A Texas appeals court has again blocked the state from investigating gender-affirming care for their trans children as child abuse.
In its decision, the court stated that it would block such investigations to "prevent irreparable harm" to trans children and their families.
In February, Attorney General Ken Paxton published an opinion saying that "there is no doubt that [gender-affirming] procedures are 'abuse' under Texas law, and thus must be halted."
He continued: "The [DFPS] has a responsibility to act accordingly. I'll do everything I can to protect against those who take advantage of and harm young Texans."
The Texas Department of Family and Protective Services was investigating at least nine families under Paxton's directive, a DFPS spokesperson told ABC News.
Texas Gov. Greg Abbott followed Paxton's opinion with a letter ordering the DFPS to investigate such treatments as child abuse.
The letter also says Texas law requires that all licensed professionals who have direct contact with children who may be subject to such "abuse," are also reported
This would implement criminal penalties for doctors, nurses, teachers and others who fail to report the known "abuse," according to Abbott's directive.
On March 11, District Judge Amy Clark Meachum issued the first temporary statewide injunction on such investigations after hearing from the parents of a 16-year-old transgender girl who were under investigation by the Texas Department of Family and Protective Services.
Meachum also heard from attorneys from the state.
Several medical organizations, activist groups, and companies have denounced the Texas directive.
"As physicians, our job is to support the health and well-being of our patients," read a letter signed by the American Academy of Family Physicians, American Academy of Pediatrics, American College of Obstetricians and Gynecologists and more.
"Recent legal opinions and executive and legislative efforts targeting young people and aimed at curtailing the provision of appropriate medical care undermine our ability to do so," it continued.
Gender affirmation is when transgender people make changes to their lives in accordance with their gender identity, according to the Centers for Disease Control and Prevention.
That can be done through a change of clothing, hairstyles, mannerisms, names and pronouns.
For LGBTQ youth going through puberty, gender affirmation can also come in the form of hormone therapy or puberty blockers.
"Texas parents who support their trans kids should be applauded, not prosecuted," Amit Paley, CEO and executive director of LGBTQ suicide awareness organization The Trevor Project in a statement to ABC News.
He continued: "Our research found that gender-affirming hormone therapy has been linked to lower rates of depression and suicide risk among trans youth who wanted it. The government should not be involved in personal decisions that force doctors and families to act against the medical community's standards of care for transgender young people."