Texas ban on youth gender-affirming medical care pushes family to cross state lines

The political battles over the rights of transgender Americans have led to difficult decisions for several families, especially those living in states with restrictions on transition-related medical care for minors. Laura Barrón-López reports on a Texas family’s journey to access that care.
Geoff Bennett:
The political battles over the rights of transgender Americans have led to difficult decisions for a number of families, especially those living in states with restrictions on transition-related medical care for minors.
Laura Barron-Lopez has the story of one family’s journey to access that care.
Rhyan, 14 Years Old: When are we leaving?
Mia, Mother:
Twenty minutes, 20, 10 minutes.
Laura Barron-Lopez:
Fourteen-year-old Rhyan (ph) and his single mom, Mia (ph), have waited over a year for this day. They’re getting ready for a doctor’s appointment.
Mia:
Yes. Can you put that away?
Laura Barron-Lopez:
But that appointment is in Albuquerque, New Mexico, more than 600 miles from their home here in Austin, Texas. It is a journey they are making because Rhyan is trans.
This is something that you didn’t just decide one day. You felt this for a long time?
Rhyan:
Yes. I was really young. I was — like, I was 6, and I knew for sure that I was not a girl.
Mia:
He was always a dude. He was always a little dude. And then, right before he came out, he cut his hair, and looking back on it now, like, cutting all those curls off and everything, like, I can see how his — he was starting to align.
And it just in hindsight makes it way more clear than it was at the time. But, yes, he’s always been who he’s been.
Laura Barron-Lopez:
Rhyan saw doctors and therapists for years before starting medication around the age of 10 to temporarily pause the effects of puberty.
A few years later, he began testosterone treatments, which can lead to things like hair growth and a deeper voice. All those steps fall within guidelines for gender-affirming care, which is supported by major U.S. medical associations, including the American Academy of Pediatrics.
But around the globe, medical experts and government health officials haven’t been in complete agreement. Gender-affirming medical care for minors has come under increased scrutiny.
State Sen. Ben Adams (R-ID):
If they really feel that their best choice is to mutilate themselves, they better wait until they are an adult.
Laura Barron-Lopez:
As conservatives, from local lawmakers to the Republican presidential nominee, have used it to mobilize their base.
Donald Trump, Former President of the United States (R) and Current U.S. Presidential Candidate: Can you imagine you’re a parent and your son leaves the house, and you say, Jimmy, I love you so much, go have a good day in school, and your son comes back with a brutal operation? Can you even imagine this?
Laura Barron-Lopez:
Lies spread by former President Donald Trump and others in his party about things like surgeries on minors have helped fuel a wave of state legislation.
In 2021, Arkansas became the first state to ban transition-related medical care for those under 18. Since then, restrictions have passed in 25 more states, home to 40 percent of the nation’s trans youth, including Texas. It’s law went into effect last September. It revokes the licenses of doctors who provide gender-affirming medical care to minors and requires anyone on treatment to be weaned off.
Mia:
It was terrifying. Like it was, immobilizing, immobilizing.
I pounded the pavement. I knocked on doors. Like, I did my best as, like, a mom and as a constituent to the plea my to plea my case and plead our family’s case. I watched experts get disregarded and dismissed. I watched facts and evidence be ignored. And they voted for it anyways.
Laura Barron-Lopez:
What’s your message to those lawmakers who passed that ban?
Rhyan:
You don’t know the people you’re affecting. You don’t know how much of a, like, impact it has on them, how dangerous it is.
Laura Barron-Lopez:
As the measure moved through the Texas legislature, Rhyan and Mia were told his doctor couldn’t see him anymore. They lost access to his prescriptions and had to stretch the medicine they did have as long as possible.
Mia started looking for care in other states. But between the cost of travel, the appointment, and the medicine, they couldn’t afford it.
Mia:
There’s no way. I’m already, like, barely, barely scraping by. I don’t have — actually, if my car breaks down, I don’t have extra funds. And there’s days where I have to — like, I had to choose between, like, gas or food. And there’s days I went hungry so my kid could eat.
Laura Barron-Lopez:
Mia ultimately connected with the Campaign for Southern Equality, a nonprofit focused on LGBTQ rights. Its Trans Youth Emergency Project helps families cover the costs of travel for out-of-state treatment.
Mia got Rhyan an appointment at a University of New Mexico clinic in Albuquerque. But she still didn’t have enough money to cover the entire cost of the trip. Enter Elevated Access, whose volunteer pilots fly patients living in places with abortion or gender-affirming care bans to out-of-state appointments for free.
A pilot we’re just calling Clyde to protect his identity volunteered to fly Rhyan and Mia from Austin to Albuquerque in his Cessna.
Clyde, Pilot:
The biggest surprise for me is how I reacted emotionally to this need. It just seems so political, so ridiculous because it was political.
Rhyan:
I think it’s stupid. We shouldn’t have to take a private plane to go to a fully different state for some little vials of medicine, a shot. And I don’t think old men should be making laws about something that doesn’t affect them at all.
Mia:
Our pilot, the people that go out of their way to risk it, that are risking their livelihoods or putting themselves at risk for no reason, they’re just — they’re kind, and they understand what’s at stake. And that’s the part that — it gets to me. It gets me in my heartstrings.
Clyde:
And I will see you tomorrow maybe.
Mia:
Oh, thank you. Oh, yes, for sure. Thank you very much. really appreciate it.
Clyde:
Rhyan, give you a hug.
Rhyan:
Thank you.
Mia:
You’re our hero today, for sure.
(Crosstalk)
Laura Barron-Lopez:
The next morning, Rhyan and Mia arrived for their appointment with Dr. Michele Hutchison, a pediatric endocrinologist. About half her patients are now from Texas.
Dr. Michele Hutchison, University of New Mexico Health: I hate that this is happening to my families. Being transgender is hard. Transitioning is hard. And then you’re doing all of this in the background of everybody coming at you and telling you that it’s wrong. How would you not have anxiety? How would you not have depression?
This is — it’s just a mountain to overcome.
Laura Barron-Lopez:
And there are new obstacles. Texas’ attorney general has tried to access medical records of trans patients getting care out of state. Trans Texans can no longer change their gender on birth certificates or driver’s licenses.
Meanwhile, the U.S. Supreme Court is set to decide whether bans like the one in Texas are constitutional.
Donald Trump:
Transgender insanity the hell out of our schools.
Laura Barron-Lopez:
And Mia says that, if Trump is reelected, she will move her family out of the country.
Mia:
The stakes are high. It is that scary. I want to — yes. No, I wouldn’t stay. How — how could I do that in good faith and be a good parent?
Laura Barron-Lopez:
But, for now, Rhyan’s care moves forward. Dr. Hutchison said Rhyan was handling his treatment well, gave him a new testosterone prescription, and scheduled a follow-up appointment for six months.
Rhyan:
I’m excited. And now we have, like, plans set in place, and like, resources available. I’m happy.
Mia:
I love you. Yes, today’s a good day. I have been emotional all morning. But it’s a good day. This is happy tears. I’m just — I’m overwhelmed with gratitude.
Laura Barron-Lopez:
They went to a pharmacy nearby to fill the prescription.
Mia:
Thank you very much.
Laura Barron-Lopez:
A moment of relief amid near-constant struggle.
For the “PBS News Hour,” I’m Laura Barron-Lopez.