Text of TX HB 3399 (2025)

89R8311 EAS-D By: Money H.B. No. 3399 A BILL TO BE ENTITLED AN ACT 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. BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: SECTION 1. 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 [FOR CERTAIN CHILDREN] SECTION 2. 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: Sec. 161.701. DEFINITIONS. In this subchapter: (1) ["Child" means an individual who is younger than 18 years of age. [(2)] "Health care provider" means a person other than a physician who 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. (2) [(3)] "Medicaid" means the medical assistance program established under Chapter 32, Human Resources Code. (3) [(4)] "Physician" means a person licensed to practice medicine in this state. Sec. 161.702. PROHIBITED PROVISION OF GENDER TRANSITIONING OR GENDER REASSIGNMENT PROCEDURES AND TREATMENTS [TO CERTAIN CHILDREN]. For the purpose of transitioning a person's [child's] biological sex as determined by the sex organs, chromosomes, and endogenous profiles of the person [child] or affirming the person's [child's] perception of the person's [child's] sex if that perception is inconsistent with the person's [child's] biological sex, a physician or health care provider may not knowingly: (1) perform a surgery that sterilizes the person [child], including: (A) castration; (B) vasectomy; (C) hysterectomy; (D) oophorectomy; (E) metoidioplasty; (F) orchiectomy; (G) penectomy; (H) phalloplasty; and (I) vaginoplasty; (2) perform a mastectomy; (3) provide, prescribe, administer, or dispense any of the following prescription drugs that induce transient or permanent infertility: (A) puberty suppression or blocking prescription drugs to stop or delay normal puberty; (B) supraphysiologic doses of testosterone to females; or (C) supraphysiologic doses of estrogen to males; or (4) remove any otherwise healthy or non-diseased body part or tissue. Sec. 161.703. EXCEPTIONS. (a) Section 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: (1) puberty suppression or blocking prescription drugs for the purpose of normalizing puberty for a minor experiencing precocious puberty; or (2) appropriate and medically necessary procedures or treatments to a person [child] who: (A) is born with a medically verifiable genetic disorder of sex development, including: (i) 46,XX chromosomes with virilization; (ii) 46,XY chromosomes with undervirilization; or (iii) both ovarian and testicular tissue; or (B) does not have the normal sex chromosome structure for male or female as determined by a physician through genetic testing. (b) Section 161.702 does not apply to the provision of a prescription drug to a person [child] that is otherwise prohibited by that section if: (1) the prescription drug is part of a continuing course of treatment that the person [child] began before June 1, 2025 [2023]; and (2) the person [child] attended 12 or more sessions of mental health counseling or psychotherapy during a period of at least six months before the date the course of treatment described by Subdivision (1) began. (c) A person [child] to whom the exception under Subsection (b) applies: (1) 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 (2) may not switch to or begin a course of treatment on another prescription drug that a physician or health care provider is prohibited from providing to the person [child] under Section 161.702 or otherwise receive a procedure or treatment prohibited by that section. Sec. 161.704. PROHIBITED USE OF PUBLIC MONEY. 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 [child] that is prohibited under Section 161.702. Sec. 161.705. PROHIBITED STATE HEALTH PLAN REIMBURSEMENT. 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 [child] that is prohibited under Section 161.702. SECTION 3. 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) [(pp)] The medical assistance program may not provide coverage for services prohibited by Section 161.702, Health and Safety Code, that are intended to transition a person's [child's] biological sex as determined by the person's [child's] sex organs, chromosomes, and endogenous profiles. SECTION 4. 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 [ON CERTAIN CHILDREN]. SECTION 5. 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. SECTION 6. This Act takes effect September 1, 2025.