Elon Musk replied “They do” on Wednesday to an X post by Billboard Chris declaring, “Vote like children’s lives depend on it. Because they do.” The exchange placed children’s medical treatment at the center of the November 3 Texas U.S. Senate contest between Republican Attorney General Ken Paxton and Democratic state Rep. James Talarico (D-District 50).
They do https://t.co/kIXpkaOmBo
— Elon Musk (@elonmusk) October 28, 2026
The post included a political illustration labeling buildings “Transition Hospital” and “Detransition Hospital” beside depictions of the candidates. The artwork does not show actual facilities. Its message came one day after Paxton announced that Texas Children’s Hospital had opened a clinic to help patients who previously received medical interventions intended to change sex characteristics.
The race remains close: a Fox News survey of 1,398 likely voters conducted October 15-19 found both nominees at 49%. RealClearPolling’s October 8-21 average gave Talarico a 1.8-point lead.
Texas Children’s Hospital Settlement Raises Questions
Paxton’s office says Texas Children’s Hospital agreed to pay $10 million to resolve claims that it billed Texas Medicaid for prohibited or unallowable interventions, as previously reported by The Dallas Express. The attorney general alleged improper billing for treatments intended to change patients’ sex characteristics. The agreement also requires changes to medical-staff privileges and compliance policies.
The hospital must fund the new clinic for five years, permitting eligible patients to receive services without charge, according to Paxton. The clinic offers care through age 21 and some related obstetric and gynecologic services for older patients. The hospital confirmed to Becker’s Hospital Review that the clinic operates and that it is complying with settlement requirements.
Talarico’s Votes And Undercover Remarks Raise New Questions
As The Dallas Express documented October 23, Talarico supported 2023 amendments that would have excluded 16- and 17-year-olds from certain prohibitions under Texas Senate Bill 14 or provided exceptions for children with specified diagnoses. He ultimately voted against the law.
In a September 2026 Fox News interview in Dallas, Talarico answered “Absolutely” when asked if he would support a national ban on “sex-altering” surgery for minors. He defended his vote against SB 14 by arguing that the measure also restricted other treatments. This shows that his current stated opposition to surgery does not amount to support for Texas’ broader restrictions on drugs and surgeries.
Talarico also told Fox News he opposed athletes who identify as “transgender” competing in girls’ sports when their participation endangered safety or fairness. Yet, he previously opposed Texas legislation requiring school athletes to compete according to biological sex.
Additionally, footage from a September 13 campaign stop at Wheeler Avenue Baptist Church in Houston raises questions about how substantially Talarico has changed his position. In an undercover recording published September 29 by The Daily Wire, a woman posing as a supporter asked whether he would stand up for her niece who identifies as “transgender,” including participation in girls’ sports. Talarico replied, “Always.”
“The way I fought for trans kids in the legislature is how I will fight for them in the U.S. Senate. And my position hasn’t changed,” Talarico said in the recording published by The Daily Wire. He also argued that schools and sports organizations should decide eligibility locally, “sport by sport, athlete by athlete.”
Another undercover recording, published September 16 by The Daily Wire, features the Rev. Babs Miller, a minister at St. Andrew’s Presbyterian Church in Austin, which Talarico has attended. Miller predicted, “I can guarantee you that once he gets elected, he’ll change his tune back to where he was.” She claimed that advisers had encouraged him to moderate his public rhetoric for the campaign.
A separate recording featured Jennifer Miranda, whom The Daily Wire identified as associated with Texas Together and the Texas Democratic Party. Miranda characterized Talarico’s messaging as an effort to appeal to a broader set of Texas voters, including Republicans.
Parents And The Child-Abuse Debate
In May 2025, Talarico voted for a failed amendment from state Rep. Jolanda Jones (D-District 147) that would have classified certain parental refusals to affirm a child’s perceived gender or expressed sexual orientation as abuse, according to Texas House journal records previously examined by The Dallas Express. The next day he voted against legislation barring abuse or neglect findings solely on that basis.
Talarico described parental rights as “sacred” during an October 14 CNN and Jubilee Media town hall in Fort Worth, as reported in earlier DX coverage. Paxton, meanwhile, has pursued broader restrictions on medical interventions for minors and enforcement against providers.
Depression And Suicide Data Show Serious Risks, Not Simple Answers
The Williams Institute at UCLA analyzed responses to the “2022 U.S. Trans Survey” in a report published in June 2026. Among respondents, 38.9% reported seriously considering suicide during the preceding year and 5.3% reported a suicide attempt. The researchers also found higher reported risk among younger respondents and people who experienced violence or rejection. Those survey figures measure reported suicidal thoughts and attempts among respondents, not the effects of particular treatments.
Trump, Biden And A National Senate Vote
President Donald Trump signed a January 28, 2025, executive order directing agencies to restrict federal support for specified medical interventions for people under 19, within applicable law. That marked a reversal from the Biden administration’s support for access to those interventions and related federal protections.
The Centers for Medicare & Medicaid Services finalized restrictions in August 2026 on federal Medicaid payments for these procedures for children under 18 and federal CHIP payments for those under 19. The rule took effect October 13 and allows a limited transition period for certain existing hormone prescriptions. It does not end ordinary mental-health coverage.
Paxton’s record and Talarico’s recent statements offer voters different approaches to federal restrictions, state enforcement, medical discretion, and parental authority.
With Election Day just six days away, the stakes extend far beyond a viral exchange on X. At the center of this discussion stand consequential questions about parental rights, medical accountability, and the protection of children.
