Bexar County District Attorney Joe Gonzales will not prosecute families, medical professionals or teachers who support gender-affirming care for children as abuse, defying directives from two of the state’s top Republicans.

In a statement Thursday, Gonzales, a Democrat, said his office will focus on “matters where there is demonstrated child abuse and neglect.”

“Politicians should stop inserting themselves into medical care decisions that are best left to doctors and patients,” he said. “Our office would not prosecute the family members, medical professionals, teachers and others who provide medical care, unconditional love and emotional support for this vulnerable population.”

Texas Attorney General Ken Paxton issued a nonbinding legal opinion Friday, stating that certain gender-affirming care for children, such as gender reassignment surgery and puberty-blocking medications, constitute child abuse under the law.

Gov. Greg Abbott followed on Tuesday by directing state agencies to conduct “prompt and thorough” investigations into the use of gender-affirming care for transgender youth. He said doctors, nurses and teachers must report instances of child abuse and that the law provides criminal penalties for failing to report “such child abuse.” There are similar penalties for the general public, he wrote.

Gonzales joined other Texas officials who said they would not follow Abbott’s directive. Harris County Attorney Christian Menefee, another Democrat, said in a tweet that his office would not participate “in this political game.”

In a statement, Harris County District Attorney Kim Ogg said she would not prosecute anyone for providing medically appropriate care.”

“As a member of the LGBTQ community myself, I am particularly sensitive to the invidious nature of this order—it turns family members against each other at the expense of their children,” she said. “It is a remnant of a hateful past that I had hoped our society had matured beyond.”

Republican legislators attempted to pass a bill last year that would have classified the gender-affirming treatments for children targeted by Abbott and Paxton as child abuse. The Texas Senate passed Senate Bill 1646, but legislation in the House died in committee.

Brian Klosterboer, staff attorney at the ACLU of Texas, said in a statement that Paxton’s opinion has no legal impact and does not change the “constitutional rights of Texas families.”

“But they spread fear and misinformation and could spur false reporting of child abuse at a time when [the Texas Department of Family and Protective Services] is already facing a crisis in our state’s foster care system,” he said “The law is clear that parents, guardians and doctors can provide transgender youth with treatment in accordance with prevailing standards of care. Any parent or guardian who loves and supports their child and is taking them to a licensed healthcare provider is not engaging in child abuse.”

Major medical associations, including the American Psychological Association and the American Academy of Pediatrics, support the use of gender-affirming care for transgender youth.

Maddie Deutsch, president of the U.S. Professional Association for Transgender Health, said in a statement that the group strongly opposes Abbott’s directive to investigate this treatment as child abuse.

“Identifying these treatments and interventions as ‘child abuse’ is not based on any evidence and will only bring about harm and disruption to these children and their families,” she said in the statement.

This article has been updated to reflect that Christian Menefee is the Harris County attorney, not the district attorney.

Brooke Crum

Brooke Crum is the San Antonio Report's education reporter.