A bitter custody battle in Dallas that centers on the gender identity of a 7-year-old child provoked an outcry among conservatives this month.
The child’s mother, Anne Georgulas, had honored what she said was the child’s preference to live as a girl and sought to compel the father, Jeffrey Younger, to do the same, according to court documents. But Mr. Younger insisted that the child is a boy and said that Ms. Georgulas was manipulating the child’s identity.
The case attracted major interest after Mr. Younger created an extensive website, posting photos and videos of his children and sitting for interviews with conservative podcasts and news outlets. He raised tens of thousands of dollars in donations, saying that he was fighting forced and irreversible medical procedures, though experts who treat transgender youths disputed that characterization.
In a ruling on Thursday, Judge Kim Cooks in the 255th District Court in Dallas said that the parents should have joint custody and that the state could not require Mr. Younger to treat the child as a girl. She also forbade either parent from speaking to the news media and ordered Mr. Younger to shut down his site. (It appeared to have been taken down on Friday.)
Mr. Younger’s characterization of medical care for children wrestling with gender identity is hotly disputed, and the judge’s ruling noted that Ms. Georgulas had not tried to “surgically or chemically transition the child’s sex,” as alleged. (The New York Times is withholding the child’s name for privacy reasons.)
Experts say that the best practices for treating prepubescent children who may be transgender are to affirm the child’s choices and afford them the space to explore their identity.
“All anybody would be saying at this point is support your kid in the gender they identify with,” said Dr. Michelle Forcier, a professor of pediatrics at the Warren Alpert Medical School at Brown University who specializes in treating gender-diverse patients.
“You don’t have to do anything medical; you don’t have to do anything permanent,” she added. “You don’t have to do anything but listen to your kid.”
Dr. Forcier said that transgender youths are more likely than their cisgender peers to struggle with mental illness. But she added that a parent’s support, such as using preferred names and pronouns, can improve the health and wellness of their offspring.
Conservative outlets like LifeSite News, which calls itself the “No. 1 pro-life news website,” have covered the case in great detail, attracting attention from across the country and putting pressure on state officials to get involved.
Gov. Greg Abbott announced on Wednesday that state officials were looking into the case. On Friday, Attorney General Ken Paxton sent a letter to the state’s Department of Family and Protective Services expressing his worry that the department had not intervened in the case and calling for an immediate investigation.
“The children at the center of this dispute are in immediate and irrevocable danger,” he wrote.
Representative Chip Roy, who represents a district northwest of San Antonio, sent a letter to federal officials calling for a study of “forced medical treatment of gender dysphoria in prepubescent children.” State Representative Matt Krause, whose district includes Fort Worth, suggested that he would introduce a bill to prohibit the use in minors of puberty blockers, which block secondary sex characteristics like breasts and Adam’s apples.
Neither parent nor their lawyers responded to repeated requests for comment. Mr. Younger has said in interviews that their marriage was annulled after Ms. Georgulas accused him of making fraudulent claims.
The American Academy of Pediatrics, a leading medical group, issued its first policy statement on treating gender-diverse and transgender youths last year. The statement, written by Dr. Jason Rafferty, a pediatrician and child psychiatrist also affiliated with Brown University, calls for doctors to use a gender-affirmative care model “oriented toward understanding and appreciating the youth’s gender experience.”
Dr. Rafferty said that best practices call for slow and carefully considered steps in treating gender-diverse and transgender youths, in close consultation with a patient’s family.
“When we look at the actual gender-affirming care, it’s all developmentally informed,” he said. “You’re looking at where the child is at different stages of their life and how to talk about these issues at different stages.”
No medical intervention is recommended before the onset of puberty, he said. Around puberty, hormone blockers to stop secondary sex characteristics from developing may be used. From there, a young person may choose to progress to gender-affirming hormones, and perhaps eventually surgery.
The effects of hormone blockers are reversible, but would most likely have adverse effects on fertility if the patient started taking them at an early age, he said.
As discussion of medical interventions for gender-nonconforming youth becomes more common, the related legal debates seem likely to multiply.
A study published this year in the journal Family Court Review looked at 10 cases in the United States in which mothers had taken an “affirming” approach to their transgender or gender-nonconforming child, and then had their custody rights challenged by partners who disagreed with that approach.
All 10 of the women described being blamed by their former partners for “causing” the children to assert transgender identities. Court officials in the cases were frequently unfamiliar with the concept, and some of the mothers lost custody.
Susan C. Beachy contributed research.