Emiliana “Emily” Edwards wants El Pasoans to know that she’s a normal kid. The 14-year-old middle schooler loves singing, watching anime, and playing games on her computer. But unlike her cisgender classmates, Emily’s identity as a transgender child is currently at the center of a heated ideological debate in the Texas Legislature.
“Having access to (gender-affirming) care — it’s very, very, very helpful,” Emily said.
Her mother, Lorena Edwards, said Emily first told the family she was transgender when she was 9, and began a gradual process of transitioning over the next couple years. Lorena said Emily’s school, Hornedo Middle School, was supportive of her transition — the family decided that the last day of fifth grade was the last time Emily would go to school as a boy.
For a cisgender person, their gender aligns with the sex they were assigned at birth. But transgender people like Emily often struggle with gender dysphoria, a distress because their gender identity does not match the sex they were assigned at birth. Lorena said that Emily has largely been able to avoid gender dysphoria because of the supportive community around her during her transition.
Resources and support structures that Emily uses to aid in her transition are currently being challenged by conservative state lawmakers through proposed legislation that would ban medical care and sports participation for trans kids.
Although prospects for some of the proposals are dim in the waning weeks of the current session in Austin, others are still being considered. They include Senate Bill 1646 which, if passed, would define gender-affirming care –including the use of puberty blockers, hormones or surgery for transitioning– as child abuse.
Senate Bill 1311 would revoke the medical licenses of practitioners who provide gender-affirming care to trans minors, while Senate Bill 247 would allow lawyers to refuse service to transgender people on the basis of religion. The legislative session ends May 31.
Senate Bill 29, which would ban trans kids from school sports by mandating that students only participate in activities in accordance with their “biological sex,” was initially halted when it failed to get voted out of a House Committee on Education. But the measure was later revived in a retaliatory move by a Democratic state representative.
The term “assigned sex” is often used by advocates for transgender rights and medical practitioners in place of “biological sex,” to reflect that although one sex was assigned by a doctor when a child was born, it might not align with the body or gender identity of the person it describes.
State Sen. Charles Perry, R-Lubbock, is the author of S.B. 1646 and S.B. 29 and a Baptist deacon who has invoked his religion to promote these measures. Perry has said he wants to protect children from making irreversible medical decisions and thinks transgender girls have an unfair advantage in sports with other girls.
Jeff Younger, who has been embroiled in a legal battle over gender-affirming care for his transgender daughter, has also been a prominent advocate of these measures in Texas.
In April, a group of El Pasoans caravanned to the Capitol to speak out against the measures and emphasize the harm they would pose to trans kids and their loved ones.
For Emily, the prospect of losing access to puberty blockers is terrifying.
“Not having access to blockers would be very threatening to my, I guess you could say self-health,” she said.
Transgender minors are at a heightened risk of suicide, but recent studies show that gender-affirming care can play an important role in mitigating that risk.
Transgender youth who receive gender-affirming hormone treatment are less likely to die by suicide, according to a 2019 study by the American Psychological Association. The risk also decreases among transgender youth who use puberty blockers, according to a 2020 study by the American Academy of Pediatrics. But the sobering statistics have El Paso parents fearing the potential harms of the current legislative efforts.
“It seems like the legislation is proposing things without truly understanding the impact that it’s going to have on families,” said Tyler Edwards, Emily’s father. “Not only families, but also medical care providers. Like some of the laws where they would criminalize or possibly remove the license of a doctor because they’re providing care that’s in the best interest of the child — that seems ridiculous to me.”
El Paso doctors on gender-affirming care
El Paso medical providers who work with transgender children say that the legislative proposals are fueled by myths about what gender-affirming care entails.
“There are lots of misconceptions, unfortunately, in gender dysphoria,” said Dr. Krishnaswamy Rao, a pediatric endocrinologist with the Texas Tech Physicians of El Paso who treats trans kids. She emphasized that surgery is almost never performed on adolescents under the age of 18, and that puberty blockers are a reversible treatment.
“The issue is that they identify with a gender that does not align with their body … and so they display these features during childhood, but it becomes more obvious — it almost explodes when they go through puberty.” But puberty blockers alleviate mental and physical distress to “a very large extent,” she added.
