Karen was scared. It was March of 2022, and Texas Governor Greg Abbott had recently ordered the state’s child welfare agency to investigate parents for abuse if they helped transgender kids access gender-affirming medical care, including medicines that pause the physical changes caused by puberty.

Karen and her husband — both lifelong Texans — have a transgender daughter who was approaching puberty. 

One afternoon, while they were driving home from acting class, Karen explained the situation to her daughter, who was sitting in the back seat.

“She got really quiet,” Karen told Marketplace in an interview at the time. “And then she asked, ‘Am I going to die?’”

Karen pulled over and opened the back door. “And I just said, ‘No. Oh, my gosh, no. You’re not going to die. Why would you ask me that?’” Karen recalled. “And she said, I mean, without a beat, ‘Because everybody hates me.’ And that was when I just knew, I can’t do this.”

So last June, the family packed up their house in Austin, put it on the market and drove 2,000 miles to Portland, Oregon. They happened to arrive during the city’s Pride festival.

“We drove through this sea of rainbows,” Karen said in a recent interview. “It was unbelievable. I mean, what a welcome.”

A year ago, Marketplace interviewed several families facing a painful decision: Stay in Texas and risk persecution, or move to a more welcoming state. Now, with more states adopting bans on gender-affirming medical care for trans youth, we followed up with two of those families to see how they’re doing today. 

“It feels great here,” Karen’s daughter, O, said via Zoom from her new house in Portland. To protect the privacy of the individuals who spoke to us, we agreed to use only first names or initials.

“It was hard to leave my friends because I like them so much, but I knew that it would be a much better place here in Oregon and much safer for me,” she said. 

O is 11 now and in the fifth grade. She has long brown hair and a sweet smile. She seems to be settling right into her new home.

“I like the scenery a lot,” she said. “It’s very green, and all the trees are like massive, and it’s really cool.”

O plays ultimate frisbee, loves to draw and is really into the Japanese manga series “Demon Slayer.” She even learned to play the theme music on the cello, which she was happy to demonstrate on the video call that afternoon.

For Karen though, the move has been harder. She and her husband were lucky they could both keep their jobs and work remotely, but they had to spend more than $30,000 on movers, storage and hotels. When they arrived in Portland, they struggled to find a doctor who would accept their insurance.

Moving also hasn’t solved the larger issue. The onslaught of legislation targeting trans kids’ rights — to play sports, to use the bathroom, to choose their pronouns at school — shows no sign of slowing down. Eighteen states have now enacted laws or policies banning gender-affirming care for minors, including recently Oklahoma, Montana and Missouri, though courts have blocked some efforts. Many more states are considering similar bans. 

“I do feel safer, you know, with that ‘r’ in parentheses, but I don’t feel safe,” Karen said. “And I worry about what I’ve seen in Texas, and I worry that people don’t think it can happen here.”

She also feels a lot of guilt for leaving behind those who are still fighting for trans rights in Texas, she said.

One of them is Ed, in San Antonio.

“We’re still here,” he said when Marketplace followed up recently. “We haven’t moved.”

Ed also has deep roots in Texas. He and his wife both own businesses, which employ a lot of people. They share custody of Ed’s transgender daughter, Charli, with Ed’s ex-wife, so moving would be challenging. Plus, Charli loves her school. She’s 11 and has started taking puberty blockers.

When we talked, the governor’s child abuse order was tied up in the courts, but the Texas Senate had just passed a bill banning such care for all minors in the state. The House was weighing a companion bill.

“It does feel a little bit scary,” said Charli, who’s in sixth grade. She likes science and swimming and plays piano.

“Like a lot of the parents, I mean, we’re all pretty scared, because if they make her care against the law, I mean, what choice do we have but to move?” Ed said. “I don’t really want to move. It would be really difficult.”

Proponents of these bans say they’re trying to protect children from interventions they might later regret. Recent studies have found that those regrets are rare, and numerous studies have shown that transgender and nonbinary youth who receive gender-affirming care and family support have lower rates of depression, substance abuse and suicide risk. Major medical groups, including the American Academy of Pediatrics, the American Medical Association and the Endocrine Society all support the developmentally appropriate use of puberty blockers and hormone therapy for trans youth. Surgical procedures are uncommon in young people under age 18.   

When Charli first told her parents she was a girl at age four, Ed said he didn’t know anything about what it meant to be transgender.

“So we hired professionals, we got curious, and we waited,” he said. “Her life became more joyful, the more support she got, and so there’s no going back at this point.”

He worries about trans youth who don’t have supportive families. In a 2023 national survey on LGBTQ youth mental health from the Trevor Project, just 35% of transgender and nonbinary youth found their homes to be gender-affirming. 

“The thought of living somewhere that was more safe, it would be really difficult, but we could do it,” Ed said. “But if all of us left, who would stay and fight for the kids who don’t have that support?”