When Katerina was 4 years old, she told her older brothers that she wasn’t comfortable in her body and wanted to be a girl. They didn’t take her seriously, but their response would impact her for years; they told her they didn’t want a transgender sibling and would disown her if she wanted to be a girl. “You won’t be our sibling anymore,” they told her.
Katerina suppressed her feelings and didn’t act on them, but inside, she suffered for years. Her Catholic upbringing told her that her desires were an unholy mutilation. As a result, she suffered depression and other mental health issues, and when her body began going through puberty, she spiraled.
It would take years for her to receive treatment at Children’s Health’s Genecis clinic, a multi-disciplinary treatment center established to provide gender-affirming care to patients like Katerina. The clinic closed late last year after pushback from conservative groups.
Katerina says Genecis saved her life. Shortly after her 13th birthday, already taking the depression medication Lexapro, she raided her supply along with whatever else she could find in the family’s medicine cabinet. Her father caught her in the process, and fortunately, nothing she took was fatal.
Her father took her to a psychiatric hospital, where she spent several days recovering. While there, she met other teenagers suffering from gender dysphoria who were not transitioning. She realized then that she was not alone. She had never met anyone who felt the way she did. “That was a pretty eye-opening experience,” she says.
But even then, she didn’t tell her doctors that she felt gender dysphoria. Instead, she framed her issues as depression. She felt like it was a dirty secret that would land her in a mental hospital.
Later, her father’s job would take the family to North Texas, but she continued hiding her feelings from him (her mother was not in her life). She grew her hair out and would change into women’s clothing after she left the house. She began using she/her pronouns at school. It was easy to hide her social transition from a family with a single father and four siblings.
But it finally got to be too much. Her dysphoria was causing her to throw up multiple times a day, and her grades were suffering because she was missing so much school. She gritted her teeth and told her father that she was transgender and wanted to start receiving gender-affirming care.
She braced for a screaming tirade, fearful that she would be kicked out of the family. At one point, her father contemplated conversion therapy for Katerina, but he told her that he would help her in whatever way she needed. He was ready to listen.
Katerina reached out to the now-defunct Genecis Clinic at Children’s Health but didn’t get an appointment until she met with a specialist for her stomach issues, who helped connect them.
The pure existence of the clinic impacted Katerina’s mental health even before any treatment started. “Going to my first appointment was one of the most euphoric moments in my entire life,” she says. “They seemed to really care.”
She thought her first appointment would end with puberty blockers, but the process was more involved. She and her father both spoke with a psychologist together and individually, as did her sister. They met for hours with providers, discussing how long the issues had been displayed, her suicide attempt, and what they hoped to accomplish.
Katerina had contemplated some DIY transgender health moves she found on Reddit and was looking into using the dark web to buy puberty blockers and hormones. Every day more permanent biological changes were happening. “I was very desperate because it was making it to where I didn’t want to live,” she says.
After a waiting period, she received testosterone blockers, a reversible treatment administered through an implant in her arm. The day she picked them up, she could feel her spirits lift, and she hasn’t looked back since. While she was still being bullied at school, she stopped throwing up, and she hasn’t taken any anxiety or depression medicine in years.
“I was finally able to engage in life because I had the confidence that my body is not going to change anymore,” she says.
“There’s Nobody to Advocate for Kids”
The Genecis clinic was a literal life-saver for Katerina; its gender-affirming care was unlike anything she had received before. The clinic’s concern for her mental health, the collaboration between providers, and their use of the proper pronouns were comforting.
When Katerina heard that the Genecis clinic was unbranding and not taking any new patients for hormone therapy, she was crestfallen. She shared a statement of her thoughts about the closing:
“Genesis was a light in the dark for trans kids in DFW amidst a sea of both national and state legislation telling us that we were invalid. Dallas Children’s told us that we were, in fact, valid. When they pulled the pressure from Save Texas Kids, that went away,” she wrote. “They instead sent the message that they were wrong and we are no longer valid. I personally come from a fairly conservative family that took a long time to accept my transgender identity. It was only due to the Genesis program advocating for me to my parents and a suicide attempt that my parents allowed me to receive puberty blockers, which saved my life. Now that the program is gone, there’s nobody to advocate for kids that are in the same situation I was in.”
Last week, Katerina and many children and adolescents like her were attacked again. Texas Gov. Greg Abbott sent a letter to the Texas Department of Family and Protective Services pushing the agency to prosecute gender-affirming healthcare services like those offered at the now-shuttered Genecis Clinic at Children’s Medical Center as child abuse. Surgeries, puberty blockers, and hormone therapy were all on the list of procedures that the governor considered abuse, using an order issued by Attorney General Ken Paxton as backing.
Abbott also called on physicians, nurses, teachers, and others aware of such abuse to report the care or face prosecution themselves. And he urged DFPS to investigate families for approval of these “abusive gender transitioning procedures.”
Many authorities have come out to say they will not be following Abbott’s orders. Dallas County District Attorney John Creuzot said he wouldn’t be prosecuting gender-affirming care, joining other district attorneys in Bexar, Travis, Fort Bend, and Nueces counties. The president of the University of North Texas called opposing gender transition “intolerant.” Although he still has a healthy polling lead in the gubernatorial race, Abbott’s outspoken conservative talking points have been pulled to the right by challengers like Don Huffines and Allen West.
Katerina’s father’s tolerance would be considered child abuse if Abbott’s rule is ever enforced. Although Katerina is now an adult, she is worried about kids like her who aren’t getting the care they need. Abbott’s newest salvo makes that care even more unlikely for many.
Today, Katerina lives on her own, goes to school, was recently promoted to supervisor at Starbucks. She is trying to figure out what the rest of her life looks like. Because she was already a patient when the change happened, she is still able to receive gender-affirming care at Children’s, although no longer under the banner of Genecis.
She is saddened that future children may not have the same opportunities to receive gender-affirming care. The clinic’s treatment was life-changing, but she says the clinic’s existence was just as powerful. “They’re not advertising it, and they’re not advocating for trans kids anymore, which is a big thing,” she said. “Now there’s nobody in Texas doing that.”