Video games and prediction markets are pulling Texas children toward compulsive behavior and gambling-like risks faster than families and regulators can respond, physicians told the Texas Senate Committee on State Affairs.
In testimonies on behalf of the Texas Medical Association and the Texas Pediatric Society (TPS), Lauren Gambill, MD, and Lindy McGee, MD, warned that platform design, marketing, and algorithms are capturing children’s attention and families’ money, and that state safeguards have not kept pace.
TMA and TPS are asking lawmakers to set a minimum age of 21, with verification, to participate in prediction markets, and to require strong default protections for minors on gaming platforms.
Approximately 85% of U.S. teens report playing video games, and 41% say they play every day, according to the Pew Research Center. Many games now come with virtual economies, microtransactions, paid subscriptions, and other ways for children to spend money.
“Features like streaks, persistent notifications, rewards, leaderboards, and social pressure can encourage children to remain online or return repeatedly,” Dr. Gambill testified on behalf of TMA and TPS. “Some games even remove natural stopping points so a person continues playing.”
Children and adolescents may be less developmentally able to recognize or resist the psychological pressures built into the games, the Austin pediatrician says. That makes it harder for young people to establish healthy boundaries with technology and redirect attention to sleep, school, physical activity, family, and other activities important to their well-being.
Almost nine out of 10 gamers say they play online with others, connecting via chat rooms and virtual social spaces. Safeguards should be in place to prevent younger gamers from being funneled into private, unmonitored chat rooms, Dr. Gambill says.
“TMA and TPS urge the legislature to require strong default protection for minors rather than placing the entire responsibility on children and their parents,” she testified. “Parents should not have to navigate each platform’s generated experiences, complicated privacy settings, direct messages, and private servers.”
Dr. McGee says prediction markets, via their online platforms, pose similar risks to children and adolescents. Prediction markets have already expanded beyond traditional gambling and can reach those who don’t consider themselves gamblers.
“Almost one in four boys engage in gaming that mimics gambling,” the Houston pediatrician testified on behalf of TMA and TPS. “More than half of the boys playing these games spend real money on chance-based prizes, showing how easily gambling-like activities can become part of the online spaces young people already use.”
While prediction markets are not classified as gaming under current Texas law, “these prediction markets can have similar negative psychological and behavioral health outcomes, especially for adolescent boys who are more vulnerable to addiction,” she said.
Dr. McGee and Dr. Gambill have both previously served as chair of TMA’s Committee on Child and Adolescent Health. Both called for continued research so Texas’ safeguards can evolve along with the technology, grounded in evidence.
Follow TMA’s legislative testimony and related Texas Medicine Today coverage on the state advocacy webpage.