Randell and his family are bracing for the worst-case scenario.
Over the past few months, the 16-year-old North Texas boy has watched 鈥� which would bar transgender youth like himself from receiving puberty blockers and hormone therapy 鈥� sail through the Senate and a House committee. The legislation would also ban transition-related surgeries, but they are rarely performed on kids. And on Tuesday, the bill could be up for a key vote in the lower chamber, where the legislation has more than enough support to pass.
鈥淚 am a really happy kid, and I have a really positive outlook on life,鈥� said Randell, who is usually quick to laugh. 鈥淭hat would push me past my breaking point.鈥�
That legislative progress means Texas, which has among the country鈥檚 biggest trans youth , is on the brink of joining other states in banning transition-related care for minors 鈥� treatment medical groups and LGBTQ advocates say is vital for a portion of the youth population at high risk for depression and suicide.
鈥淭he last appointment we went to, the endocrinologist didn鈥檛 start with, 鈥楬ey, how鈥檚 your medicine going?鈥欌�� said Kay, Randell鈥檚 mother. 鈥淭hey started with, 鈥楾he government鈥檚 probably going to shut down the clinic. Where will you go for your next appointment?鈥欌��
At the moment, Randell hasn鈥檛 completely worked out what he鈥檒l do next, though he is lining up options.
His doctor has connected him with an out-of-state clinic, and he still has enough supply of testosterone to last a few months. Though the family also worries about the possibility that they would have to uproot their lives so Randell could continue getting the hormone therapies he has been taking for years.
Kay is already planning to take on extra jobs this summer to save up for a potential relocation 鈥� something she said isn鈥檛 an option for all families. And she would have to move alone with Randell, leaving behind her husband so he could care for some of their older children with health needs. Kay and her husband have even considered divorcing, if that is what鈥檚 needed to make the plan work.
鈥淚t鈥檚 such garbage,鈥� Kay said. 鈥淲e鈥檙e both very angry about this. I think [my husband鈥檚] almost convinced himself that none of this will happen, but I worry too much.鈥�
Randell and Kay agreed to speak to The Texas Tribune if only their full names aren鈥檛 used because they fear being the targets of a child abuse investigation in the future.
Randell鈥檚 family is also hardly the only one in Texas 鈥� home to between the ages of 13 and 17 鈥� grappling with these difficult decisions. With four weeks left to go in the lawmaking session, LGBTQ Texans could see their lives upended in any number of ways, depending on which bills make it to Gov. 鈥檚 desk 鈥� and what shape they鈥檝e taken once they get there.
Among the litany of bills restricting the rights and representation of trans Texans , SB 14 has moved the furthest, already clearing the Senate and headed for the House floor. If the bill passes in its current version, it would require that trans Texans under the age of 18 already receiving transition-related care be 鈥渨eaned off鈥� of their treatments and eventually stop taking them.
Texas lawmakers pushing the prohibition have disputed the science and research behind transition-related care. They have also cast doctors who provide transition-related care as opportunists who put profit above children鈥檚 well-being and push life-altering treatments on kids who may regret taking them later in life.
鈥淥ur children need counseling and love, not blades and drugs,鈥� said state Sen. , R-New Braunfels, during a previous hearing on SB 14, which she authored.
Medical groups and several families with trans kids . They say transition-related care involves a lot of thoughtful decisions made over an extended period of time. And, they say, it鈥檚 vital to improving the mental health of a highly stigmatized and vulnerable part of the population.
鈥淚f we resort to a medical model that doesn鈥檛 offer a treatment that alleviates and helps with mental health, you could just imagine the impact it鈥檚 going to have on children and families,鈥� said Alfonso Mercado, a licensed psychologist and associate professor at the University of Texas Rio Grande Valley. He鈥檚 also the immediate past president of the Texas Psychological Association, which has publicly opposed the legislation.
In addition, many other bills working through the Capitol go beyond restricting trans kids鈥� access to transition-related care. And the state鈥檚 GOP opposes 鈥渁ll efforts to validate transgender identity.鈥�
Texas is hardly the only state pushing such legislation. Across the country, Republican-controlled legislatures are either considering or have already passed that ban transition-related care for kids, restrict educators from discussing gender identity and prohibit trans athletes from joining the sports teams that align with their gender. Social conservative groups have they are using trans rights as the new wedge issue to rally the Republican base.
At the same time, political experts like Joshua Blank said the topic is still a 鈥渧ery new issue鈥� for many Texas voters, and that most Texans an openly trans person. And recently redrawn political maps have also for the next decade.
鈥淭here鈥檚 no downside for most Republican elected officials to advance legislation that restricts the rights of transgender people,鈥� said Blank, director of research for the Texas Politics Project at the University of Texas at Austin, about electoral politics.
