Republican Gov. Greg Abbott heads into Texas primary with an anti-transgender directive at odds with his parental rights advocacy

• Abbott says parents should be the "primary decision-makers" for their children's health and education.
• But that doesn't include all parents — or all types of health care, his recent directive shows.
• He wants parents investigated for child abuse if their trans children receive gender-affirming care.

Texas Gov. Greg Abbott has said parents should be the "primary decision-makers" for their children's education and health care. But that doesn't include all parents – or all types of healthcare, his latest actions indicate.

The Republican governor, who faces a primary election Tuesday in his bid for a third term, wants state authorities to investigate parents for child abuse if their transgender children are receiving gender-affirming medical care. 

Abbott's February directive came a month after he unveiled a "Parental Bill of Rights," which he said would amend the state Constitution to "restore parents as the primary decision-makers over their child's education and healthcare."

"For Greg Abbott, all parents are not created equal," James Henson, director of the Texas Politics Project at the University of Texas at Austin, told Insider. "I think that's evident in those two positions."

The Abbott directive highlights a red line for conservatives: They are positioning themselves as "the party of parents" this campaign season when it comes to parents' concerns about controversial books or the teaching of race and gender in the public education system. But they aren't willing to defer to parents when it comes to their concerns about transgender health.

"I think their version of a parental rights bill excludes parents of trans kids," said Ricardo Martinez, CEO of Equality Texas, an LGBTQ-advocacy group. "It's for everyone except parents of trans kids or folks that do not align directly to their vision of what Texas should be."

Abbott's move comes as Republicans nationally have been promoting parental rights in education after the issue helped Republican Glenn Youngkin flip the governor's mansion in Virginia from blue to red. House Republicans pushing a parents bill of rights, pitting parents against public schools, say parents have a "God-given right to make decisions for their children." 

Abbott unveiled a similar bill at a campaign event in January, touting as pro-parent his decisions to ban mask mandates for students and the teaching of critical race theory in schools. As governor, he said, he has "fought to defend the rights of parents, whether it comes to education or health care."

Not unique to Texas

Abbott's transgender policy isn't unique to Texas. There are currently more than two dozen bills — mostly led by Republicans — in more than a dozen states that would deny gender-affirming medical care for transgender youth, according to the Equality Federation.  

In Arizona, state Senate Republicans just pushed through a measure to prohibit gender reassignment surgeries for minors. The Alabama Senate also approved legislation to prohibit transgender minors from being given puberty-blockers, hormones, or surgeries to affirm their gender identity, and the bill's GOP sponsor called the treatments "child abuse."

Deeming "so-called 'sex change' procedures" child abuse under Texas law, Abbott urged the state's Department of Family and Protective Services in a February 22 letter to conduct a "prompt and thorough investigation" of reported instances of reassignment surgeries, puberty-blocking drugs, and hormone therapy for minors. 

Doctors, nurses, teachers, and members of the general public, are required to report "such child abuse" under Texas law, which carries criminal penalties for not doing so, he wrote.

"Texas law also imposes a duty on DFPS to investigate the parents of a child who is subjected to these abusive gender-transitioning procedures, and on other state agencies to investigate licensed facilities where such procedures may occur," he wrote.

A spokesperson for Abbott did not respond to a request for comment.

Texas lawmakers failed to pass legislation last session that would have classified gender-affirming care as child abuse. Abbott's directive cited a legal opinion from Texas Attorney General Ken Paxton. While Abbott is favored to win his primary, Paxton is in a tougher primary race and looks increasingly less likely to avoid a runoff election, Henson said.

"In the short term, certainly this is an issue that is going to play well with likely Republican primary voters," Henson said. Polling in October showed 45 percent of Republicans approved somewhat or strongly of how state leaders and the legislature have handled transgender students in public schools, which Henson said mainly concerns the state's new ban on transgender girls from participating in female sports. 

But Henson said Republicans have in some cases overreached on transgender issues, which are still relatively new to people. In the same poll, 39 percent of Republicans either didn't take a position or said they didn't know, Henson noted. "There's still evidence that the jury is out with a lot of folks and I expect this will continue to move," he said.

The Abbott directive has triggered a backlash. Five Texas district attorneys called it "cruel" and "part of a continued onslaught on personal freedoms" that they won't enforce, saying they won't "interfere with the medical decisions made between children, their parents, and their medical physicians."

The heads of the Texas State Teachers Association and National Education Association also blasted the directive in a joint statement: "No parent should worry that their child's gender affirming – and sometimes lifesaving – care is criminalized because of bigotry and misinformation."

Abbott's position on transgender medical care is not only at odds with his own statements on parental rights, but with major medical organizations that oppose state legislation prohibiting "medically necessary gender transition-related care" for minors.

Equality Texas fought 76 anti-LGBTQ bills in the state legislature last year — the most ever filed in any state in history, Martinez said. The state passed an anti-transgender sports ban that took effect in January. All of this is impacting trans children, who are being harassed and assaulted and who are increasingly calling crisis centers, he said. 

"It's just devastating to know that kids are going into hostile school environments every day," Martinez said. "And on top of that, you add this directive that forces kids to be on high alert in schools, not knowing that at any moment someone could call DFPS on them."