said she has observed physicians leaving the state due to fears of future criminal prosecution.

“When we talk about limiting care that can be provided between a patient and their doctor, we are telling doctors as a whole that we do not trust their clinical opinion, their training, and their expertise on healthcare,” Guerra said.

“We’re being told that our judgment is flawed. This is going to have an impact on our ability to recruit and retain physicians in the state of Texas. They will be leaving. They will not be coming.”

Some families, including the Olivers, said they will also consider moving.

“If this bill goes through and we can’t get Max the mental, emotional and physical healthcare that Max needs, we will leave. We will get it somewhere,” Julie Oliver said.