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A BILL TO BE ENTITLED
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AN ACT
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relating to the provision of procedures and treatments for gender |
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transitioning, gender reassignment, or gender dysphoria and the use |
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of public money or public assistance to provide those procedures or |
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treatments. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. The heading to Subchapter X, Chapter 161, Health |
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and Safety Code, as added by Chapter 335 (S.B. 14), Acts of the 88th |
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Legislature, Regular Session, 2023, is amended to read as follows: |
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SUBCHAPTER X. GENDER TRANSITIONING AND GENDER REASSIGNMENT |
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PROCEDURES AND TREATMENTS [FOR CERTAIN CHILDREN] |
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SECTION 2. Sections 161.701, 161.702, 161.703, 161.704, and |
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161.705, Health and Safety Code, as added by Chapter 335 (S.B. 14), |
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Acts of the 88th Legislature, Regular Session, 2023, are amended to |
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read as follows: |
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Sec. 161.701. DEFINITIONS. In this subchapter: |
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(1) ["Child" means an individual who is younger than |
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18 years of age. |
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[(2)] "Health care provider" means a person other than |
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a physician who is licensed, certified, or otherwise authorized by |
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this state's laws to provide or render health care or to dispense or |
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prescribe a prescription drug in the ordinary course of business or |
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practice of a profession. |
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(2) [(3)] "Medicaid" means the medical assistance |
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program established under Chapter 32, Human Resources Code. |
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(3) [(4)] "Physician" means a person licensed to |
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practice medicine in this state. |
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Sec. 161.702. PROHIBITED PROVISION OF GENDER TRANSITIONING |
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OR GENDER REASSIGNMENT PROCEDURES AND TREATMENTS [TO CERTAIN |
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CHILDREN]. For the purpose of transitioning a person's [child's] |
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biological sex as determined by the sex organs, chromosomes, and |
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endogenous profiles of the person [child] or affirming the person's |
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[child's] perception of the person's [child's] sex if that |
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perception is inconsistent with the person's [child's] biological |
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sex, a physician or health care provider may not knowingly: |
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(1) perform a surgery that sterilizes the person |
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[child], including: |
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(A) castration; |
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(B) vasectomy; |
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(C) hysterectomy; |
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(D) oophorectomy; |
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(E) metoidioplasty; |
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(F) orchiectomy; |
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(G) penectomy; |
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(H) phalloplasty; and |
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(I) vaginoplasty; |
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(2) perform a mastectomy; |
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(3) provide, prescribe, administer, or dispense any of |
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the following prescription drugs that induce transient or permanent |
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infertility: |
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(A) puberty suppression or blocking prescription |
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drugs to stop or delay normal puberty; |
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(B) supraphysiologic doses of testosterone to |
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females; or |
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(C) supraphysiologic doses of estrogen to males; |
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or |
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(4) remove any otherwise healthy or non-diseased body |
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part or tissue. |
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Sec. 161.703. EXCEPTIONS. (a) Section 161.702 does not |
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apply to the provision by a physician or health care provider to a |
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person, including a child with the consent of the child's parent or |
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legal guardian, of: |
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(1) puberty suppression or blocking prescription |
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drugs for the purpose of normalizing puberty for a minor |
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experiencing precocious puberty; or |
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(2) appropriate and medically necessary procedures or |
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treatments to a person [child] who: |
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(A) is born with a medically verifiable genetic |
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disorder of sex development, including: |
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(i) 46,XX chromosomes with virilization; |
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(ii) 46,XY chromosomes with |
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undervirilization; or |
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(iii) both ovarian and testicular tissue; |
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or |
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(B) does not have the normal sex chromosome |
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structure for male or female as determined by a physician through |
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genetic testing. |
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(b) Section 161.702 does not apply to the provision of a |
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prescription drug to a person [child] that is otherwise prohibited |
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by that section if: |
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(1) the prescription drug is part of a continuing |
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course of treatment that the person [child] began before June 1, |
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2025 [2023]; and |
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(2) the person [child] attended 12 or more sessions of |
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mental health counseling or psychotherapy during a period of at |
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least six months before the date the course of treatment described |
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by Subdivision (1) began. |
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(c) A person [child] to whom the exception under Subsection |
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(b) applies: |
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(1) shall wean off the prescription drug over a period |
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of time and in a manner that is safe and medically appropriate and |
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that minimizes the risk of complications; and |
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(2) may not switch to or begin a course of treatment on |
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another prescription drug that a physician or health care provider |
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is prohibited from providing to the person [child] under Section |
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161.702 or otherwise receive a procedure or treatment prohibited by |
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that section. |
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Sec. 161.704. PROHIBITED USE OF PUBLIC MONEY. Public money |
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may not directly or indirectly be used, granted, paid, or |
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distributed to any health care provider, medical school, hospital, |
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physician, or any other entity, organization, or individual that |
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provides or facilitates the provision of a procedure or treatment |
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to a person [child] that is prohibited under Section 161.702. |
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Sec. 161.705. PROHIBITED STATE HEALTH PLAN REIMBURSEMENT. |
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The commission may not provide Medicaid reimbursement and the child |
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health plan program established by Chapter 62 may not provide |
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reimbursement to a physician or health care provider for provision |
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of a procedure or treatment to a person [child] that is prohibited |
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under Section 161.702. |
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SECTION 3. Section 32.024(pp), Human Resources Code, as |
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added by Chapter 335 (S.B. 14), Acts of the 88th Legislature, |
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Regular Session, 2023, is redesignated as Section 32.024(rr), Human |
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Resources Code, and amended to read as follows: |
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(rr) [(pp)] The medical assistance program may not provide |
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coverage for services prohibited by Section 161.702, Health and |
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Safety Code, that are intended to transition a person's [child's] |
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biological sex as determined by the person's [child's] sex organs, |
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chromosomes, and endogenous profiles. |
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SECTION 4. The heading to Section 164.0552, Occupations |
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Code, is amended to read as follows: |
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Sec. 164.0552. PROHIBITED ACTS REGARDING GENDER |
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TRANSITIONING OR GENDER REASSIGNMENT PROCEDURES AND TREATMENTS [ON |
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CERTAIN CHILDREN]. |
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SECTION 5. If before implementing any provision of this Act |
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a state agency determines a waiver or authorization from a federal |
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agency is necessary for implementation of that provision, the |
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agency affected by the provision shall request the waiver or |
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authorization and may delay implementing that provision until the |
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waiver or authorization is granted. |
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SECTION 6. This Act takes effect September 1, 2025. |