After Texas Bans Puberty Blockers and Hormones for Trans Children

WACO, Texas (KXXV) — When the Texas Legislature moved to ban puberty blockers and hormone therapy for minors in 2023, Colin Zicko was worried about trans teenagers.

Zicko, 22 at the time, knew what it was like to be a teenager seemingly trapped in the wrong body, desperate to stop the gender changes brought on by puberty and better align one’s physical features with the person inside.

(Texas Conservatives Plan to Further Restrict Trans Lives This Legislative Session)

He also knew what it was like to be denied that option. Assigned female at birth, Zicko came out as trans when he was a teenager. Without his parents’ permission, he couldn’t start puberty blockers or hormone treatment, ushering in what he calls the “tunnel years,” where darkness closed in, his mental health collapsed, and he considered death. suicide.

When he finally started hormone therapy as an adult, he felt like he could breathe again, the constant noise in his head about his body and gender presentation calming down enough to allow him to think. Zicko was angry that lawmakers were trying to take that peace away from teens whose parents supported their transition.

And then he got a call from his doctor.

“The nurse, her voice was broken and she was trying not to cry,” he remembers. “She said, ‘I’m sorry, but we’re going to have to stop taking care of you.'”

Even though he was an adult, Zicko’s doctor was at Dell Children’s Medical Center in Austin. In May 2023, all service providers suddenly left the clinic after Attorney General Ken Paxton opened an investigation, citing a video from Project Veritas, a right-wing activist group, that claimed the practice provided some gender-affirming care to patients as young as eight years old.

Zicko had two months of hormones left. Everywhere he called, there were waiting lists of months. As an adult, there are no laws preventing Zicko from accessing hormone treatment. But as he and other trans adults learn, the state’s hostility toward health care for trans minors has also significantly reduced their ability to access care.

“An attack on any trans person, regardless of age, is an attack on the entire community,” said Laura Terrill, CEO of Planned Parenthood South Texas, which provides transitional care for adults. “Even though the bans have focused on minors, which is heartbreaking, the impact that this has on adults, trans adults, is a shame and a stigma, and one wonders whether or not they will be able to continue to access health care. care they need and deserve.

Get out of the tunnel

As a young child in rural Louisiana, Zicko didn’t think much about gender. All the children played together, had the same interests and dressed the same.

He then moved to suburban Texas to live with his father.

“All of a sudden I was told I had to wear a dress. If I wanted to wear jeans, it was only while I was playing. I had to wear pink,” he recalls. “And very immediately, I felt bad.”

When Zicko was 14, he came out as trans to his family. Confused and frustrated, his father made him sew and wear a dress to prove he was a girl. Without his father’s permission to take hormones, Zicko began binding his breasts, eating foods he believed could increase his testosterone, and rapidly losing weight in an attempt to avoid puberty.

The more her body changed to resemble that of a woman, the worse her gender dysphoria, the distress someone can feel when their body does not match their gender identity. He began smoking marijuana and dissociated himself from reality as much as possible, unable to bear living in a body that seemed so foreign to him.

Colin Zicko on November 20, 2024. Credit: Jack Myer for The Texas Tribune When he was 19, he finally went to see a gender affirmation gynecologist, who put him in touch with doctors at Dell Children’s. They offered him not only transition-related care, but also a holistic experience: he met a dietitian who helped him after years of eating disorders, a phlebotomist who monitored his blood tests, and a wide range of other health care providers to help manage his chronic problems. terms.

Taking testosterone changed his physical appearance. It also calmed the anxiety and fixation on gender that had plagued him for years. Things that seemed so important to him, like what he perceived as girl’s hands, turned into normal-sized worry.

“Gender dysphoria is a lying little bitch,” he said.

After years stuck in the tunnel, Zicko emerged into the light and began living as the transmasculine person he always knew he could be. He found a job, started a community and reconnected with his father. He eventually gained his father’s support by framing the issue as one of personal freedom in the face of government surveillance, which seemed to do the trick.

“I know people who say if someone has ever been transphobic towards you, never forgive them,” he said. “But I’m very, very forgiving of people who have changed. People are just ignorant. Ignorance is not a sin.

Texas Tackles Trans Issues

Since Zicko came out, being trans in Texas has become both easier and harder. More and more people are coming out, creating more community, connections, and strength in numbers. But the reaction was fierce, particularly from conservative lawmakers in the Texas Legislature.

Texas, like most red states, has focused primarily on legislation about what children can do. They restricted this sports teams trans students can play, have tried to limit what they can be taught about gender and sexuality, and have banned minors from medically transitioning. Governor. Greg Abbott ordered the national child protection agency to investigate the parents of trans children, and Attorney General Ken Paxton brought investigations And lawsuits against the doctors who provided these services.

Although these efforts targeted trans children, the effects rippled across all age groups. Some doctors proactively left Texas, while others intended for the treatment of minors also treated adults, leaving these patients without providers.

Planned Parenthood South Texas provides gender-affirming care to adults at its clinics in San Antonio and the Rio Grande Valley. Demand has quadrupled since 2018 as more people make the transition with fewer doctors to care for them.

“There is so much misinformation from patients about what they can still access in Texas,” Terrill said. “A lot of our work is reassuring patients and making sure our patients know their rights. »

When Zicko’s doctors suddenly left Texas in the spring of 2023, he had two months of testosterone left. He called gender-affirming clinics and gynecologists in the Austin area, each with a longer wait list than the last. The earliest possible appointment was in October, six months away.

When his medication ran out, the old familiar darkness returned. His periods returned, his voice began to rise high again, and he felt his body change, bringing with it crippling physical pain. He was often unable to get out of bed, unable to go to work, unable to imagine that things would ever get better.

Desperate, he made another round of calls and was able to get a last-minute appointment with Planned Parenthood, where they stocked up on testosterone and set him up with a new care team.

“And thank God, because it got to the point where I couldn’t go another week,” he said. “I wanted to die, not because of my thoughts, but because I was in so much pain. »

He has since found a new job and moved in with his girlfriend. He is living a life he could never have imagined when he was a teenager. He is happy.

But he knows the fight is not over. Those months without care foreshadowed the pain and suffering transgender people could endure if conservatives got what they wanted, he said. The Texas Legislature will return in January, emboldened by new President Donald Trump, who has promised to embrace an aggressive anti-trans agenda. Zicko knows that more restrictions, more hostility, more debate about his right to live his life the way he wants are on the horizon.

His father offered to pay for him to move out of state so he could reliably access health care and perhaps feel safer. He knows trans people who left Texas, but he decided to stick it out.

“They want us to leave, because the more we leave, the fewer people there will be to fight,” he said, echoing a sentiment from his girlfriend. “But I want to stay. Because as long as there is a trans person in Texas, there will be trans people in Texas.

This article was originally published in The Texas Tribune has https://www.texastribune.org/2024/12/04/texas-trans-adult-care-diminishing/.

The Texas Tribune is a nonpartisan, member-supported newsroom that informs and engages Texans on state politics and policy. Learn more at texastribune.org.