But for Texans like Randell and his family, who are caught in the clash of changing social and political winds, the stakes couldn鈥檛 be higher.
鈥淚t鈥檚 just cruel,鈥� Kay said.
鈥淎 house full of boys鈥�
For Randell, transitioning started slowly.
When he first came out at age 11, Kay and her husband didn鈥檛 rush into getting Randell transition-related care. The family hardly knew any trans people at the time and had thought that their child was possibly just going through a phase. But after doing research, meeting other parents of trans kids and talking about the issue in therapy, they started to change their mind.
Still, Kay said, they took small steps.
For the first few years, Randell was seeing a therapist as he transitioned socially by getting a new name at school, cutting his hair short and getting new clothes. It wasn鈥檛 until he turned 13 that he was able to change his name and gender marker on official documents 鈥� after which, he quickly bloomed. His mood lifted. His friend circle blossomed.
鈥淩ecognizing who he is, that was what made the difference,鈥� Kay said. 鈥淗e was such an angry kid before, and I don鈥檛 even know if he knew why he was so angry.鈥�
Then, as Randell considered starting hormone therapies, there was a year鈥檚 worth of conversations and official interviews with social workers, doctors and psychologists. Randell and his parents also needed multiple health care providers to sign off on the treatments. He eventually started the testosterone injections at age 14, beginning with a 鈥渢iny鈥� dosage and increasing it over time 鈥� a process that entails more doctor appointments and bloodwork. Since then, he said the treatments have only improved his quality of life. And the physical changes, starting from the shortest of chin hairs to growing a beard, thrill him.
鈥淚 have never once not liked the effects of testosterone,鈥� he said.
For Kay, his transition has been bittersweet, even as she supports his plan. In the first year, she was heartbroken 鈥� not so much about losing her child, but about losing the future she thought was certain. But now, she sees Randell as no different than her four other sons who still live at home.
鈥淚 have a house full of boys, and they鈥檙e all very stinky,鈥� Kay said. 鈥淚f I talk about the kids at home, it鈥檚 only ever sons 鈥� the switch is absolutely 100% permanent, and I wouldn鈥檛 switch it back. I don鈥檛 see any scenario in the future that he would detransition. Simply because he wasn鈥檛 happy before and now he is.鈥�
A short-lived exemption
But if SB 14鈥檚 current language is enacted, Randell would be forced to taper off his hormone therapies and eventually stop them altogether. This, he said, would amount to forcing him to detransition.
SB 14 originally banned transition-related care for anyone under age 18. But in a stunning move during the Senate debate, Campbell, the bill鈥檚 author, amended the legislation to allow kids currently receiving transition-related care to continue treatments. But she after it came under fire from her party, though she attributed the reversal to questions raised by the short-lived exemption.
When the legislation came to the House Public Health Committee, it . Republican state Rep. of Cypress tweaked SB 14 and its companion so that doctors could wean patients off of hormone therapies in a 鈥渕edically appropriate manner鈥� rather than abruptly stop them.
In on the bills, the Texas Medical Association warned that a sudden end to treatments like puberty blockers and hormone therapies could result in negative health effects for trans youth, and force physicians to choose between the law and their ethical obligations. Instead, the group advocates that those who are already getting this care be allowed to continue receiving treatments, similar to what was initially but . Oliverson previously for such an exemption as long as it doesn鈥檛 let trans kids 鈥減rogress to additional escalating treatments.鈥�
But the current version of the legislation hasn鈥檛 calmed the TMA鈥檚 worry, though the group is staying neutral on the bills.
鈥淎nd while the amendment 鈥� appears to step in the direction of the grandfather provision we requested, it differs from our recommendation and our concern would be the potential effect on patients,鈥� Brent Annear, a TMA spokesperson, said in a statement to the Tribune.
Louis Appel, who serves as president of the Texas Pediatric Society and who has testified against the proposals, echoed this sentiment.
鈥淚 think you can say from the side effects of stopping the hormones, a better approach is to taper off than to stop suddenly,鈥� the Austin-based pediatrician told the Tribune. 鈥淚 don鈥檛 know that you can say it鈥檚 medically safe because you still have the issue that someone has been forced off a medication that they were taking for their health.鈥�
According to Appel, cutting off hormone therapies could lead to adverse effects. For instance, if a trans girl stops taking estrogen, she could get hot flashes, headaches, fatigue and mood swings. Meanwhile, a trans boy who has been getting testosterone could become lethargic and have mood instability without it. These symptoms could also vary based on how long the individual has been taking the hormones and how the person gets off of them.
