Last week, I testified before the House Judiciary Subcommittee on the Constitution and Limited Government to speak about the crisis children in America face and urge Congress to act. But while I talked about rising child poverty, hunger, homelessness, and struggles obtaining health care, the Subcommittee majority was, sadly, more interested in stoking culture wars than solving problems for children and youth.

Maybe the majority called the hearing to distract from what the full House of Representatives was doing to threaten the health, education, development, safety, and well-being of children through the budget process. On April 9, 2025, votes were pending in the House on a parliamentary vote to move the budget forward to a final vote on passage of the budget proposal.

Those two votes set into motion the process by which Congress may cut up to $880 billion in cuts to Medicaid and the Children’s Health Insurance Program (CHIP), $330 billion in cuts to SNAP or food stamps, and $230 billion in cuts to education, including school meals – all of which would have significant negative and disproportionate consequences on tens of millions of children across the country.

Consequently, I was grateful for the invitation to testify from Democratic Committee members Jaime Raskin (D-MD) and Mary Gay Scanlon (D-PA), who serve as Ranking Members of the full House Judiciary Committee and Subcommittee on the Constitution and Limited Government, respectively. They asked me to speak to the “status of children” in this country and how we might best address their needs, concerns, and interests.

This hearing followed one in the Subcommittee a few weeks earlier on birthright citizenship in which the Subcommittee majority failed to acknowledge that President Trump’s Executive Order 14160, which seeks to gut birthright citizenship, targets one group of people for harm: BABIES.

My testimony and opening statement made the following points:

  • Children face many growing threats: these include rising infant and child mortality, rising child poverty, increasing uninsured rates, a children’s mental health crisis, the reemergence of vaccine-preventable diseases (e.g., measles and pertussis), increases in homelessness and hunger, a child care crisis, increases in child abuse deaths, the on-going threat of school shootings, and the growing fear of children living in immigrant households all threaten kids.
  • Our failure to care for and support children leads to poor outcomes: the failure of other systems to care for and support children is more likely to lead to problems that come before the House Judiciary Committee, including juvenile interactions with the justice system and child exploitation.
  • Money matters: evidence clearly shows that investing in children has the highest rate of return of just about any federal spending for our nation’s future. For example, research by economists Nathaniel Hendren and Ben Sprung-Keyser finds that investments in children produce the highest return on investment of any category of federal spending examined.
  • The Trump Administration, in just a short period of time, is failing our kids: actions by the Administration on the budget, through its executive orders, and its dismantling of government departments and agencies, have repeatedly failed kids or, even worse, targeted them for harm.
  • The American people strongly support making investments in kids: on issue after issue, the American people have demonstrated that they support making investments in kids and oppose policies that would harm them in any way.
  • Children have fundamental rights too: these rights and voices should be recognized and defended, but unfortunately, they are often ignored or dismissed.

What El Paso Taught Me About Why Kids Need Advocates

In speaking to the House Judiciary Subcommittee, I emphasized that I didn’t come as a lawyer, or a doctor, but as a child advocate informed by growing up in El Paso, Texas, as the child of educators and seeing firsthand the struggles that children face, including poverty, the lack of health care, underinvestment in education, and societal injustice that take root and hurt kids.

From my parents and others in my family who were educators, I learned how poverty, health care, hunger, homelessness, domestic violence, and child abuse all play major roles in a child’s education and life opportunities.

I explained:

Children are not asking for luxury. They are not lobbying for tax shelters or asking for loopholes. Their needs are focused on their health, education, development, safety, and well-being. They and their families are asking for stability, safety, and a fair chance for an opportunity to thrive.

These are the building blocks of childhood, and yet across our country, those foundations are cracking — sometimes collapsing completely.

Children’s Issues Should Be Bipartisan

Throughout its 20-year history, First Focus on Children has worked on a bipartisan basis with Democrats and Republicans alike to champion children’s health care, nutrition, education, and safety. These aren’t red issues or blue ones. They are children’s issues.