Micaela Varela, principal of Hornedo Middle School, said the school has had multiple transgender students in recent years. The El Paso Independent School District’s non-discrimination clause was updated in 2018 to include protection from discrimination in educational programs on the basis of gender stereotyping or perceived sexuality.
“What’s comforting to me is how our school community has been so opening and accepting of their peers,” Varela said. “(Students are) kind of becoming who they are (during middle school years).”
Dr. Shivani Mehta, an El Paso child psychiatrist who works with transgender children, said another common misconception is that being transgender is “a phase” that kids will outgrow.
“Kids when they are aged 2, around that time, they begin identifying themselves or describing themselves as girls or boys. By age 3 to 5, they know who they are, they know their gender identity,” she said.
Rao said gender identity solidifies as children age. “If you identify as transgender after puberty, it’s very unlikely to change,” she said.
Marcy, an El Paso mother of a 15-year-old trans son, said her understanding of her son’s gender identity was what needed to change, not his.
“He’s known since he was a baby, a toddler, how he’s felt about his body,” she said. “The one that didn’t know it was me, the one that needed to come to terms was me.” (Marcy asked that the family’s last name not be used out of concerns for their safety.)
Marcy describes her son Leo as “a bright and funny kid.” He recently graduated from high school after turning pandemic isolation into an opportunity to focus on his studies, finishing two years early. He likes to play with his cats and watch “The Office.”
Marcy said she wishes legislators could see the humanity of trans kids like her son.
“I feel that once you see me or you see my son, it’s not just a concept,” she said.
Leo said he is aware of how much harder it is for trans kids who lack access to gender-affirming care.
“I’ve actually been pretty lucky with my transition overall, as my family has been very supportive, and I’ve had a very supportive community of people around me,” he said.
A national debate with local impacts
Sweeping legislative efforts directed at transgender children are not unique to Texas.
More than 100 bills have been introduced throughout 33 states this year targeting trans people, and similar legislation to that being presented in Texas has passed in other states like Arkansas, with grim consequences. Arkansas physicians say they have seen an increase in suicide attempts by trans young people in response to the measure.
Although the Trevor Project does not report a spike in crisis calls in Texas linked to recent proposed legislation, the crisis services team has been hearing from transgender and nonbinary young Texans who are scared and worried about the implications of these bills, spokesperson Rob Todaro said.
President Biden has broadly signalled his support for transgender rights, and said in a recent address to the nation that transgender youth are “brave.” He also signed an executive order on the prevention of discrimination based on gender identity.
“I feel much more reassured that the president … is on our side,” Emily said.
The way in which Republican legislators are choosing to legislate gender identity is misguided, Leo said.
“I actually think it’s quite funny that most of the problematic bills are centered around tracking children’s genitals,” Leo said. “As most conservative individuals have started to build a narrative that trans people are predators, I just think it’s rather ironic that they’ve taken this approach.”
Emily’s mother Lorena said that the stress caused by the Texas proposals has taken a toll on Emily’s education. She went from being an honors student to failing four classes in recent weeks.
“(Emily says), ‘I don’t know what future Emily is gonna look like. Is future Emily gonna be half transitioned into being a girl and then de-transitioning at the same time?’” Lorena said. “She doesn’t want to do her school work because she’s like, ‘Why bother? Because if this law passes, we will have to move from El Paso.’”
Marcy, Leo’s mother, said she wishes more people viewed the issues within the context of a longer history of discrimination and prejudice.
“If legislation can come in and try to dictate how we love our children, how we care for our children, how we support our children, it’s not that much further [from] how they’ll tell you to love your children,” she said.
“One day it’s transgender children. A while ago, it was Jewish children, Native American children. Although it seems like something that won’t affect everybody, it’s nice for the community to jump in and support,” she said.
The TrevorLifeline offers 24/7 confidential crisis support, suicide prevention training and other resources at 1-866-488-7386.
Cover photo: The Edwards family at the Borderland Rainbow Center on May 12. Lorena Edwards, right, is also an employee of the center, which offers support and services for LGBTQ+ people and their families. (Corrie Boudreaux/El Paso Matters)