HOUSTON (AP) – Texas has declared the genital mutilation of a child for purposes of gender confirmation, a surgery almost never performed on minors, should be considered child abuse.

The Houston Chronicle reports the state Department of Family and Protective Services made the determination Wednesday per Gov. Greg Abbott’s request.

Abbott said the agency’s ruling was effective immediately, meaning doctors, nurses, teachers, daycare employees, and other professionals who work with children are now required to inform DFPS within 48 hours if they have reason to believe a child has or may undergo gender-confirming surgery.

Those who do not report can be charged with a class A misdemeanor.

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