SB 1257 requires that any health benefit (except for employer self-funded plans) plan that currently covers or has ever covered specific gender-affirming care (GAC) sought by trans people (and only when sought by trans people, and including mental health services, annual screenings, necessary monitoring) also cover any costs associated with treating “adverse consequences” of those procedures and any costs related to “detransitioning.”

Insurance companies would be responsible for providing that coverage even if the person seeking “detransition” care was not enrolled in that same insurance plan when they received the initial care.

Deterring the Coverage of Care

By increasing the financial burden on health benefit plans to cover unforeseeable and limitless costs, this bill may potentially deter insurance companies from providing coverage for GAC, including mental health services, meaning companies may cease covering gender-affirming care services altogether.

Increasing Costs 

If an insurance company chooses not to stop providing coverage for GAC (and therefore agrees to cover the additional costs required by this bill), those plans will likely become more expensive, thus creating an additional financial barrier for trans people seeking life-saving, medically-necessary care. While SB 1257 is not directly a healthcare ban, it may have similar effects on the ability to access care as if it were banned. Care will still be legal to provide and receive, but it may become more costly and, for some, entirely cost prohibitive. Texas has taken similar aim at adult healthcare for trans Texans on Texas Medicaid when, in 2024, the Texas Health and Human Services Commission (HHSC) reversed its policy providing coverage for gender-affirming care sought by trans people. As a result, people lost access to their healthcare because the out-of-pocket costs became too expensive.

Appealing a Health Plan Decision 

If your health insurer refuses to pay a claim or ends your coverage, you have the right to appeal the company’s decision and have it renewed by a third party. That right includes asking your insurance company to reconsider its decision. Insurers are also required to tell you why they denied your claim or ended your coverage, and they have to let you know how you can challenge their decisions.

HB 1106 amends Texas Family Code Chapter 261 to exclude from the definition of “abuse” and “neglect” a parent or guardian’s refusal to support their queer, transgender, or gender expansive children. It also includes a specific provision regarding protecting the refusal to honor their child’s name or pronouns, even if their name has been legally changed.

Interfering with the Individualized Assessment that Child Welfare Cases Require

HB 1106 prevents Child Protective Services (CPS) from intervening in cases where a child experiences psychological harm from their parents because they are queer and/or trans. HB 1106 would also prevent a court from making a factual inquiry into a child’s wellbeing if they are queer or gender expansive and that fact is central to understanding the child’s circumstances.

This bill aims to shield parents and guardians from accountability for mistreating their queer and trans kids (especially in custody proceedings).

SB 1188 requires that electronic health records (EHRs) include a space in a person’s record for “biological sex at birth” according to “the biological trait that determines whether a sexually reproducing organism produces male or female gametes,” thus enforcing binary sex designations on all Texans, regardless of their gender identity or the status of their legal documents.

This bill prohibits amendments to the marker listed in a person’s EHR except in instances of clerical errors or cases in which someone is diagnosed with an intersex condition. Despite allowing people who are intersex to amend their EHR sex markers, SB 1188 still forces intersex people into binary sex categories, even if neither “male” nor “female” accurately represents their physiology and lived experience.

While this bill enables EHRs to also include information in a person’s record about their lived gender, it does not require that this field be included. Because the inclusion of a space for gender identity is not mandated, the decision to include one will be left up to the discretion of individual EHR vendors.

Lastly, SB 1188 grants parents and guardians total access to their minor children’s health records and includes licensing and monetary penalties of up to $250,000 for EHR vendors, medical providers, and otherwise “covered entities”.

Patient Privacy

Permitting parents and guardians to access their minor children’s EHRs encroaches upon and violates the trust between patient and provider. This could place vulnerable youth who lack support at home in harm’s way and erode trust between the patients and provider if they fear that what they disclose to their doctor will be accessible to their parents or guardians as well.

The required inclusion of someone’s “biological sex assigned at birth” is also not always relevant to the healthcare someone might receive. But as a result of this bill, people’s personal and sensitive health information will be revealed to every medical provider and healthcare support/administrative staff who has access to patient EHRs, no matter why or for what health concern a person is seeking services.

Insurance Implications

SB 1188 may create disruptions to and confusion regarding insurance coverage for TGE patients whose sex marker listed on medical records and with their insurance plans align. The requirement for EHRs to list “biological sex at birth” may result in discrepancies between medical records and insurance information, and having mismatched markers can result in the denial of coverage for essential healthcare services and medications.

