Liz hoped things wouldn’t get to this – however she knew it was a long shot with Texas Lieutenant Governor Dan Patrick and Governor Greg Abbott signaling their support of a slate of anti-trans bills – so she began planning.

As Senate Bill 14, proposed legislation that blocks access to gender-affirming care for minors and penalizes those providing it, made its way through both the House and the Senate – she made a decision.

Liz would move with her nine-year old daughter, Cal and her younger son Collin, to her parents' house in Southern Illinois where Cal wouldn’t have to worry about her ability to get the care she needed.

However, there was a problem with this plan: Liz’s husband, Eugene (the family declined to have their real names' used in this article) would stay behind to continue to work as a teacher in Texas.

This plan may now become a reality, as the bill is on its way to Abbott’s desk where it will likely receive approval. Although Liz wants to wait and see what could occur in the coming weeks, if the law stands, they will move in a month or so.

“How do I prepare my kids to move across the country in two or three months?” Liz said. I can’t tell them to say goodbye to their friends at the end of the school year yet, because I don’t know for sure when or what we are going to do.”

Difficult Decisions Ahead

As families across the state face the same decision as Cal’s; Equality Texas, the Transgender Education Network of Texas and other political advocacy and LGBTQ support organizations are working together to connect families with the resources and assistance they need.

Johnathan Gooch, communications director of Equality Texas, said alongside these local community partners, they are trying to find ways to help lift the financial burden of families who want to move, but may be unable to afford it.

“When this bill becomes law – because it likely will – it will force a lot of people to make a lot of difficult decisions,” he said. “We want to do everything we can to make those decisions and those big life transitions as smooth as possible.”

Liz said one thing that keeps her going, is knowing that her family is in a unique situation. They have people to turn to and do not have to go through this alone.

“We are privileged to have a safe place, we’re surrounded with a lot of support throughout this whole process and that’s what I have to keep in the forefront of my mind,” she said.

Liz, who is a mental health provider,  knows that this is not the case for everyone having to navigate similar obstacles and sees the direct impact on a daily basis in the work she does.

“Just by debating these things – there is trauma associated with it,” she said. “This past weekend, on top of my emotions, I was getting a lot of texts from my clients. They’re worried about their health care or their friends or family members, it’s just a lot.”

And For Those Who Stay?

Dr. Bhavik Kumar, medical director for primary and transgender care at Planned Parenthood Gulf Coast, said he is most concerned about what will happen to those who stay in Texas.

Although his patients are 18 and up and will not be directly affected by this proposed legislation becoming a law; he said they view this as a warning sign of what could come next.

“We’ve seen reproductive health care on the line, we are seeing contraception questioned, we are seeing this now,” Kumar said. “Once politicians feel like they can interfere with what health care people can and cannot access the list can go one from there.”

According to Kumar, it is already common for him to hear from patients that they have accessed this care on their own at one point or another, because they were scared or hesitant to talk to their health care provider.

Gender-affirming care is regulated and safe, but when it is unregulated it may be potentially unsafe – as patients may or may not be receiving routine blood work that may be required or do not not know exactly where medications they use come from, he said.

And restricting access to care does not make the need for it go away; instead, it increases the risk of physical and mental health issues, “When this care is not available, people’s lives will be at a limbo to the point where some people may consider taking their own lives and that is why this care is so important, because we can avoid this,” Kumar said.

In 2021 alone, the Trevor Project, a nonprofit organization focused on suicide prevention for LGBTQ youth, reported receiving 3,900 total crisis calls, texts and chats from transgender or nonbinary youth.

“For me, as a physician who prioritizes the health, safety and well-being of my patients, this is a slap in the face and in opposition of everything I stand for and what I want for the people I am trying to take care of,” Kumar said.

Kumar is also concerned for current health care providers such as himself, and what the ever-changing political landscape could mean for their ability to practice this care.

Just last week, Dell Children’s Medical Center in Austin announced that all the physicians who had previously staffed their adolescent medicine clinic would be leaving.

This decision came after Attorney General Ken Paxton said the state would be launching an investigation because of claims they received that the healthcare center was engaging in “potentially illegal” activity based on a video report by a far-right activist group allegedly showing a Dell Children’s social worker saying the hospital provides certain gender-affirming treatment for patients “as young as eight, nine."

This investigation was launched despite Senate Bill 14 not yet officially a law.
“Now we’re seeing attacks on places that have provided this care and this is really just another political maneuver – likely to be unfounded. State officials have done this for a long time, starting with those who provide abortion care,” Kumar said. “It’s really fear mongering and attempting to silence people that are vocal and speaking out in opposition to things that are harming them.”

Kumar said in speaking with some medical students who are in schooling or training in Texas, future providers are also affected by these law makers’ efforts, as most that want to pursue this healthcare will be unable to gain exposure to it.

“This is really concerning because the effect of this will not just be immediate, we will have an entire state with a healthcare system that does not have education on trans people and trans-care,” he said. “A whole group of providers are not going to understand this community, what their needs are and how these medications work or what they can do during an emergency.”

What Comes Next

Gooch said there is one final step for this proposed legislation, where it will go to Abbott to receive his veto or approval – which he will make official by signing it into law.

As this process is underway, another way Equality Texas is assisting those in need is by working to update and keep them informed with what comes next, “We are putting in effort to build a plan that is developing,” he said.

And despite this year’s legislative session ending soon, Gooch advises those to remember which lawmakers voted for the passage of SB14 – as several Democrats broke from majority party support against the bill.

On Thursday morning – after the Senate approved the House’s changes to the bill which would allot time for minors currently receiving care to gradually get off their medications – the American Civil Liberties Union of Texas, Lambda Legal and the Transgender Law Center announced they would be filing a lawsuit against Texas over the bill.

Based on Junk Science

Although Liz hopes that her family may be able to reunite if they choose to move away soon after they leave – she knows everything is up in the air.

“I am just tired of this constant crap, that’s what it is – it’s crap,” she said. “They’re basing all of this off of junk science and people that are on their side that are reporting problems that we are not having here in Texas. We shouldn’t have to leave our home for this.”
“I just remember that they’re (the law makers) the ones that don’t know anything about this, then I feel okay, you can’t be bitter if you don’t understand,” Cal said. “But I do want to go to the Capitol, I want to talk to them about how I feel and how they don’t feel.”

When Cal asked her mother if she could go testify, Liz reminded her that testifying was over. Although she had told Cal about the status of the bill and what this meant – Cal started to tear up, causing Liz to also.

“These are the things we go through. I feel like I’ve explained something, but then there is one part that was missing,” Liz said.

“These bills take up so much of our joy – I come home on Friday, and I am listening to the Senate – like who wants to do that?" Liz said.

“I would rather be there (Illinois) than here right now,” Cal said. “But this has been here – my life
and my everything.”