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(NEXSTAR) – Texas Gov. Greg Abbott is facing harsh online criticism in the wake of his Tuesday letter to the Texas Department of Family and Protective Services directing the agency to criminally investigate parents in the state who help their transgender children get gender-affirming care.

In the letter, Abbott asks that any “reported instances of Texas children being subjected to abusive gender-transitioning procedures” be investigated by the Texas DFPS. Last week, Texas Attorney General Ken Paxton issued a legal opinion saying Texas law can legally be interpreted to say giving children gender-affirming care is “child abuse.”

Opponents of Abbott’s recommendation (not officially a law) say it will allow trans children to be outed and parents to face charges for supporting them. Additionally, the letter says medical professionals could also face repercussions for not reporting any gender-affirming care given to children.

One of Abbott’s fiercest opponents is his current rival for the Texas governorship. In a tweet Wednesday, Democratic gubernatorial candidate Beto O’Rourke said:

“Foster kids have been forced to sleep on the floor in Abbott’s CPS system where harm to children is “overlooked, ignored or forgotten.” Texas leads the nation in uninsured kids. Now @GregAbbott_TX is cruelly and obsessively bullying children. Texas kids deserve so much better.”

Beto o’Rourke

The ACLU said Wednesday that Abbott’s letter and Paxton’s opinion “have no legal effect” and “can’t override the constitutional rights of Texas families.” The organization further commented that no U.S. court has ever found gender-affirming care to be tantamount to child abuse.

Reaction online was strong nationally, with Abbott’s name trending through the afternoon.

“Wow, just when you thought he couldn’t get any worse… Greg Abbott is a ghoul,” said actor Elijah Wood. “My heart is with the families that are affected by this heinous order. #protecttranskids.”

Advocate and writer Charlotte Clymer wrote Wednesday: “…Greg Abbott basically just told closeted trans children that if they come out, his state government is going to take them away from their affirming parents. Imagine being a closeted, scared trans child with that responsibility on your heart.”

Meanwhile, writer/cartoonist Trung Lê Capecchi-Nguyễn tweeted: “Most queer kids have, at some point in their childhood, considered the possibility that they might have to go it alone in case their coming out goes badly. And now Abbott wants to deprive the trans kids who do have loving parents of their family support. Just evil.”

Abbott’s letter comes little over a week after 21-year-old Cyprus Ramos, a transgender woman, was found brutally beaten to death in Lubbock, Texas. The Human Rights Campaign reports Ramos’ death is at least the third violent killing of a trans or gender non-conforming person this year.

Medical associations on gender-affirming care

Despite opinions by lawmakers, a host of major medical associations support gender-affirming care for trans/non-conforming youth.

These organizations include the American Psychiatric Association, American Medical Association, American Academy of Pediatrics and the American Academy of Child and Adolescent Psychiatry.

Last year, the American Medical Association spoke out against legislation attempting to block trans health care for children, saying:

“Proponents of these disturbing bills often falsely assert that transgender care for minors is extreme or experimental. In fact, clinical guidelines established by professional medical organizations for the care of minors promote supportive interventions based on the current evidence and that enable young people to explore and live as the gender that they choose.”

american medical association

Gov. Abbott’s office did not immediately respond for comment.