Months after a Texas law banning gender-affirming health care for minors went into effect, Austin leaders are looking to limit the impacts of that measure and possible future legislation within city limits.

What's happening?

City Council on May 2 could formally deprioritize enforcement of any laws targeting transgender or nonbinary people seeking medical care, and individuals or health care groups providing such treatment.

The council direction would discourage city resources from being used to investigate either individuals or health care providers. It'd also make any enforcement the lowest priority for city employees, including the police, to tackle.

The May 2 resolution from council member Chito Vela charts a similar course to a measure he introduced in 2022—the GRACE Act, or Guarding the Right to Abortion Care for Everyone Act—intended to limit Austin's enforcement of Texas abortion laws.

“Generally speaking, I trust Texans to make their own medical decisions, whether they are deciding they want to terminate a pregnancy or whether they’re deciding what type of medical treatment their child that’s struggling with gender identity issues needs," Vela told Community Impact. "Those are decisions that should be between the individuals and their licensed physician, and not areas that should be the subject of criminal enforcement. This is not an appropriate area for us to be using public safety dollars.”

If approved, the resolution would limit Austin's role in:
  • Investigating, prosecuting or penalizing trans and nonbinary people for seeking care, and anyone offering care
  • Enforcing any state law aimed at health care for trans and nonbinary individuals
  • Providing information for other jurisdictions' investigations, and detaining or arresting people, under other gender care laws
Additionally, the resolution calls for the city to create a new program that'd offer support to Austinites and Travis County residents facing criminal penalties or other sanctions under laws like Senate Bill 14, the existing prohibition on gender care for minors. It also calls for "vigorous" enforcement of hate crime and anti-discrimination laws within the city.

A closer look

Vela said his approach followed months of consultation with local stakeholders, many of whom are either trans or engaged with trans health care issues and have expressed concern about the effects of current and future legislation.

Austin's LGBTQ Quality of Life Advisory Commission, Human Rights Commission and Joint Inclusion Committee all recommended similar proposals to council last month.

Vela said he doesn't intend for the measure to overstep Austin's authority and land the city in court, and called the May resolution the "most defensible and effective step" Austin can take on the issue today. However, he also noted that state agencies can still enforce the law and impose criminal penalties.

“Unfortunately, providing treatment will still be illegal under state law. So unfortunately, I don’t expect the landscape to change that substantially," Vela said. "I do hope that there is less fear and less stress for, at least, residents of Austin and medical practitioners in Austin that either have patients that are dealing with these issues or they themselves, or have family members and friends who are dealing with these issues. Just to know that we understand, we want to help as much as we possibly can."

Vela also said the measure isn't meant to make Austin a "sanctuary city" for gender-related medical care, and that he views the policy as removing the city government's role in activity tied to what he labeled as unnecessary law.

SB 14 was passed during the Texas Legislature in 2023, with many backers including Gov. Greg Abbott stating that the measure was needed to protect children and prevent what supporters pointed to as harmful medical intervention.

Zooming out

Staff with Vela's office said Austin could follow the path of cities like Kansas City tackling gender care issues in response to state legislation.

Matt Pagnotti—director of state and local government relations with Vivent Health, a national health care and HIV prevention nonprofit that serves many trans people—said that even though Austin won't be overruling state law, the local protections could still help residents facing possible enforcement by Texas or other states' agencies.

“One of the outcomes of laws like this is even beyond the specific provisions of a state ban like SB 14, we know part of the intent is to have that chilling effect," he said. "To me, I think any effort the city can make to try to provide some shielding and comfort to sort of combat that chilling effect can’t hurt.”

The impacts of legislation like SB 14 has already extended from the local level to other states.

Pagnotti said SB 14 has produced "ripple effects" for many in the LGBTQ community, such as a wave of clients relocating from Texas to Colorado, straining health care resources there. He also pointed to negative impacts on the health of both minors and adults given stigmas around care and what he called the "transphobic rhetoric" in many policy debates.

“While we don’t provide care for youth, one of the reasons we opposed SB 14 and similar legislation is that creating those barriers to essential, life-saving gender-affirming care services has long-term implications for the health and wellbeing of trans people and those trans youth who are not able to access the care that they need at this point," Pagnotti said. "As those youth grow older ... we know that that’s going to potentially cause harm and additional barriers to care for folks later throughout their lifetime.”

Looking ahead

Following council's approval of the GRACE Act back in 2022, dozens of cities in Texas and other states took similar actions to deprioritize enforcement of abortion laws. Vela said this spring's resolution could also inspire local legislation elsewhere.

“I would expect, honestly, a similar reaction, potentially, with this ordinance. It wouldn't surprise me if other places took a similar approach," he said.

Vela added that, to his knowledge, Austin hasn't seen any criminal cases raised in relation to abortion since the GRACE Act resolution passed.