SB 115

relating to civil liability for, governmental health plan coverage
of, and public funding for gender modification procedures and
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1.  The legislature finds that:
(1)  as evidenced by a 2018 video of a Vanderbilt
University Medical Center administrator who promoted gender
modification surgeries as financially beneficial and stated that
entire clinics are being financed by phalloplasties, the medical
community has knowledge that many so-called "gender-affirming"
treatments are not in the best interest of the health of the patient
but rather are being promoted for the monetary gain the health care
facilities will receive from providing those treatments; and
(2)  the medical community has a conflict of interest
in offering gender modification treatments and procedures because
those treatments and procedures create lifelong patients as a
result of required follow-up visits after those treatments and
SECTION 2.  Title 4, Civil Practice and Remedies Code, is
amended by adding Chapter 74B to read as follows:
CHAPTER 74B.  LIABILITY FOR GENDER MODIFICATION PROCEDURES AND
Sec. 74B.001.  DEFINITION.  In this chapter, "gender
modification procedure or treatment" means a health care procedure
or treatment provided for the purpose of transitioning a patient's
biological sex, as determined by the patient's sex organs,
chromosomes, and endogenous profiles, or affirming the patient's
perception of the patient's sex if that perception is inconsistent
with the patient's sex.  The term includes:
(1)  a surgery that sterilizes the patient, including:
(3)  the prescription, administration, or supply of any
of the following medications that induce transient or permanent
(A)  puberty-blocking medication to stop or delay
(B)  supraphysiologic doses of testosterone to
(C)  supraphysiologic doses of estrogen to males;
(4)  the removal of any otherwise healthy or
non-diseased body part or tissue.
Sec. 74B.002.  CONFLICT OF LAWS.  To the extent this chapter
conflicts with another law, this chapter prevails.
Sec. 74B.003.  STRICT LIABILITY FOR HEALTH COVERAGE.  A
health benefit plan issuer is strictly liable to a patient for the
patient's medical, mental health, and pharmaceutical costs,
including costs associated with reversing a gender modification
procedure or treatment, incurred for the life of the patient as a
result of a gender modification procedure or treatment covered by
Sec. 74B.004.  LIABILITY FOR PHYSICIAN OR HEALTH CARE
PROVIDER.  A physician or health care provider who provides a gender
modification procedure or treatment to a patient is:
(1)  liable to the patient for a malpractice claim in
the provision of the procedure or treatment; and
(2)  strictly liable to the patient for the patient's
medical, mental health, and pharmaceutical costs, including costs
associated with reversing a gender modification procedure or
treatment, incurred for the life of the patient as a result of the
Sec. 74B.005.  EXCEPTIONS.  Sections 74B.003 and 74B.004 do
not apply to the provision by a physician or health care provider,
with the consent of a child's parent or legal guardian, if
applicable, and the coverage by a health benefit plan of
appropriate and medically necessary gender modification procedures
or treatments to a patient who:
(1)  is born with a medically verifiable genetic
disorder of sex development, including:
(A)  46,XX chromosomes with virilization;
(B)  46,XY chromosomes with undervirilization; or
(C)  both ovarian and testicular tissue; or
(2)  does not have the normal sex chromosome structure
for male or female as determined by a physician through genetic
SECTION 3.  Subtitle F, Title 10, Government Code, is
amended by adding Chapter 2273A to read as follows:
CHAPTER 2273A.  PROHIBITED USES OF PUBLIC MONEY
Sec. 2273A.001.  DEFINITIONS.  In this chapter:
(1)  "Gender modification procedure or treatment" has
the meaning assigned by Section 74B.001, Civil Practice and
(2)  "Governmental entity" means this state, a state
agency, or a political subdivision.
Sec. 2273A.002.  USE FOR GENDER MODIFICATION PROCEDURE OR
TREATMENT.  A governmental entity may not use or provide public
money for the provision or administration of a gender modification
SECTION 4.  Subtitle E, Title 8, Insurance Code, is amended
by adding Chapter 1373 to read as follows:
CHAPTER 1373.  PROHIBITED COVERAGE OF GENDER MODIFICATION
Sec. 1373.001.  DEFINITION.  In this chapter, "gender
modification procedure or treatment" has the meaning assigned by
Section 74B.001, Civil Practice and Remedies Code.
Sec. 1373.002.  APPLICABILITY OF CHAPTER.  Notwithstanding
any other law, this chapter applies only to:
(1)  a basic coverage plan under Chapter 1551;
(2)  a basic plan under Chapter 1575;
(3)  a primary care coverage plan under Chapter 1579;
(4)  a plan providing basic coverage under Chapter
(5)  the state Medicaid program, including the Medicaid
managed care program operated under Chapter 540, Government Code;
(6)  the child health plan program under Chapter 62,
Sec. 1373.003.  PROHIBITED COVERAGE; EXCEPTION.  (a)  A
health benefit plan may not provide coverage for a gender
modification procedure or treatment.
(b)  This section does not apply to the coverage by a health
benefit plan of appropriate and medically necessary gender
modification procedures or treatments to a patient who:
(1)  is born with a medically verifiable genetic
disorder of sex development, including:
(A)  46,XX chromosomes with virilization;
(B)  46,XY chromosomes with undervirilization; or
(C)  both ovarian and testicular tissue; or
(2)  does not have the normal sex chromosome structure
for male or female as determined by a physician through genetic
SECTION 5.  (a)  Chapter 74B, Civil Practice and Remedies
Code, as added by this Act, applies only to a cause of action that
accrues on or after the effective date of this Act.
(b)  The changes in law made by this Act apply only to a
health benefit plan delivered, issued for delivery, or renewed on
or after the effective date of this Act.
SECTION 6.  This Act takes effect September 1, 2025.