Texas doctors condemn closure of Dallas clinic for transgender children

More than 400 doctors and health care professionals signed a letter addressed to two Dallas hospitals decrying the closure of the state’s only comprehensive medical program for transgender children, The Dallas Morning News has learned.

Addressed to leadership at the University of Texas Southwestern and Children’s Health and sent in late November, the letter urges the hospitals to reverse course on shuttering the clinic. The News exclusively obtained the letter from sources involved in its drafting.

“As Texan health care providers, we are writing to you to express grave concerns regarding recent news that there are plans to shut down the Genecis clinic, which provides treatment for transgender and gender-diverse youth,” the letter’s signers said.

“The mission of Children’s Health is to make life better for children. How can this decision possibly be in line with your mission?” they asked. “The values of UT Southwestern are excellence, innovation, teamwork and compassion. How can this decision possibly be in line with your values?”

“You will be jeopardizing the lives of hundreds if not thousands of transgender youth in Texas and across the Southwest,” they added. Many of the doctors and health professionals were previously or are currently affiliated with the hospitals.

The News reached out to UT Southwestern and Children’s Health about the letter and has not received a response.

Genecis — which stands for Gender Education and Care, Interdisciplinary Support — was a highly acclaimed seven-year-old program created by the hospitals to provide transgender and gender-diverse youth with health care, including mental health counseling and hormone therapy.

Copies of the letter were sent shortly after the hospitals quietly stopped providing hormone or puberty-suppression therapy for new patients at Genecis. They were delivered to leadership via email and via courier, said Dr. L.E. Wolovits, a private pediatrician in Dallas and one of the letter’s organizers.

Wolovits previously trained and worked at UT Southwestern and Children’s Health but no longer works at the hospitals. She said she never received a response to the letter from hospital leadership.

More than two months later, the reduced access to care remains in place, Wolovits said.

Genecis is no longer accepting new patients for hormone or puberty-suppression therapy to treat gender dysphoria, hospital officials said last year. Health care for current Genecis patients is now managed and coordinated through different specialty departments at Children’s Health and UT Southwestern Medical Center.

They added that all references to the program previously known as Genecis were removed from the hospitals’ websites to provide more security to these current patients.

Since November, UT Southwestern and Children’s Health have not responded to The News’ questions about why new patients will not be provided the same level of care as those already enrolled in the program.

When local health care professionals began collecting signatures for the letter, they emphasized not sharing it over social media, Wolovits said. “It seemed to me it should just be a conversation from physicians to hospitals and physicians and hospital administrators,” she said.

Republican politicians in Texas have increasingly put the medical treatment of transgender children under the spotlight in recent months as they enter a competitive re-election season next year.

Earlier this year, after state lawmakers tried unsuccessfully to change state law to ban gender-affirming care, Gov. Greg Abbott encouraged child protective services to redefine abuse to include surgical intervention for trans youth.

In December, Texas Attorney General Ken Paxton promised to push the state to expand this abuse definition to include more common types of transgender care for children, including hormones and puberty blockers. He announced investigations into two pharmaceutical companies for allegedly marketing these products to trans minors.

Paxton and Abbott both face GOP primary challenges.

For new pediatric and adolescent patients in Texas seeking gender-affirming medical care, the nearest clinics are now hours away and beyond state lines. Wolovits said one of her patients was supposed to begin going to Genecis in January. They are now looking at other options across the country.

“A program like Genecis means the difference between life and death in the most extreme cases but, in all cases, means that trans kids receive necessary best-practice health care that simply supports all of who they are,” said Emmett Schelling, executive director of the Transgender Education Network of Texas, a transgender rights advocacy organization.

“What we are seeing with UT Southwestern’s decision to shutter this clinic is an entity who purports in their mission statement that they are ‘... bringing an unwavering integrity to everything we do,’ [but who] completely and utterly abandons that commitment to trans kids and their families here in Texas,” he said.

Withholding gender-affirming medical treatment from adolescents risks psychological distress and increased chances of abuse and stigmatization, according to the state and nation’s most prominent child welfare and medical groups.

The World Professional Association for Transgender Health, or WPATH, recommends that medical interventions such as hormones should be explored only for youth who have experienced the onset of puberty and after undergoing mental health evaluations.

For children who have not reached puberty, mental health care is the primary form of treatment for gender dysphoria.

Gender dysphoria is the feeling of discomfort or distress that can occur in people who identify as a gender that is different from the sex assigned at birth, according to the Mayo Clinic.

Surgery to treat gender dysphoria is not recommended until a patient has reached the legal age of maturity to give consent for medical procedures and has lived continuously for at least a year in the gender role consistent with their gender identity, according to best practices set out by WPATH, the group that authors the standards of care for the health of gender-diverse people.

In Texas, the age of consent is 18.

Health care providers are not required to follow the standards of care, although it is typically suggested that they do.