Confusion Within the Healthcare System

SB 1188 places the burden on providers, hospital systems, and EHR vendors to update their EHR systems with the mandated sex field. These system-wide changes will likely be costly and ensuring total compliance with the bill will not only be an administrative strain but may also result in errors in people’s records and, as a result, potentially in the care they receive or the way they are treated as people. Additionally, the monetary and licensing penalties associated with noncompliance may cause providers to overcomply and update people’s EHRs without their knowledge and/or without reason, thus creating confusion for patients, doctors, and other staff.

Mistreatment of Trans, Gender Expansive, and Intersex Patients

The allowance for including gender identity on medical records does not nullify the harm that this bill has the potential to cause. Not having identifying information that accurately reflects who someone is can make navigating medical settings increasingly prohibitive and dangerous by effectively outing trans, gender expansive, and intersex people to providers and other medical system employees, regardless of whether or not the care being sought is relevant to a person’s gender or sex.

Parent Access and Control

SB 12 grants parents near-total access to their child’s school records, including what library books they check out, what counseling services they seek and receive, what information they learn in the classroom, and what activities they take part in. This bill also affords parents and guardians the ability to completely opt their children out of receiving instruction and activities regarding health education, sexual orientation, and gender identity, among other topics. By requiring written parental consent for a student’s participation in human sexuality instruction, access to mental health services at school, access to certain library materials, and participation in clubs, SB 12 may cause schools, teachers, and other school employees to completely avoid providing services or accurate, LGBTQIA+ inclusive instruction to students out of fear that they will face consequences.

Student Clubs

SB 12 also prohibits school districts from authorizing and sponsoring Gay-Straight Alliances (GSAs), Sexuality and Gender Alliances (SAGAs), and any other clubs specifically dedicated to supporting queer and trans students.

Supporting TGE Students

In addition to stripping students of access to safe and affirming spaces at school, SB 12 also aims to ban teachers and other school or district employees from “assisting” a student with social transitioning, and “providing any information about social transitioning or providing guidelines intended to assist a person with social transitioning.”

Importantly, however, the bill does not clearly define what “assisting” means in the context of social transitioning. This vagueness was not only deemed unconstitutional by a federal judge in February 2026, but has led to ISDs interpreting and implementing this provision in different ways, regardless of whether a parent is supportive of their student’s chosen name/pronouns. 

SB 12 also emboldens district employees or any parent with a child enrolled in the school district to report suspected violations of this ban on “assisting” a student with their social transition. This means that any parent with an enrolled student in the school district can file a grievance with the district about a child that is not their own, resulting in and encouraging a culture of surveillance, distrust, and violations of privacy.

On the “Social Transition Ban”

While on paper SB 12 aims to ban “assisting” with a student’s social transition and to punish school staff who support trans and gender-expansive students, both state and federal law protect the rights of students to have their chosen names and pronouns respected in school. The Transgender Law Center and the ACLU of Texas, as well as the federal judge who issued the preliminary injunction, have all encouraged school districts to follow federal law when state and federal laws conflict. 

 Firstly, the Texas Education Code only requires schools to identify students by their legal surnames on official documentation and records, meaning that there is no legal requirement to exclusively use a student’s legal first name on non-official documents and records, in class, at all school events, in yearbooks and clubs.

 Secondly, Federal law protects students’ rights to be addressed by their chosen name and pronouns, and deadnaming/misgendering a student is also a violation of federal privacy laws like the Family Educational Rights Privacy Act (FERPA). Further, refusing to honor a student’s chosen name and pronouns can constitute gender-based harassment under Title IX and the U.S. Constitution. 

 Despite the existence of state and federal protections and interventions by legal experts, we know that schools are continuing to perpetuate harm against trans and gender-expansive students, denying them basic dignity and respect in the classroom.

If you or your child are experiencing SB 12-related discrimination, please reach out to us at support@transtexas.org.

