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As a psychologist, I see the sadness, worry, angst, and anxiety that children and families have when the child finally gathers the courage to tell their parents how long they have been experiencing gender dysphoria. Gender Dysphoria involves extreme distress or discomfort caused by the discrepancy between experiencing oneself as a different gender than that assigned at birth. People should understand that these children and adolescents, along with their parents, are genuinely affected by gender dysphoria. Parents know this is a much harder path for their children to follow. Yet, to imply that everyday parents want a harder life for their children, are abusing them when they provide necessary care, and that Child Protective Services should be involved, is tragic. What would actually constitute medical and psycological neglect is if parents fail to obtain evaluations and psychotherapy for their children who have gender dysphoria. Teenagers are already at high risk of suicide, so to add the awful stress of failing to assist those with gender dysphoria only increases the risk of depression and suicide. The rate of suicidal ideation in sexual minority youth (LGTBQ) is twice that of other adolescents. It is unconscionable that these children and their concerned parents are blamed, judged, and persecuted, further increasing their isolation and distress.

It is crucial that individuals with gender dysphoria receive medical care from a team of professionals. Most often, the team includes psychologists, counselors, an endocrinologist, the primary care physician, and a surgeon if warranted. This is no hasty or impulsive process, as there are numerous decision points within the process and prudent safeguards in place to protect children. The World Professional Association of Transgender Health (WPATH) is a non-profit established in 1979 to encourage research and education. They set the Standards of Care (SOC) on which involved professionals base their care.

It is a long, careful, and medically-guided process to move from gender dysphoria to transitioning as transgender, and not everyone with gender dysphoria makes that transition. Gender dysphoria, but NOT transgender status, is a psychiatric disorder with a specific set of criteria as notated in the Diagnostic and Statistical Manual-5th Edition (American Psychiatric Association). The beginning of the process is a psychological evaluation to determine if the individual meets the criteria for gender dysphoria. If the diagnosis fits, psychotherapy is provided for at least a year to explore identity and sexuality and to assist the family in coping with the ramifications of their child’s gender dysphoria. Next, if the family sees that their child needs further steps, and if the team of medical professionals agree, the next part of the process involves living as the alternative gender and possibly having hormone therapy--for a minimum of one year. Only after the child turns 18 years old is it possible to consider transition surgery, after having completed a second rigorous psychological evaluation.

What is most important is that we have empathy for the individuals with gender dysphoria and for their loved ones who are on this difficult journey with them. It is the right of individuals, families, and medical professionals to make decisions about the journey. It is absolutely NOT the place of government, politicians, religious groups, or Child Protective Services to make these personal and medical decisions for them. To do so is an abuse of power, infringing on people’s choices over their own bodies. When government mandates prohibit the rights of sexual minorities, it goes beyond discrimination to outright societal persecution of those with such differences. Is this the kind of state Texans want? Is this the kind of country to which we should aspire? Acceptance of differences of all kinds should be the aspirational goal, not persecution of others.

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