13-05-2025
Texas bill requiring insurance companies to cover gender detransitioning heads to governor
A Texas Senate bill requiring insurance companies to cover all follow-up care and treatment for potential adverse effects to patients who receive gender affirming care, including "therapy necessary to manage, reverse, reconstruct from, or recover from" such care is headed to Gov. Greg Abbott to become law after the House passed the proposal Monday and the upper chamber signed the measure Tuesday.
The House on Monday also advanced to the Senate a proposal limiting the definition of sex to male and female. The proposal acknowledges intersex people, or those born with a combination of male and female biological traits, though it specifies there is no third gender, instead the proposal calls for special accommodations as per federal and state law. Several rights groups and LGBTQ advocates have been fighting the proposals, which they say will erase the lived experiences of transgender Texans and hurt their health.
Equality Texas, an LGBTQ rights advocacy group, organized a rally Friday at the Capitol with dozens of rallygoers to oppose the measures that they say are anti-LGBTQ. The group is tracking more than 200 bills this legislative session that it says are harmful to LGBTQ Texans. The number of such proposals in Texas tops similar legislative considerations compared with any other state, CEO Brad Pritchett said at the rally.
House Bill 229 by Rep. Ellen Troxclair, R-Lakeway, would require government entities to only recognize the sex of an individual at birth, prohibiting the agencies from accepting the gender identities of transgender Texans or of a person who identifies as nonbinary, meaning they neither identify as a man nor a woman.
"It affects every aspect of our daily lives," said Shelly Skeen, South Central director of Lambda Legal, about the bill's potential effect on identities. "Mismatched IDs out you and that can immediately lead to violence," not getting paid for work, not accessing health care and more.
About 1.6 million people over the age of 13 in the U.S. are transgender, including 92,900 adults in Texas, according to the UCLA School of Law Williams Institute. Beyond individuals who transition to a different gender than the one assigned to them at birth, the United Nations estimates that about 1.7% of the population is born with intersex traits.
Troxclair has dubbed her bill the "Women's Bill of Rights," saying the definition of sex needs to be clarified and codified to help and protect women whose gender aligns with their sex at birth.
"We can't have women's rights if we don't even know what a woman is," she said in a Texas Public Policy Foundation video earlier during the legislative session. "We need to define what a woman is to bring clarity, certainty and uniformity in the way women are treated under Texas law."
All world health and major medical associations recognize transgender youth, according to GLAAD, an advocacy organization for LGBTQ rights, and many have rejected insurance exclusions or limitations on gender-affirming care. Many of those organizations have asserted that gender-affirming care can be life-saving for those who suffer from gender dysphoria, severe mental distress for people whose sex at birth does not align with their gender identity.
Senate Bill 1257 by Mineola Republican Sen. Bryan Hughes wouldn't limit gender affirming care explicitly, but it would put health insurance agencies on the line for "all possible adverse consequences" related to a gender transition and all follow-up appointments to monitor the health of the patient.
In a statement to the American-Statesman, state Rep. Jeff Leach, R-Plano, who carried the companion legislation in the House, said SB 1257 is about "basic fairness and responsibility in health care coverage."
'If an insurance plan chooses to cover gender reassignment procedures, it must also cover the side effects and provide care for those who later seek to reverse those procedures," Leach said. "We've heard directly from brave individuals who have detransitioned—people whose pain and healing journeys are real and cannot be ignored. Their voices matter, and this bill ensures they are not abandoned in their time of need by the very systems that once supported their transition.'
But advocates fear the bill will make it so burdensome for health care providers to treat transgender patients that they could deny coverage.
"It doesn't just lead into gender affirming care. It leads into health care that we all need, that we all deserve, that the state needs to make it great, to have our population healthy," said Emmett Schelling, executive director for the Transgender Education Network in Texas.
Rox Sayde, a 30-year-old nonbinary advocate who is also a field intern at Equality Texas, said they are speaking out for their late partner, Amelia, a transgender Texan who died by suicide and could not access the mental health services she needed. When Sayde speaks out, they feel Amelia with them, and know she would be proud.
"I'm here because of her. Every day I think of her, and it keeps me going," Sayde said. "I'm not that spiritual of a person, but I think that the people we lose are still with us, when we think about them, and in the way that she shapes my life."
Sayde, who is nonbinary and is seeking gender affirming care, said they don't know if their health care will be possible because of SB 1257.
"They're trying to legislate transgender people out of public life," Sayde said. "I'm just here because I have so much love for my community ... look at how beautiful we are."
Mandy Giles, a mom of two transgender children who are now young adults, came to the Capitol from Houston to testify and fight against bills she said would hurt transgender Texans. The proposals have created a tremendous amount of stress for her family.
"This is our home," Giles said. "To feel like our family is being split apart because my kids are being targeted" and they don't want to live here.
Giles cried at the rally Friday, she said, because she became overwhelmed by the "bittersweet" nature of being united with people who will fight for her kids, but also because of the need to fight in the first place. Seeing her kids be their authentic selves is a "beautiful journey" that makes her happy and hopeful, and she wished more people would help protect their rights.
"I wish there were more allies here, because it's a terrible burden for transgender community to bear," Giles said. "To not be erased."
Democratic state Reps. Aicha Davis of Dallas and Ron Reynolds of Missouri City attended the rally Friday in support of LGBTQ Texans and fight against the bills.
State Rep. Venton Jones, the vice chair of the House's LGBTQ Caucus and a Democrat from Dallas, promised advocates that though there are people who push legislation that hurts transgender people, there are "so many more that love you, that accept you, that will do anything to protect you."
"As a Black gay man living with HIV, it's not the easiest to come into this building every day. It's not the easiest to work across the aisle when someone was actively making legislation to make not only your life worse, but the lives of the people that you love and that you give everything for every day," Jones said. "And so I just want to say to you all, when you think about the thoughts around leaving this state how important it is for us to stay."
This article originally appeared on Austin American-Statesman: Texas lawmakers OK bill mandating insurance coverage for detransitioning
