Performing a transgender surgery on a child constitutes sex abuse, Texas Department of Family and Protective Services (DFPS) Commissioner Jaime Masters confirmed Wednesday.

Republican Texas Gov. Greg Abbott had called on DFPS Friday to say whether transgender surgeries for children constitutes child abuse. Masters quickly responded in a Wednesday letter calling these surgeries “genital mutilation of a child” and confirming that the surgeries constitute child abuse.

“Genital mutilation of a child through reassignment surgery is child abuse, subject to all rules and procedures pertaining to child abuse,” Masters said. “Such mutilation may cause a ‘genuine threat of substantial harm from physical injury to the child.’”

“As you have described,” she continued, “this surgical procedure physically alters a child’s genitalia for non-medical purposes potentially inflicting irreversible harm to children’s bodies. Generally, children in the care and custody of a parent lack the legal capacity to consent to surgical treatments, making them more vulnerable.”

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Masters said that the surgical procedures may not constitute abuse when they are medically necessary: for example, if a child has had body parts affected by illness or trauma, if a child is born with a medically verifiable genetic disorder of sex development (like ovarian or testicular tissue), or if the child “does not have the normal sex chromosome structure for male or female as determined through genetic testing.”

A doctor, teacher, nurse, day-care employee, or any individual who has “cause to believe” that a child has been abused by sex change surgeries must personally report his suspicions within 48 hours to DFPS, Masters’ letter said.

“Failure to report is a Class A misdemeanor punishable by up to one year in jail, a fine of up to $4,000, or both,” the letter said.

Abbott pointed out in his Friday letter to DFPS that Texas already outlaws female genital mutilation of children, writing, “presumably that also constitutes child abuse.”

The governor also said that if DFPS classifies transgender surgeries for children as child abuse, it would need to follow through and “conduct prompt and thorough investigations of the child’s parents, while other state agencies would be obliged to investigate the facilities they license.”

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