Randell, who has been doing usually one testosterone shot every Saturday since he was 14, knows these effects firsthand after accidentally missing them for three weeks earlier this year.
鈥淚 felt so down and drained,鈥� he recalled. 鈥淚 found no motivation to do anything, and I鈥檓 usually a very motivated person. I volunteer, I go to work, I tutor people, so that was very unusual.鈥�
These effects hurried the teen to return to the regular injection schedule. And after a few days, he said he was back to his normal self.
Still, these symptoms are not medical experts鈥� biggest concerns on this issue. Instead, they have raised the loudest alarms about the potential psychological distress of banning such care. Trans youth are also already more likely to be at risk of depression and suicide than their peers.
鈥淔or those who are already receiving hormones and are exhibiting improved mood and function in their life, removing access to an effective treatment is simply unethical,鈥� said Karen Welch, an Austin-based family medicine doctor who has experience prescribing transition-related care for minors and adults. She also noted that removing puberty blockers could also translate to long-term dysphoria for some.
Oliverson鈥檚 and Campbell鈥檚 offices did not respond to requests for comment. Though Oliverson said in that he was 鈥渓ooking forward to bringing SB14 to the House floor on Tuesday and ending these harmful practices.鈥�
And Randell stressed that his previous forgetful mishap is vastly different from the prospect of being forced by the state to taper off and stop taking hormone therapy permanently, which could lead to the return of physical traits associated with his sex assigned at birth.
鈥淭hat would make life insufferable,鈥� he added. 鈥淭hat is a death sentence.鈥�
A community mobilizes
This is also not the first time Randell has had to grapple with leaving the North Texas community and house he has lived in his entire life.
In February 2022, the state鈥檚 child welfare agency to investigate parents who鈥檝e provided their trans kids access to transition-related care for child abuse. At the time, the teenager had been receiving hormone therapies for about a year 鈥� and the directive sent his family into a tailspin.
In the initial whirlwind, Randell learned how to climb a ladder propped up against the fence in his backyard in case state officials came knocking on his childhood home鈥檚 front door. He memorized how to catch a ride to the airport and how to book an out-of-state flight to temporarily stay with his sister in Kansas. And, at all times, he had a ready-to-go duffle bag that was stuffed with enough clothes, toiletries and chest binders to last him a week. He also packed a photo of his 6-year-old dog Burr, who has been with the family since he was a puppy.
鈥淚t was a horrible, horrible time for all of us,鈥� Randell said. 鈥淚t was really scary having to pack that go bag and be like, 鈥榃ell, I don鈥檛 know if I'm going to be OK. I don't know if [Child Protective Services] is going to come get me just because I鈥檓 trans.鈥�"
But after receiving advice from their attorneys, the family quickly scrapped that plan in favor of legally fighting the agency if officials show up. Abbott鈥檚 order would also soon face lawsuits from and of trans kids 鈥� as well as from CPS staff tasked with carrying out these investigations 鈥� before by the courts, at least for now.
Since then, Randell said his bag has sat, still packed, somewhere in the house. And so has Kay鈥檚 鈥渂ig binder of proof鈥� that she鈥檚 a good mother.
And these days, on top of preparing for the worst-case scenario, Randell has been wracking his brain to find a way to make lawmakers listen to him.
鈥淚鈥檓 going to organize a march or something,鈥� he said last week.
LGBTQ advocacy groups, which have held numerous during this legislative session, are also now racing to figure out how to shut SB 14 down.
LGBTQ Texans and their allies will once again pack the Capitol Tuesday morning to sing and protest the bill ahead of its House debate. They will also mobilize community members to contact lawmakers while increasing their presence at committee hearings for other proposals that target LGBTQ Texans. For advocates like Andrea Segovia, senior field and policy adviser for the Transgender Education Network of Texas, it鈥檚 a battle worth fighting 鈥� even as the majority of House members already back SB 14.
鈥淚t鈥檚 heartbreaking,鈥� she said. 鈥淏ut the thing that we keep reminding ourselves at TENT is that [trans people] have been in far worse situations. It鈥檚 an uphill battle, but it鈥檚 not a battle that they haven鈥檛 seen before and that they haven鈥檛 dealt with and come out stronger. That鈥檚 just what we keep reminding people and reminding youth especially.鈥�
Ultimately, regardless of how SB 14 progresses, Randell said getting off testosterone and detransitioning is simply not an option for him. Kay agrees. Even if that means making regular trips to another state. Or separating the family and leaving the state with Randell.
鈥淚 will not allow anyone to take me off hormones. Over my 鈥︹�� the teen said before trailing off. 鈥淚t鈥檚 not over my dead body because that would just be letting them win. I鈥檓 not going to be another statistic.鈥�
