AUSTIN — In marathon hearing that lasted late into the evening, a Texas Senate committee on Thursday debated several bills to ban gender affirming care for transgender minors and penalize doctors who provide it.

Senate Bill 14, the first to be heard, would bar doctors from providing a number of common treatments for gender dysphoria to those under 18, including puberty blockers, hormone therapy and surgical interventions, commonly referred to as “gender affirming care.” It would also require the state medical board to revoke the license of physicians who provide this care, and bar taxpayer money to entities or individuals that facilitate or provide these treatments to minors.

On March 20, the Senate Committee on State Affairs approved the bill and send it to the full Senate. If passed, it would head to a committee in the Texas House for further debate. Both chambers must approve and the governor must sign any bill for it to become law.

Debate on the bills last week began just after 1:30 p.m. Thursday and lasted around nine hours.

Bill author Donna Campbell, an emergency room doctor, said the legislation is meant to protect children from what she described as a “cottage industry” eager to capitalize on the confusion and concern of families and kids. The bill would not prohibit these same treatments for non-transgender minors.

“Our children need counseling and love, not blades and drugs,” said Campbell, R-New Braunfels.

More than 50 members of the public spoke, nearly equally split between those for and against. The debate was mostly polite and subdued, with a few brief bursts of contention and emotion.

Contrary to past sessions when transgender youth and their families packed hearing rooms on similar bills, their presence was largely absent this year after the state began investigating gender affirming care given to minors as child abuse.

Texas Medical Association neutral

Jacqueline Murphy, 22, waited until 7 p.m. to testify against the bill.

“I understand that this committee is unlikely to be swayed by the facts of the issue,” said Murphy, a transgender woman from Austin who said she began puberty blockers and hormone therapy as a minor. “Whether it is because of genuine bigotry or merely political expediency, you have made your political mission clear. You are not protecting me.”

The largest state and national medical groups support age-appropriate and individualized medical treatments for youth experiencing gender dysphoria, which the Mayo Clinic defines as the feeling of discomfort or distress that might occur in people whose gender identity is different from their sex assigned at birth. Transgender means identifying as a different gender than one’s sex at birth.

But the Texas Medical Association, which has previously urged the state not to criminalize this care, on Thursday said it was taking a neutral stance on the bill.

“This is a vulnerable population of patients, which makes the relationship and communication with the physician even more important,” Dr. John Carlo said on behalf of the TMA. “While physicians want to provide medically appropriate care for all patients, we understand there is an ongoing debate over what is medically appropriate with regard to transgender adolescents.”

Carlo asked Campbell to amend her bill to allow transgender minors already receiving gender affirming care to be allowed to continue, and to shift enforcement power from the attorney general to the state medical board.

The Texas Pediatric Society and Texas Psychological Association testified against the bill.

A number of transgender adults spoke of how they wished they’d had access to gender affirming care when they were younger. Some made references to research, including a recent Trevor Project survey, that show transgender Texas youth experience suicidal thoughts at higher rates than their peers in large states and had a harder time accessing mental health care. There are more than 122,000 transgender Texans over the age of 13, a recent statistical analysis by the Williams Institute at the University of California at Los Angeles showed.

Transgender bills supporters

Senate Bill 14 is one of Lt. Gov Dan Patrick’s 30 priorities this session, and it has 10 GOP senators signed on as co-authors. Similar bills have been introduced in the Texas House, but neither the speaker nor Gov. Greg Abbott have publicly backed the effort.

Dozens of bills that would negatively, and positively, affect the LGBTQ community in Texas have been filed this session. The Texas Legislature is majority Republican. Earlier in the day, the committee approved a bill to restrict transgender college athletes. That effort is supported by Abbott and a majority of members of the Texas House.

Eight other states, some just within the past weeks and months, have already banned or enacted similar penalties on gender affirming care for minors. Some of the bill’s supporters noted that European countries have modified their stances on these treatments in recent years as evidence that the U.S. should too. However, none of those countries have instituted an outright ban like that on the table here.

Those speaking for the bill included representatives from the Christian advocacy group Texas Values, current and former pediatricians and a prominent anti-LGBTQ activist. The committee invited several individuals who regretted their decision to access gender affirming care, commonly called detransitioners, to speak.

Abel Garcia, who now lives in Dallas, said he moved from California and criticized the adults there “who betrayed me” and a state that he said treats people like “lab rats.”

“I request that these bills be passed so that we can protect all children in Texas and allow them to grow into their healthy bodies,” he said.

After more than six hours of debate on Campbell’s bill, the Senate took up three other transgender-related bills. Senate Bill 162 by Sen. Charles Perry, R-Lubbock, would bar someone from changing the sex listed on their birth certificate unless to fix a “clerical error” or, in the case of an intersex person, to choose a sex if one wasn’t at the time of birth.

Senate Bills 250 and 1029 by Sen. Bob Hall, R-Edgewood, would also ban gender affirming care for minors, as well as prohibit physicians from getting professional liability insurance coverage for providing these procedures and require private insurance companies to cover detransitioning costs if they covered any gender affirming care.

During debate on Hall’s bills, Sen. José Menéndez clashed with longtime anti-LGBTQ activist Steven Hotze over appropriate language. Hotze, a Houston-area physician who is currently suing to block access to HIV prevention drugs, repeatedly called transgender people and the doctors who treat them “pedophiles” pushing an “evil, perverted, immoral lifestyle.”

“They are not perverts and pedophiles,” said Menéndez, a San Antonio Democrat who said he has transgender friends and staff members. “They’re living as their true selves.”

Hotze, off microphone but still audible, then uttered an expletive back at the senator. Chairman Bryan Hughes, R-Mineola, immediately asked Hotze to leave the table.

Debate continued until just after 10 p.m., when the committee adjourned. The 2023 legislative session ends May 29.

CORRECTION: A previous version of this story incorrectly stated that the Texas Medical Association wanted implementation of Senate Bill 14 to lie with its organization. The TMA wants enforcement power shifted from the attorney general to the state medical board.