"Terrifying": Understanding Abbott's order on trans kids in Texas

• "My first reaction is anger and fear," Landon Richie, a 19-year-old trans man who is a sophomore at the University of Houston, told Axios' Asher Price.
• "For myself and so many other trans people, gender affirming care has been life-saving. To equate gender affirming care with child abuse is just outrageous and extremely harmful," Richie said.
• "This order is the most powerful political figure in the state ... saying that ... not only does he not believe that trans young people should be able to access appropriate medical care, but he believes that if your parents love you and are providing you the care that doctors say is required, that that would be considered child abuse," said Amit Paley, CEO of the Trevor Project.
• "That is terrifying," Paley added.

Over two-thirds of LGBTQ youth said recent debates over state laws that target transgender people have negatively impacted their mental health, according to a poll by the Trevor Project, which provides crisis intervention and suicide prevention services to LGBTQ youth.

• The impact is even greater among trans and non-binary youth: 85% of those polled — four in five of this group — said their mental health had been negatively affected, the poll released last month found.

The big picture: Medical organizations, including the American Academy of Pediatrics, the American Psychological Association and the American Medical Association, have condemned legislation to restrict gender-affirming medical care, saying it could have a detrimental effect on the mental health of transgender youth.

• "Research consistently shows that access to gender-affirming medical care and family acceptance of a young person’s gender identity result in better mental health outcomes, including lower rates of suicidality," Jack Turban, MD, chief fellow in child and adolescent psychiatry at Stanford School of Medicine, wrote in an email to Axios.
• No other state in the U.S. considers gender-affirming care to be child abuse but legislation to block gender-affirming care for minors was introduced in at least 21 states in the last year alone.

State of play: Abbott asked Texas' Department of Family and Protective Services to follow an opinion issued by the state's Attorney General Ken Paxton in which he argues that gender-affirming care "can legally constitute child abuse."

• While neither Abbott's letter or Paxton's opinion contain enforcement guidance, the latter suggests that the order may be imposed via court order if a judge considers gender-affirming care to be child abuse.

The ACLU and Lambda Legal in their lawsuit argue that Abbott's order to investigate parents for child abuse if they seek gender-affirming care for their children has no "[c]onstitutional or statutory authority."

• The ACLU also fears that the order will lead to an increase in false accusations of child abuse "directed at parents who are simply supporting and loving their child," Adri Pérez, policy and advocacy strategist at the ACLU of Texas, told Axios.

What we're watching: On Wednesday, a Texas court on Wednesday temporarily blocked the state from conducting a child abuse investigation on the parents of a trans teenager receiving gender-affirming care.

• In this decision, the judge did not block all such investigations. A following hearing has been scheduled for March 11 to decide whether to block the Abbott's directive more broadly.

President Biden has called Abbott's order "government overreach at its worst," adding that it threatens "to harm children and their families just to score political points."

• "Children, their parents, and their doctors should have the freedom to make the medical decisions that are best for each young person — without politicians getting the way."
• The Health and Human Services Department announced a series of steps "to protect trans and gender diverse youth in Texas," including issuing a memo letting states know they "should use their child welfare systems to advance safety and support for LGBTQI+ youth,  which importantly can include access to gender affirming care."
• HHS Secretary Xavier Becerra released a statement Wednesday calling the Texas government's actions "unconscionable," saying "at HHS, we listen to medical experts and doctors, and they agree with us, that access to affirming care for transgender youth is essential and can be life-saving," he said.

The bottom line: "Separating a child from a loving supportive home has been linked to a range of bad outcomes including depression, physical health problems and even shorter life expectancy," Turban told Axios.

• "These actions by Abbott and Paxton are tantamount to telling the parents of children with diabetes that they will put their children in foster care if they give them insulin. They are ill-informed and dangerous."

Go deeper:

• ACLU sues to block Texas from investigating gender-affirming care for trans kids
• Texas business community condemns Gov. Abbott's transgender order