relating to the provision of procedures and treatments for gender transitioning, gender reassignment, or gender dysphoria and the use of public money or public assistance to provide those procedures or treatments.
Note
the uses of and here is legally significant such that they create a definitive separation of concerns, making it possible to create a list from the sentence.
Note
The title of the bill can be read as:
AN ACT relating to:
• the provision of procedures for gender transistioning, gender reassignment or gender dysphoria
• the provision of treatments for gender transistioning, gender reassignment or gender dysphoria
• the use of public money or public assistance to provide those procedures or treatments.
Caution
This amendment is seeks to expand the definition of the affected individuals to which current prohibitions apply by removing the definitions and stipulations that currently affect only CHILDREN
The heading to Subchapter X, Chapter 161, Health and Safety Code, as added by Chapter 335 (S.B. 14), Acts of the 88th Legislature, Regular Session, 2023, is amended to read as follows:
SUBCHAPTER X. GENDER TRANSITIONING AND GENDER REASSIGNMENT PROCEDURES AND TREATMENTS
Note
The current title of Subchapter X, Chapter 161, Health and Safety Code is:
SUBCHAPTER X. GENDER TRANSITIONING AND GENDER REASSIGNMENT PROCEDURES AND TREATMENTS FOR CERTAIN CHILDREN
Note
This section removes the FOR CERTAIN CHILDREN verbiage from the current subchapter title
Sections 161.701, 161.702, 161.703, 161.704, and 161.705, Health and Safety Code, as added by Chapter 335 (S.B. 14), Acts of the 88th Legislature, Regular Session, 2023, are amended to read as follows:
Tip
This section describes legally significant definitions for terms used elsewhere in the amendment
In this subchapter:
Health care providermeans a person other than aphysicianwho is licensed, certified, or otherwise authorized by this state's laws to provide or render health care or to dispense or prescribe a prescription drug in the ordinary course of business or practice of a profession.Medicaidmeans the medical assistance program established under Chapter 32, Human Resources Code.Physicianmeans a person licensed to practice medicine in this state.
Note
This amendment removes the following definition
"Child" means an individual who is younger than 18 years of age.
Caution
The removal of instances of CHILD or CHILDREN from this bill indicates that it is intended to affect a wider range of people
Sec. 161.702 PROHIBITED PROVISION OF GENDER TRANSITIONING OR GENDER REASSIGNMENT PROCEDURES AND TREATMENTS.
Tip
This section describes a PROVISIONAL PROHIBITION
For the purpose of transitioning a person's biological sex as determined by the sex organs, chromosomes, and endogenous profiles of the person or affirming the person's perception of the person's sex if that perception is inconsistent with the person's biological sex, a physician or health care provider may not knowingly:
- perform a surgery that sterilizes the person, including:
- castration;
- vasectomy;
- hysterectomy;
- oophorectomy;
- metoidioplasty;
- orchiectomy;
- penectomy;
- phalloplasty;
- vaginoplasty;
- perform a mastectomy;
- provide, prescribe, administer, or dispense any of the following prescription drugs that induce transient or permanent infertility:
- puberty suppression or blocking prescription drugs to stop or delay normal puberty;
- supraphysiologic doses of testosterone to females; or
- supraphysiologic doses of estrogen to males; or
- remove any otherwise healthy or non-diseased body part or tissue.
Note
The current title of Section 161.702 is:
PROHIBITED PROVISION OF GENDER TRANSITIONING OR GENDER REASSIGNMENT PROCEDURES AND TREATMENTS TO CERTAIN CHILDREN
Note
The only difference between the verbiage of this amended section, and the current is the removal of references to child or children
Warning
The current implementation of this section describes a general prohibition for the listed procedures and treatments for minors under the age of 18.
Currently, it is illegal for children to undergo the listed procedures and treatments
Caution
The removal of the uses of CHILDREN or CHILD from this section indicates that the current prohibitions will be expanded to all individuals regardless of age
Tip
This section provides exceptions to the prohibitions listed above for persons and children (with legal guardian consent)
(a) Sec. 161.702 does not apply to the provision by a physician or health care provider to a person, including a child with the consent of the child's parent or legal guardian, of:
- puberty suppression or blocking prescription drugs for the purpose of normalizing puberty for a minor experiencing precocious puberty; or
- appropriate and medically necessary procedures or treatments to a person who:
- is born with a medically verifiable genetic disorder of sex development, including:
- 46,XX chromosomes with virilization;
- 46,XY chromosomes with undervirilization; or
- both ovarian and testicular tissue; or
- does not have the normal sex chromosome structure for male or female as determined by a
physicianthrough genetic testing.