Helping children should never be a partisan issue. It hasn’t been for most of my career—and it shouldn’t be now.

Unfortunately, instead of working across the aisle to address the growing needs of America’s children, what unfolded during the hearing and on the floor of the House was something else entirely.

The House voted later that evening 216-215 (Roll Call #94) to proceed with the budget vote and 216-214 (Roll Call #100) the next morning in favor of the Republican leadership’s budget proposal that could lead to hundreds of billions in cuts to investments, programs, and services to children at the very time they are facing enormous challenges. This budget proposal is, quite frankly, an “assault” on children.

What the Committee Chose to Spotlight Instead

The Subcommittee hearing title was “Ending Lawfare Against Whistleblowers Who Protect Children,” but I remain unsure what the true purpose of the hearing was. Based on the hearing title, I would have hoped that the Subcommittee would have tackled cases involving children, such as:

In many of these cases, if adults had listened to the kids themselves, abuse and harm could have been averted and children protected, but the voices of young people were repeatedly ignored.

This was, once again, often true in this hearing. The topic involved Dr. Eithan Haim, who opposes gender-affirming care and sent partially redacted medical records of children’s appointments without their consent to right-wing blogger Christopher Rufo. This action led the Department of Justice to charge the physician with violating the Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule.

I leave it to others to decide whether this particular case violated HIPAA, but it was important that Rep. Pramila Jayapal (D-WA) raised and spoke eloquently about the concerns of children and their parents with respect to medical privacy rights.

In an exchange with Dr. Haim, Rep. Jayapal also explained why adolescents and their parents should not have their medical records released without their consent.

The Congresswoman concluded with a passionate argument as to why we needed to protect the privacy rights of adolescent transgender kids.

What About Texas Child Protective Services?

One of the bombshells that went largely ignored from Dr. Haim’s testimony was that Texas Child Protective Services (CPS) was failing to protect children who were hospitalized at Texas Children’s Hospital due to child abuse.

Dr. Haim testified that he did not bother to call Texas Child Protective Services (CPS) to report his concerns because the agency never “actually protected children” in cases that he witnessed involving “dozens of children who suffered unfathomable abuse such as intentional starvation, cigarette burns, finger amputations, etc.” He said he would see the “abusers” in the room making medical decisions for those they harmed.

If protecting children was the goal of this hearing, Dr. Haim raises disturbing claims about the failure of Texas CPS to protect children from horrific cases of medical abuse. His testimony should prompt a follow-up investigation and hearing focused on the failure of CPS to protect children in the Chairman’s State of Texas.

What say you, Chairman Roy?

Turning a Hearing That Should Have Been About Kids into a Culture War

Instead, much of the time of the Subcommittee Republicans was focused on dismissing gender dysphoria and attacking gender-affirming care. Several Republican members on the Subcommittee argued in favor of government stepping into the role of banning or regulating such care, despite numerous medical societies having created evidence-based guidelines related to such care, and adolescents and their parents seeking out and consenting to such treatment.

In Texas, Governor Greg Abbott and Attorney General Ken Paxton have equated gender-affirming care with abuse and have asked Texas CPS to investigate parents and families for gender-affirming care.

We disagree.

At First Focus on Children, we joined an amicus brief before the Texas Supreme Court in 2022 that opposed efforts to label gender-affirming care as child abuse. Our position follows established standards of medical practice and defends the medical rights of young people and their parents, in partnership with their doctors, to receive gender-affirming care. The amicus brief reads:

Gender-affirming care is not child abuse… By definition, care that is recommended and appropriate pursuant to standards of care that are widely agreed upon by professionals who treat child abuse cannot be child abuse. Gender dysphoria is real. And gender-affirming care to treat gender dysphoria is appropriate under the established standards of care and practice.

Rep. Becca Balint (D-VT) made this point and explained how such care is evidence-based and has saved lives.

These attacks on such care are not just rhetorical – they have real-world consequences. When states criminalize gender-affirming care, families are forced to flee, kids are denied medical support, and a chilling effect ripples through pediatric practices and children’s hospitals.

For example, Congress is holding up extension of the pediatric graduate medical education (GME) reauthorization bill over gender-affirming care. This threatens the medical education of pediatric residents for all pediatric medical care, including pediatric oncology, endocrinology, cardiology, diabetes, pulmonology, neurology, orthopedics, prosthetics, rheumatology, nephrology, and neonatal and perinatal medicine. If funding is threatened, life-saving medical care delivered in children’s hospitals all across this country would be put at risk.

The doctors, nurses, and medical staff at children’s hospitals are heroes who save the lives of children every single day. Congress has a moral responsibility to protect and support all children, including the funding that supports their care.

Turning Attention Back to the Challenges Facing Children

Rep. Balint urged the Subcommittee to turn its attention to the major challenges that children are facing in this country, including the votes the House was preparing to make on the federal budget later that evening and the next morning.

Rep. Balint discussed with me the myriad of challenges facing our nation’s children, including infant and child mortality, child poverty, hunger, homelessness, children’s mental health crisis, and with an important addition from Rep. Raskin, gun violence. We discussed how massive budget cuts being proposed by House leadership would make these matters much worse for children.

The data speaks for itself:

  • Infant and child mortality are rising for the first time in decades.
  • Child poverty has more than doubled since pandemic-era relief was cut.
  • Millions of children have lost health coverage as Medicaid protections ended.
  • Mental health crises continue to soar, with rates of anxiety, depression, and suicide among youth climbing year after year.

These are not abstract problems. These are children with names, faces, and dreams being derailed and harmed by policy failures and budget cuts.

After the Recess

After a break for members to cast votes on the House floor, the hearing resumed and took some disturbing turns, such as Rep. Harriet Hageman (R-WY) declaring there is “zero” benefit from gender-affirming care. She wishes for government to outlaw it and, ironically, to overturn the decision-making authority of parents and adolescents with their doctors.

The American Academy of Pediatrics, the Academic Pediatric Association, the American Academy of Child and Adolescent Psychiatry, the American Academy of Family Physicians, the American Academy of Nursing, the American College of Obstetricians and Gynecologists, the American College of Osteopathic Pediatricians, the American College of Physicians, the American Pediatric Society, the Association of American Medical Colleges, Association of Medical School Pediatric Department Chairs, the Endocrine Society, the National Association of Pediatric Nurse Practitioners, the Pediatric Endocrine Society, the Society for Adolescent Health and Medicine, and the Society of Pediatric Nurses, who know the real evidence and science, disagree.

In an amicus brief they filed in February, they explicitly state “gender-affirming medical care for people under nineteen, which as this brief describes, is critical, medically necessary, evidence-based care for gender dysphoria.”

They add:

…gender dysphoria can result in debilitating anxiety, depression, and self-harm, and is associated with suicidality. As such, the effective treatment of gender dysphoria saves lives.

Finally, Chairman Chip Roy (R-TX) tried to play a game of “gotcha” in which he asked me repeatedly about the role of parents in making decisions about their children’s health care (again, ironic because it is the Subcommittee Republicans and President Trump that seek to deny parents, children, and their doctors the ability to make these decisions).

Three straight times, I repeatedly said either:

We believe that medical decisions should be made by doctors, parents, and children, Doctors, parents, and children should make medical decisions based on best practices.

