HB 3399

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
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
Sec. 161.701.  DEFINITIONS.  In this subchapter:
(1)  ["Child" means an individual who is younger than
[(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
(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
(3)  provide, prescribe, administer, or dispense any of
the following prescription drugs that induce transient or permanent
(A)  puberty suppression or blocking prescription
drugs to stop or delay normal puberty;
(B)  supraphysiologic doses of testosterone to
(C)  supraphysiologic doses of estrogen to males;
(4)  remove any otherwise healthy or non-diseased body
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
(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;
(iii)  both ovarian and testicular tissue;
(B)  does not have the normal sex chromosome
structure for male or female as determined by a physician through
(b)  Section 161.702 does not apply to the provision of a
prescription drug to a person [child] that is otherwise prohibited
(1)  the prescription drug is part of a continuing
course of treatment that the person [child] began before June 1,
(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
(c)  A person [child] to whom the exception under Subsection
(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
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
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
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.