- is born with a medically verifiable genetic disorder of sex development, including:
Note
This subdivision provides exceptions for children experiencing precocious puberty, and those legally recognized as intersexed
(b) Sec. 161.702 does not apply to the provision of a prescription drug to a person that is otherwise prohibited by that section if:
- the prescription drug is part of a continuing course of treatment that the person began before June 1, 2025; and
- the person attended 12 or more sessions of mental health counseling or psychotherapy during a period at least six months before the date the course of treatment described by Subdivision (1) began.
Note
This subdivision provides an exception for those who attended 12+ sessions of counseling/psychotherapy within 6 months before starting prescription drug treatment, provided the date of said treatment was prior to June 1, 2025
(c) A person to whom the exception under Subsection (b) applies:
- shall wean off the prescription drug over a period of time and in a manner that is safe and medically appropriate and that minimizes the risk of complications; and
- may not switch to or begin a course of treatment on another prescription drug that a
physicianorhealth care provideris prohibited from providing to the person under Section 161.702 or otherwise receive a procedure or treatment prohibited by that section.
Note
This subdivision stipulates conditions that any who were excepted by the proceeding subdivision must undergo
Important
TRANSLATION
EVEN IF YOU ARE ALLOWED AN EXCEPTION BY SUBDIVISION B, YOU ARE PROHIBITED FROM OBTAINING ANY NEW PRESCRIPTION DRUG TREATMENT, AND YOU WILL BE REQUIRED TO WEAN OFF OF YOUR CURRENT PRESCRIPTION DRUG TREATMENT
Tip
This section describes a PUNITIVE PROHIBITION for violating the provisional prohibition
Public money may not directly or indirectly be used, granted, paid, or distributed to any health care provider, medical school, hospital, physician, or any other entity, organization, or individual that provides or facilitates the provision of a procedure or treatment to a person that is prohibited under Sec. 161.702.
Note
Public Money is understood in its usual sense to mean funds provided by government sources—such as state budgets, tax revenues, grants, and public assistance programs like Medicaid.
Important
This section's intent is to make it harder for individuals to find health care providers who are willing to provide them gender affirming care by denying access to public money. In essence, using our health care system's tight-coupling with capitalism to disuade institutions from ignoring this law.
Caution
This section punishes ANY of the listed institutional types that continue to provide ANY prohibited services and treatments from receiving ANY funding from ANY of the listed government sources. This means that it will become more expensive for a health care provider to continue providing the prohibited services.
Tip
This section describes a PUNITIVE PROHIBITION for violating the provisional prohibition
The commission may not provide Medicaid reimbursement and the child health plan program established by Chapter 62 may not provide reimbursement to a physician or health care provider for provision of a procedure or treatment to a person that is prohibited under Sec. 161.702.
Caution
This section punishes doctors and health care providers by denying them Medicaid reimbursement for procedures and treatments that violate the provisional prohibition
Section 32.024(pp), Human Resources Code, as added by Chapter 335 (S.B. 14), Acts of the 88th Legislature, Regular Session, 2023, is redesignated as Section 32.024(rr), Human Resources Code, and amended to read as follows:
(rr) The medical assistance program may not provide coverage for services prohibited by Sec. 161.702, Health and Safety Code, that are intended to transition a person's biological sex as determined by the person's sex organs, chromosomes, and endogenous profiles.
Note
Removes the constraint of pertaining only to children
Tip
This section provides amendments to the occupations code
The heading to Section 164.0552, Occupations Code, is amended to read as follows:
Sec. 164.0552. PROHIBITED ACTS REGARDING GENDER TRANSITIONING OR GENDER REASSIGNMENT PROCEDURES AND TREATMENTS.
Note
Removes the constraint of pertaining only to children
Important
The occupational code reference herein threatens any health provider or physician that violates the provisional prohibition with having their license revoked and ensures the violating parting has no legal recourse for having their license reinstated. In perpetuity.
Caution
The current text of the referenced Occupations Code:
Sec. 164.0552. PROHIBITED ACTS REGARDING GENDER TRANSITIONING OR GENDER REASSIGNMENT PROCEDURES AND TREATMENTS ON CERTAIN CHILDREN. (a) The board shall revoke the license or other authorization to practice medicine of a physician who violates Section 161.702, Health and Safety Code. The board shall refuse to admit to examination or refuse to issue a license or renewal license to a person who violates that section.
Tip
This provision is essentially a safeguard to ensure that the state does not implement parts of the law that could conflict with federal regulations
If before implementing any provision of this Act a state agency determines a waiver or authorization from a federal agency is necessary for implementation of that provision, the agency affected by the provision shall request the waiver or authorization and may delay implementing that provision until the waiver or authorization is granted.
This Act takes effect September 1, 2025.