Cameron Wright, 16, has always seen himself as a "dude." As a young child, Cameron didn't have the words to explain the disconnect between how he saw himself and how the world saw him. But he knew that despite being born in a girl's body, he was meant to be a boy.
After taking reversible puberty blockers that pause a teenager's body changes, Cameron considered whether he wanted to begin hormone therapy to physically transition more permanently. He did not take the decision lightly. Cameron said his doctor made him spend almost a year mulling over the question, working with his therapist, and thinking through the life-altering implications before the doctor believed he was ready to start taking the medications in 2020.
"I thought about if I stayed a girl, life would be so much easier," said Cameron, who uses the pronouns he and him. "But this is what I want, and I'm not going to let anything stop me from being who I want to be, whether it's hard or not."
Then in November 2021, the GENder Education and Care, Interdisciplinary Support clinic in Dallas, known as Genecis, stopped taking new patients because of pressure from Republican activists and politicians. Although doctors can continue to see patients like Cameron whom they were already treating, the clinic was dismantled. Cameron and his family now have concerns about what this means for them.
The Texas attorney general, Ken Paxton, also opened investigations into pharmaceutical companies whose products are used by transgender patients, and Republican Gov. Greg Abbott and the state GOP are increasingly focusing legislative and reelection efforts on a record number of bills that target transgender young people, their parents, and their doctors.
Since then, Texas Children's Hospital in Houston announced it would stop offering hormone therapy. The Texas Tribune reported that Legacy Community Health, also in Houston, quietly paused hormone therapy for teens as well. And doctors throughout the state are telling patients they will no longer prescribe the medications under pressure from insurance companies.
Transgender young people and their families across Texas are now scrambling to find providers and maintain access to their medications, with some exploring options outside the state. An estimated 17,000 transgender people ages 13-17 live in Texas, according to Equality Texas, an LGBTQ+ education and advocacy organization.
For Chloe Ross, 15, who uses the pronouns she and her, the crackdown on her care has been distressing. "I'm just as human as everyone else," she said.
Chloe's doctor is still seeing her and prescribing her hormones. But her mother, Kathryn Ross, has started researching options for out-of-state care. The family has been saving money in case they need to move, Ross said, but they hope it doesn't come to that.
"Having just moved, and Chloe making good friends, the last thing we want to do is uproot her," said Ross. "Moving would be the last option."
During the pandemic, the family relocated to a larger city within Texas, leaving behind bullies, and the teen found acceptance from new schoolmates who know her only as Chloe, someone who loves theater and wants to study genetics. But Abbott's orders to investigate parents who allow their children to receive gender-affirming care, and legislative threats to criminalize such care, weigh heavily on Chloe.
"I'm just trying to get through high school and stuff," Chloe said through tears. "Having Gov. Abbott make me worry about that kind of stuff is terrible because I don't get a normal life anymore, you know? Right now, I'm having to go to my teachers to ask them to please not turn me in for being trans. I shouldn't have to worry about something like that."
For as long as she can remember, Chloe said, she has favored wearing jewelry, playing volleyball, and participating in theater. She did not know how to express what she was feeling and thought she was gay. Chloe and her mom said strangers regularly assumed Chloe was a girl even as she presented as a boy and had not yet come out as transgender.
Echoing other parents, Chloe's mother said that even though she was already deeply involved in LGBTQ+ support and advocacy, Chloe's coming out as transgender was a "gut punch." Never once did she disbelieve Chloe, but she feared for her daughter's future. She feared for what is happening now.
Young people receiving gender-affirming care include those who are socially transitioning — for example, wearing clothing that reflects their gender identity — and those taking puberty blockers or hormones.
Not all young people who identify as transgender, however, move beyond social transitioning or experience the condition known as gender dysphoria, which means that they experience psychological stress when their body doesn't match their identity. And people who take puberty blockers don't necessarily decide to take gender hormones. Surgery is not recommended for people younger than 18.
Although gender-affirming care for trans young people remains politically controversial in many parts of the U.S., a study published by JAMA Network Open showed a reduction in suicidal ideation in trans youths who received such care. Health care organizations that include the Endocrine Society, the American Academy of Pediatrics, and the American Medical Association endorse gender-affirming health care.
Despite the closure of Genecis, Cameron is scheduled for a May appointment with Dr. Ximena Lopez, the doctor overseeing his care. His mom, Myriam Reynolds, however, worries it won't take place. Lopez has filed a lawsuit against UT Southwestern Medical Center, which jointly operated Genecis with Children’s Medical Center Dallas, alleging that the facility discriminated against some patients by preventing them from receiving gender-affirming care based on their gender identity.
In the meantime, Reynolds picks up Cameron's hormone refills as soon as they are available to maintain a constant supply. She also said the family is considering all options to ensure Cameron can continue receiving care despite the state crackdown.
"They don't care at all about trying to help my kid," Reynolds said. "It's all political theater."
It's especially hard because access to Genecis was a consideration when the family decided to relocate from Colorado to Texas in 2017. Cameron had already come out as transgender, and, after researching the clinic, his mother believed he would receive compassionate, thoughtful care as he transitioned. Now the family is concerned about what kind of care Cameron will be able to get in Texas.
Cameron, who hopes to study music production or become a firefighter, tries to be optimistic that politicians will stop cracking down on medical care for people like him.
"I can't control the way I am," said Cameron. "This is not my mom's doing or my doctor's doing. This is just me trying to be myself."
This article was reprinted from khn.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.