Texas Governor Greg Abbott speaks at the annual National Rifle Association (NRA) convention in Dallas, Texas, May 4, 2018. (Lucas Jackson/Reuters)

Governor Greg Abbott on Tuesday ordered the Texas Department of Family and Protective Services (DFPS) to investigate doctors and parents who enable a child’s gender-transition surgery.

Abbott’s direction comes after DFPS confirmed in August that gender-transition surgery on children constitutes child abuse when Abbott asked the department to issue a determination on the matter.

Texas Attorney General Ken Paxton also said earlier this week that gender-transition procedures, including hormone therapy, puberty blockers and sex reassignment procedures, are abuse under existing Texas law.

Abbott wrote in a letter to DFPS on Tuesday directing DFPS to “conduct a prompt and thorough investigation of any reported instances of these abusive procedures in the State of Texas.”

The governor writes that the attorney general’s opinion “makes clear, it is already against the law to subject Texas children to a wide variety of elective procedures for gender transitioning, including reassignment surgeries that can cause sterilization, mastectomies, removals of otherwise health body parts, and administration of puberty-blocking drugs or supraphysiologic doses of testosterone or estrogen.”

“Texas law imposes reporting requirements upon all licensed professionals who have direct contact with children who may be subject to such abuse, including doctors, nurses, and teachers, and provides criminal penalties for failure to report such child abuse.” Abbott wrote.

The letter was also sent to other Texas agencies, including the Texas Health and Human Services Commission, the Texas Medical Board and the Texas Education Agency.

DFPS commissioner Jaime Masters wrote in an August letter to Abbott, “Genital mutilation of a child through reassignment surgery is child abuse. This surgical procedure physically alters a child’s genitalia for non-medical purposes potentially inflicting irreversible harm to children’s bodies.”

Masters cited Section 261 of the Texas Family Code that prohibits parents from imposing substantial physical harm onto their children. 

The commissioner added at the time that anyone who believes a child has undergone gender-transition surgery must report it to the DFPS and that all allegations involving the procedure on minors will be taken seriously and investigated.

Her letter noted that the surgical procedure may not constitute child abuse in cases where it is medically necessary, including for a child whose body parts have been affected by illness or trauma; who is born with a medically verifiable genetic disorder of sex development, such as the presence of both ovarian and testicular tissue’ or who does not have the normal sex chromosome structure for male or female as determined through genetic testing.

In addition to Abbott’s directive, the Texas attorney general launched a probe in December into Endo Pharmaceuticals and AbbVie Inc., two pharmaceutical companies that allegedly advertised puberty-blocking drugs for transgender children, though the drugs were not FDA-approved to treat gender dysphoria.

“The manufacture, sale, prescription, and use of puberty blockers on young teens and minors is dangerous and reckless,” Paxton said in a press release in December. “These drugs were approved for very different purposes and can have detrimental and even irreversible side effects. I will not allow pharmaceutical companies to take advantage of Texas children.”

“The OAG has the authority to investigate false, misleading, and deceptive conduct by businesses in Texas, and to take legal action to enforce the Texas Deceptive Trade Practices Act,” he added.

Paxton accused both companies of pushing hormone blockers for “unapproved uses without disclosing the potential risks associated with these drugs to children and their parents.” 

A spokeswoman for Endo Pharmaceuticals denied that the company has promoted the medications in question — Supprelin LA and Vantas — for off-label uses in a statement to Fox News at the time.

Supprelin LA and AbbVie Inc.’s Lupron Depot are approved to treat children with Central Precocious Puberty (CPP), when puberty begins at an abnormally early age. Meanwhile, Vantas is only approved to alleviate prostate cancer symptoms.

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