Texas bills affecting LGBTQ people: Here’s what you need to know

As soon as lawmakers were allowed to file legislation, some Texas Republicans authored bills aimed at hindering or outright prohibiting transgender kids from accessing certain health care treatments.

Senate Bill 14, authored by a slate of Republican senators, could effectively ban transition-related care for queer youth. It would revoke the licenses of doctors who provide anyone under 18 years old with puberty blockers, hormone therapy or other medical treatments specifically for the purpose of transitioning. And it would withhold public dollars from hospitals that provide such care. The bill also seeks to halt transition-related surgeries for minors, though medical experts say such procedures are rarely, if ever, performed on children.

In the House, 77 Republican state representatives have signed on to a similar bill. House Bill 1686 already has support of more than half of the 150-member House. The bicameral support provides a significant boost for Republican lawmakers who seek to restrict these medical treatments.

Lt. Gov. Dan Patrick made limiting such health care a priority for the Senate this year. Medical groups, doctors and transgender Texans say the lawmakers backing the proposed bans are missing the point of how transition-related health care helps trans people, improving the mental health of children who are at higher risks of attempting suicide. Critics say the Republicans pushing for the health care restrictions are deliberately misconstruing information to target an already marginalized group of people.

Sen. Donna Campbell, R-New Braunfels, amended SB 14 on March 29 to allow children who are receiving puberty blockers and hormone therapies by early June to continue such treatments if the bill is signed into law and takes effect. Her Republican colleagues supported that exception and gave initial approval to the bill. But days later, Campbell and Republican senators reversed themselves and removed those exceptions to the bill. On April 4, they approved a version of the legislation blocking transition-related health care for all trans kids. On April 14, the House Public Health Committee advanced new versions of SB 14 and HB 1686 that would require trans youth already receiving puberty blockers or hormone therapy to be “weaned off the prescription drug over a period of time and in a manner that is safe and medically appropriate.”

Leading medical groups — including the American Academy of Pediatrics, the nation’s top medical association for youth — recommend treatment for children with gender dysphoria, the distress someone can feel when their physical presentation does not align with their gender identity. For teens and youth, this kind of care is often limited to counseling and social transition — using different pronouns or wearing different clothes. But it can at times include the use of medication that temporarily delays the onset of puberty.

Rep. Tom Oliverson, R-Cypress, the primary author of HB 1686, has another bill that would allow medical providers to decline treatment to any patient for religious views, moral philosophy or “ethical position,” except for during emergency or life-threatening instances. House Bill 319 does not explicitly mention LGBTQ people, but advocates fear the bill would allow doctors to turn people away simply because of their gender or sexual identity. It has been assigned to the House Public Health Committee.

House Bill 3502 from Rep. Jeff Leach, R-Plano, proposes new requirements for insurance companies to cover any adverse consequences of gender-affirming care, including costs associated with detransitioning. Critics of the bill say it would dissuade insurance companies from covering the cost of puberty blockers or hormone therapy. Supporters argue that if insurance companies pay for the treatment, they should be liable for any side effects. HB 3502 was left pending in the House Insurance Committee after a hearing April 11.

Senate Bill 250, authored by Republican Sens. Bob Hall of Edgewood, Charles Perry of Lubbock and Campbell, would bar physicians from providing minors with puberty blockers or hormone therapies and would ban insurance companies from covering such treatment. The bill also seeks to ban transition-related surgeries for minors, though medical experts say such procedures are rarely performed on children. The legislation would also revoke the licenses of health care professionals who provide this kind of care. It has advanced out of the Senate State Affairs Committee following a 9-2 vote on April 6.

House Bill 436 from Rep. Jared Patterson, R-Frisco, aims to classify health care treatment like puberty blockers and hormone therapy as child abuse if they are administered for the purposes of transitioning. After similar legislation failed in 2021, Republican Attorney General Ken Paxton issued a nonbinding legal opinion that equated certain medical treatments and procedures for transgender teens with child abuse. Citing that opinion, Gov. Greg Abbott sent a letter to the Department of Family and Protective Services directing the agency to investigate parents who provided transition-related care to their transgender children. LGBTQ advocacy groups are fighting that directive, which a Travis County judge largely blocked last year. HB 436 has been assigned to the House Public Health Committee.