Abbott orders state agencies to investigate gender-affirming care for trans kids as child abuse

• The letter said doctors, nurses, teachers and anyone who comes into contact with a child has a requirement to report parents or face "criminal penalties."
• Abbott's letter was CC'd to several agencies, including the Health and Human Services Commission, Texas Medical Board and Texas Education Agency, according to The Dallas Morning News.

State of play: The order's immediate impacts on transgender children's access to treatments remain unclear, Kate Murphy, senior policy associate for child protection at Texans Care for Children, told The Dallas Morning News.

• "Since this is a nonbinding opinion by the attorney general right now, it’s unclear what will happen next," Murphy said, adding, "right now, we have more questions than answers."
• The order comes one day after Attorney General Ken Paxton said that gender-affirming health care for transgender kids is child abuse, per the Morning News.

Zoom out: 2021 saw a record number of anti-trans bills introduced in state legislatures. Medical experts and doctors fear an increase in mental health crises among transgender kids due to the dozens of bills introduced to criminalize gender-affirming health care.

• "I see multiple patients daily that are suffering with depression and suicide ideation and suicide attempt and anxiety, and my fear is that if we deny them this evidence-based treatment, we’re only going to see massive more patients come to the emergency room," Jesse Martinez Jr., a doctor of psychiatry at Children’s of Alabama, told Axios last year.
• Studies have shown that doctors who give children the ability to socially transition, access puberty blockers and gender-affirming hormones encounter lower rates of suicide and mental illness.

Between the lines, via Axios Austin's Asher Price: Some district attorneys in Texas's large urban counties are saying they won't follow the guidance set out by the Texas attorney general that underpins Abbott's new order.

• The order could position Abbott favorably among Republicans ahead of a potential primary for president in 2024, but may risk alienating voters ahead of a general election.

What they're saying: "Texas parents who support their trans kids should be applauded, not prosecuted," Amit Paley, CEO of The Trevor Project, which provides crisis intervention and suicide prevention services to LGBTQ youth under 25, said in a statement to Axios.

• Paley said The Trevor Project's research shows that "trans youth who feel accepted by the adults in their lives — including family members, teachers, and doctors — are less likely to attempt suicide."
• "Further, our research found that gender-affirming hormone therapy has been linked to lower rates of depression and suicide risk among trans youth who wanted it," Paley added.
• "The government should not be involved in personal decisions that force doctors and families to act against the medical community's standards of care for transgender young people."

"This smoke & mirrors attempt to place targets on parents who love & support their kids is meant to distract you from the issues that actually impact you," Adri Pèrez, policy and advocacy strategist for LGBTQ equality at the American Civil Liberties Union of Texas, wrote on Twitter about Paxton's opinion.

• "Trans kids and their parents are not a threat to you. Politicians that use them to distract you from their failures are," Pèrez said.

Go deeper:

• Doctors fear next steps if states ban care for trans youth
• 2021 sees a record number of bills targeting trans youth
• Poll: Most LGBTQ kids' mental health negatively impacted by anti-trans legislation

Editor's note: This story has been updated with additional details throughout.