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'We're going to miss Texas': Trans patients consider options after Dell Children's shake-up

A person sitting at a kitchen table with their hand covering their face
Patricia Lim
/
KUT
Leonardo, 19, has received gender-affirming care from the adolescent medicine clinic at Dell Children's since he was 17. He said he worries about finding a new clinic, although it will remain legal for him to receive hormone treatments if Senate Bill 14 becomes law.

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When Chantel saw the news that the physicians staffing the adolescent medicine clinic at Dell Children’s Medical Center were departing, her first reaction was bewilderment.

“I was like, ‘That can’t be right," she said. "That’s my clinic. That’s where our doctor is."

But a quick check of the client portal used to manage appointments seemed to confirm the news; the information page for her son's doctor was already gone.

Dell Children’s confirmed Saturday that the doctors staffing the clinic were “departing,” but said the clinic would remain open with support from other staff. Although hospital representatives did not offer a reason for the change, it followed a May 5 announcement from Attorney General Ken Paxton that he would investigate the hospital’s gender-affirming care practices.

Chantel, who requested KUT withhold her last name due to safety concerns, had already considered the possibility that her family might need to move in order to maintain access to her teenage son Juniper’s gender-affirming care. She had been rattled by Paxton’s move last year to investigate parents of trans children for child abuse and was watching the progression of Senate Bill 14, which would outlaw certain kinds of care, such as puberty blockers and surgery. The bill passed the Legislature on Wednesday and is headed to Gov. Greg Abbott's desk. The ACLU of Texas vowed to sue the state over the measure.

Chantel and her husband visited Colorado over spring break to scope out a possible move — but they had thought they had more time to consider their options.

Since losing access to care at Dell Children’s, their plans have accelerated. Chantel’s family is working on putting their house up for sale, and she is contacting clinics in Colorado to find a new provider for her son. They are considering whether Chantel’s husband and their younger child will stay behind in Texas at first while Chantel and Juniper find short-term housing.

The providers at the clinic had guided Chantel’s family through what she described as a “long, slow journey” to establish a course of care for Juniper, and losing long-built relationships with physicians felt destabilizing.

“To say the least, I’m shell-shocked,” Chantel said. “I don’t really know what to do. I’m scrambling.”

Processing the news

KUT spoke to eight patients and parents of patients who received some kind of hormone-related care at Dell Children’s adolescent medicine clinic. Like Chantel, most requested anonymity or for only their first names to be used due to safety and privacy concerns.

Among those patients, some received communication from the clinic directly about the doctors’ exit; others, like Chantel, heard the news secondhand. Rumors spread on social media in the week following Paxton’s announcement that the clinic had shut down entirely. Dell Children’s dispelled this, but confusion persists about whether doctors left voluntarily or were fired; physicians did not respond to requests for comment by KUT.

“We’ve had two suicide attempts because of hormonal imbalances. It’s like, I’m just trying to keep my kid alive, you know?”

Mother of a patient at Dell Children’s adolescent medicine clinic

A mother named Elizabeth said she had been trying to get ahold of the clinic for days when she received an email from her 12-year-old’s doctor May 11. The doctor said she and the clinic's other doctors were “mutually parting ways” with Ascension, the organization that owns and operates Dell Children’s.

Elizabeth’s child, who uses the pronouns they and them, had been receiving period suppression medication to treat a hormonal imbalance that resulted in severe emotional challenges during their cycle. While the child was considering their gender, Elizabeth said that was not the primary reason for their treatment.

“We’ve had two suicide attempts because of hormonal imbalances,” Elizabeth said. “It’s like, I’m just trying to keep my kid alive, you know?”

The parent of a 12-year-old on puberty blockers and low-dose estrogen said she had talked with her doctor in previous weeks about the possibility that SB 14’s passage would halt gender-affirming care at the clinic.

“We had a discussion about that, and they said, ‘Yeah, this legislation is going to pass, and we’re assuming we’re going to have to close," the woman, who wished to remain anonymous, said.

Still, news of the clinic’s shake-up came as a surprise to the mother. So did Dell Children’s response to Paxton’s investigation. The hospital said it prohibited surgery and prescribing hormone therapy for children with gender dysphoria, and that its pediatric and adolescent medicine clinics “did not provide these interventions.”

This statement, the mother said, was at odds with her experience. She said she had dealt exclusively with “trans-accepting” staff at Dell Children’s and that the treatment her daughter received appeared to be typical for the clinic.

“It's inconsistent with what we received, which was gender-affirming care that was consistent with the law,” she said. “Nothing felt anything but above board.”

Seeking new care

The mother says she’s lined up a new doctor for her daughter in New Mexico and is deciding whether to travel for appointments or move.

Dell Children's offered some patients a list of clinics where they might seek care in the future, including spots in Texas and other states. Several patients also received a final prescription refill.

But many patients expressed concern about their ability to find new providers among limited offerings, even young adults who could legally continue to receive care in Texas if SB 14 becomes law. Nineteen-year-old Leonardo was notified by his social worker that his doctor was leaving Dell Children’s on the same day Paxton announced his investigation. While looking for a new provider, Leonardo discovered other clinics often had wait times of at least three months. He said he fears those clinics will be inundated by calls from young adults who are losing their doctors.

“We’re all trying to go to the Kind Clinic or trying to find these specific [doctors],” he said. “If we're all flooding in and it's already three months to six months, where are we going to get our care?”

Leonardo first began hormone therapy at Dell Children’s when he was 17. Now an adult, he says stress about the safety and ease of living in Texas as a transgender person has affected his mental health.

“I have attempted to be my authentic self, but in recent years it's been even harder to really flourish,” he said. “Even if they’re targeting children, it still affects all of us.”

Leaving Texas

Although SB 14 applies only to minors, several young adult patients and parents of young adult patients told KUT they plan to move, fearing they will face barriers to health care and safety in the coming months and years.

A 25-year-old transgender man who began receiving testosterone treatments from Dell Children’s when he was 20 has been able to make an appointment with a new provider in Texas and will legally be able to continue to receive hormone therapy as an adult. But he and his wife still plan to move to Washington state, which has passed recent laws aimed at protecting transgender people.

He said he feared Texas might pass a “bathroom bill,” like the one recently passed in Florida requiring people to use bathrooms that match their gender assigned at birth.

“Having to risk a year in prison every time you use the restroom would make that trip inherently unsafe,” he said. “It’s a long drive out of Texas.”

He is able to do his engineering job remotely, and he and his wife are considering having children, so he said it feels like the right time to move. As a born-and-raised Texan, the decision wasn’t an easy one.

“We’re going to miss Texas, our community, bluebonnets, H-E-B, good brisket, and most of all the opportunity to continue advocating for other trans Texans here,” he said. “But leaving still feels like a huge weight off.”

Disclaimer: Dell Children's is a sponsor of KUT and KUTX. Sponsors have no influence over the stations' editorial content.

Olivia Aldridge is KUT's health care reporter. Got a tip? Email her at oaldridge@kut.org. Follow her on X @ojaldridge.
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