He then noted, to which I affirmatively and enthusiastically agree, that I have said – more than once – that there are other occasions when health care can and should be delivered without parental consent. Examples include:

  • Emergency care
  • Other medical circumstances in which the denial of care would threaten the life of children, such as cancer treatment
  • Services such as allowing kids to receive band-aids, medical tape for ankle or finger sprains, ice packs, or even a tissue
  • Routine medical care to adolescents, testing and treatment for infectious and communicable diseases, counseling, substance abuse treatment, etc.
  • Other circumstances, such as a rape kit exam related to sexual abuse by a parent or family member

I also pointed to the majority’s witness, Dr. Haim, who testified that he witnessed numerous cases in which “abusers” were being allowed by Texas CPS to make medical decisions related to “unfathomable abuse such as intentional starvation, cigarette burns, finger amputations, etc.” I added that cases involving child abuse by parents are a good example of when to leave parents out of decision-making.

Here is that exchange with Chairman Roy.

Unfortunately, the video misses me thanking Chairman Roy for putting my Substack posts and my letter to the House Judiciary Committee on these issues into the Committee record. I was appreciative that he did so – not because we agreed on the issue, but because he was making my point and that truth for children should be reflected in the Subcommittee record.

Here are the Substack posts that he put into the transcript”

I wish he had added:

In the end, parental consent is the norm.

However, we diverge concerning those circumstances in which parental consent may be unavailable, unnecessary, places the child at danger or high risk, or results in the denial of medically necessary care or treatment.

While some feel that the health of children, their bodies, and their lives are at the sole discretion and control of parents in all or almost all circumstances, even in cases where children would die due to medical neglect.

I do not.

As Samantha Godwin explains:

When evaluating the extent of parents’ legal rights, we should not merely consider how ideal parents exercise their power to provide the effective care and guidance children need. The extent of what the law enables imperfect parents to do to their children must also be taken into account. The issue is not only what role we hope that parents play in their children’s lives, but how the powers actually granted might be used and abused for better or worse. Thinking only in terms of how the best parents conduct themselves is a mistake; it is also necessary to account for what the worst parents can get away with.

In such cases, I would err on the side of both protecting the health and well-being of children and recognizing that children have fundamental rights too.

Highlighting How the Trump Administration’s Cuts Threaten Children

In her closing, Ranking Member Scanlon returned the focus to the Trump Administration’s proposed massive budget cuts to programs of importance to our nation’s children.

As Rep. Scanlon and I discussed, this isn’t hypothetical. These cuts will devastate children and families.

The Trump Administration has put forth budget proposals that would:

These policies don’t reflect the values of the American people. They reflect the priorities of political ideologues determined to shrink government — even if it means sacrificing children to do it.

Columnist Catherine Rampell further documents the list of attacks on children that the Trump Administration has proposed in a column that ran this morning titled Donald Trump’s war on children: The Administration is divesting from future generations. It will cost America dearly.

The Public Is on the Side of Children

Fortunately, the American people are on the side of children in the debates over the budget – overwhelmingly so.

Here’s what Americans believe:

  • 83% support maintaining or expanding Medicaid.
  • 72% support expanding the Child Tax Credit to fight child poverty.
  • 71% oppose attacks on birthright citizenship.
  • By wide margins, they believe the federal government is spending TOO LITTLE rather than TOO MUCH on children’s programs.

These aren’t partisan views. These are deeply held American values. The problem is not the people. It’s the politicians who refuse to listen to them or make children a priority.

We Can and Must Do Better

In my closing remarks, I said:

Despite being citizens who have fundamental rights, children and their voices are often locked out of political arenas and decision-making processes that impact their lives.

It is imperative that when a child cries out for help – whether it is a sick child, an abused child, a hungry child, a homeless child, or a victim of gun violence – adults should listen.

We must build a nation in which every child has a chance to grow up healthy, safe, educated, and supported.

That’s what I went to Congress to say. It’s what I’ll keep saying. And with your help — sharing this Substack post, raising your voice, pushing back against false narratives — we can help change not just the conversation, but the future for our children.

How to Help Children

  1. Watch and share the clips: use them to tell others what’s really happening in Congress and the Trump Administration.
  2. Contact your representatives: tell them to reject cuts to kids’ programs and defend children’s rights.
  3. Support organizations like First Focus on Children: help those of us working every day to make children a national priority.