Earlier this year, when a bill denying minors access to gender-affirming care, including puberty blockers and hormone therapy, was filed by several Senate Republicans in the Texas Legislature, a Houston mother of two began preparing for the worst. “We started having to make a ‘what-if’ plan,” she said. “What if this actually does pass?” Hannah—which is not her real name, as she requested anonymity to protect her family from those who might harass it—has a thirteen-year-old daughter who is transgender and receives gender-affirming care. This spring, Senate Bill 14 passed both chambers. In June, Governor Greg Abbott signed the bill into law. 

The law doesn’t take effect until September, but the medical support that Hannah’s daughter was receiving in Houston was interrupted days before the bill even passed, when it became apparent that it would. “It was canceled on us literally a day or two before an existing appointment,” Hannah said. 

Across the state, many doctors who provide transition-related care have stopped offering medical treatment out of fear of losing their jobs or getting sued. Several have already shut down their clinics, with some doctors also electing to leave the state. Treatment for gender dysphoria is widely supported by the medical community, and it can be lifesaving for transgender youth, who face increased risk of suicide. The American Academy of Pediatrics has repeatedly spoken out against legislation that limits access to gender-affirming care, calling it a threat to the health and well-being of transgender youth. This month several parents and medical providers sued the state to block SB 14 before it takes effect this fall, arguing that the bill violates parental rights and discriminates against transgender youth. 

“Before the bill passed, I kind of started the phases of grieving. I knew it was coming. I was already prepared,” Hannah said. In March Hannah started touring schools in Los Angeles. Hannah had immediate family living there, and her daughter would be able to receive the gender-affirming care she required. But moving to California would mean that Hannah would have to leave behind her aging parents, for whom she is the primary caretaker. She also worried about getting by in a city where the cost of living is at least 38 percent higher than in Houston. Hannah works part-time and her husband, who works in the energy industry, is the family’s primary earner; he doesn’t have the flexibility to work remotely.

But staying in Texas was not an option. “We can’t stay here and know that our child isn’t fully supported or that she would be denied medical care,” said Hannah, whose daughter has expressed that she was a girl since she was old enough to talk. “We were parents that did not understand what was going on at the time,” Hannah said. “But our child was very, very insistent on who she was.” After consulting with doctors and therapists, they decided to support her transition. Now her daughter’s medical support is being taken away. 

Earlier this month, she and her two children moved to Los Angeles. But her husband stayed behind. “It’s been very devastating for us to have to separate our family,” said Hannah, who is currently looking for full-time work in Los Angeles. Her husband is also looking for work there but doesn’t know when he will be able to join them. “What if it takes years to find an opportunity that makes financial sense for him?” 

In addition to Texas, nineteen other states have restricted gender-affirming care for minors. Now many parents of transgender youth are making the same hard choice as Hannah and her family: Stay or go? For transgender families in Texas, this decision has been a long time coming—starting with the “bathroom bill” in 2017, which would have regulated bathroom use to keep transgender Texans from using restrooms that aligned with their gender identities. The bill died, but in each legislative session since, a slew of anti-LGBTQ bills has made its way through the Capitol, driven, at least in part, by the perception that antitrans legislation would animate conservative voters. In 2021 Governor Greg Abbott signed a bill into law prohibiting K–12 trans athletes from participating in sports teams that aligned with their gender identities. A version of Senate Bill 14 surfaced that session, too, although it died out of committee. 

Then, in February 2022, Abbott ordered the Department of Family Protective Services (DFPS) to launch child-abuse investigations into families of trans children who reportedly received transition-related care. Abbott’s directive followed a legal opinion by now-impeached attorney general Ken Paxton, who said that gender-affirming care constitutes child abuse, inaccurately comparing it to the forced sterilization of minors. Similar to Texas abortion laws that put the onus on the citizens to report their fellow Texans, the directive allowed essentially anyone to allege abuse against the parent of a trans child. 

In 2021, Lisa Stanton’s son ran away from sleepaway camp. It was through this incident, which was investigated by Child Protective Services, that Stanton discovered that her family had been previously reported to the state for “trans-ing” their other child, she said. The following year, after the governor directed DFPS to investigate the families of trans children, Stanton, who lives in Houston and actively advocates for LGBTQ rights, was afraid that someone in her community would inform on their family again. “We had to print cards to put in our children’s backpacks with their own attorney’s name, with instructions on what to do should DFPS show up at school and pull them out for questioning,” said Stanton, who cried throughout our interview. “The fact that we had to secure their own legal counsel that represented them and not us was probably one of the most traumatic things I’ve been through.”  

Parents of trans children, including Stanton, and the American Civil Liberties Union filed a lawsuit alleging the governor and commissioner of DFPS had overreached their powers, which resulted in a series of temporary injunctions that blocked the governor’s directive. Since Abbott issued the directive last year, there have been a total of sixteen reports that led to fifteen total child-abuse investigations, according to data provided by DFPS. No children have been removed from their homes. Trans families expressed concerns that as a result of the new law, those investigations will once again resume. The Office of the Attorney General and the governor’s office did not respond to a request for comment. 

Although they were ultimately never investigated, Stanton didn’t see how she and her family could go on “living in a state where your governor and attorney general label you a child abuser,” she said, adding, “I don’t want to live in this state of terror anymore.” 

But it wasn’t until the passage of SB 14 that she and her family pulled the rip cord and made the decision to move to Colorado. Stanton works remotely, and her husband was able to find a job with a company that would allow him to work out of state. Given last year’s reversal of Roe v. Wade and the Supreme Court’s conservative majority, Stanton said she still doesn’t feel safe. “In the back of my mind, the next thing—even though we’ll be in Colorado—is laying a plan in case we need to leave this country.” 

Stanton acknowledged that she has the advantage of being able to leave; not everyone has that same privilege. “That’s not to say this hasn’t been financially devastating for us, because it’s wiped out our savings,” she said. “But we had savings. Think about people living paycheck to paycheck. . . . We were lucky.”

When I spoke to Hannah shortly after her and her children’s move to Los Angeles, she said they’d been adjusting to a major lifestyle change from Houston, where she and her husband “worked hard to build a beautiful home” for their family. Because they couldn’t afford to maintain two households, Hannah had rented a one-bedroom apartment without air-conditioning and was sleeping on the living room couch so her kids could have their own space. “We took what we could get,” she said, adding, “It’s been the hardest for my kids.”

For some, leaving Texas is simply not an option. Evelyn—a pseudonym—and her husband’s nine-year-old daughter is transgender, but Evelyn shares custody of her older daughter with her ex-husband in Austin. “It really puts us in a very complicated situation. If we need to move out of the state, that means that my older daughter would stay here with her dad and I would go from seeing her all the time to seeing her, you know, like summer and spring break,” Evelyn said. “That’s a deal-breaker for us.”

For now, Evelyn’s trans daughter is young enough that she doesn’t require gender-affirming medical care. But Evelyn also worries that the state’s child-abuse investigations will resume as a result of the new law. “If CPS weaponizes this to come after families and we start hearing that families are actually getting split apart, that’ll be the deal-breaker,” she said. “Most likely my husband and my younger daughter would get out of the state. I would stay here with our older daughter so she can finish high school.” 

She hates the idea of splitting up her family, but she believes it’s preferable to being targeted by the state. “It’s really devastating to think, ‘We don’t have to move because we’ve got some great opportunity elsewhere,’ ” she said. “This is like having to flee.”