The Bill’s Scope
This bill amends the “General Definitions” section of the Texas Government Code. Definitions in this section, which span the entire Texas Government Code, “apply unless the statute or context in which the word or phrase is used requires a different definition.” In other words, these definitions serve to “clarify” any and all Texas statutes, codes, and rules in which the words are mentioned. While the bill only specifically implicates governmental entities that “collect vital statistics information that identify the sex of an individual for the purpose of complying with antidiscrimination laws or for the purpose of gathering public health, crime, economic, or other data” and requires that those entities identify each individual as either male or female (of course, according to the definitions in this bill), the category of “governmental entity” includes an array of agencies, departments, as well as municipalities, counties, and districts.

The main entities that collect the vital statistics information described in this bill are the Texas Department of Public Safety (DPS), DPS’ Crime Records Division (CRD), and the Texas Department of State Health Services (DSHS).

Because the bill’s language is so vague in this regard, there will likely be significant confusion and inconsistencies within and between individual state agencies and other governmental bodies and political subdivisions on what policies to adopt and how to implement them, including how to approach people’s existing documents. These inconsistencies may cause confusion in other aspects of daily life, including in school, healthcare settings, and other institutions that also collect this information in some form. Mismatched documentation, especially between someone’s lived gender and sex recorded at birth, can result in not just confusion, but also violations of privacy, misgendering and involuntary outing, barriers to care or services, discrimination, and threats to physical safety.

Confusion around Enforcement
HB 229 does not include any sort of “enforcement mechanism.” It does not threaten monetary, civil, or criminal penalties for noncompliance, and it does not instruct governmental entities specifically on how to implement these new definitions. HB 229 also does not specify which policies (aside from the broad vital statistics data collection section) require reinterpretation in order to be in alignment with these definitions, and how, in practice, to ensure that these definitions are integrated and acted upon to the state’s satisfaction. 

Because the bill’s language is so vague in this regard, there will likely be significant confusion and inconsistencies within and between individual state agencies and other governmental bodies and political subdivisions on what policies to adopt and how to implement them, including how to approach people’s existing documents. These inconsistencies may cause confusion in other aspects of daily life, including in school, healthcare settings, and other institutions that also collect this information in some form. Mismatched documentation, especially between someone’s lived gender and sex recorded at birth, can result in not just confusion, but also violations of privacy, misgendering and involuntary outing, barriers to care or services, discrimination, and threats to physical safety. 

Identification Documents
There is nothing in HB 229 that explicitly addresses what actions agencies like DPS and DSHS should take regarding people’s existing driver’s licenses, state IDs, or birth certificates. It does not instruct these agencies to revert documents that have been legally changed.

However, it aims to codify the August 2024 DPS and Vital Statistics policies prohibiting trans and gender expansive Texans from making gender marker amendments on driver’s licenses, state IDs, and Texas birth certificates. 

Earlier this year, the Attorney General issued an opinion supporting the DPS/Vital Stats gender marker policy and directed the departments to revert documents that had been amended previously. Attorney General opinions are not legally binding nor are they law.

It’s also important to note that until August of 2024, the state of Texas (DPS specifically) did not formally collect, in any organized way, data concerning who sought changes to their gender markers and for what reason. In 2022, the AG requested that data from DPS but because the Department had not been collecting that data, they could not fulfill his request. That being said, unless DPS initiated additional internal policy changes since last August when the Department began creating a “list” of gender marker change requests, a mechanism to determine just how many Texans and who among them have amended their legal documents doesn’t currently seem to exist.

Unfortunately, as we have seen at the national level with passports and social security, and even at the state level with certain DL/ID renewal appointments, individual employees at these agencies who oversee and facilitate matters of documentation and document updates may feel emboldened by existing state and/or national policies to make assumptions about a person’s gender or sex and therefore what sex marker should be on their documents. It’s also not uncommon for bureaucrats to either 1) obey in advance or 2) over-comply with new policies and laws out of fear of being disciplined for not following the rules correctly or because they agree with the aim of the policy and wish to ensure they are carried out to the fullest extent. Because of this, even if there may not be any widespread reversals of DL/ID gender markers, individual clerical workers and state employees may still act on the state’s behalf (or what they think is the state’s behalf) and take it upon themselves to make unwanted changes to people’s documents.

Because of this, even if there may not be any widespread reversals of DL/ID gender markers, individual clerical workers and state employees may still act on the state’s behalf and take it upon themselves to make unwanted changes to people’s documents.

If you experience any issues at the DMV or any other administrative office where the validity of your current gender marker is challenged or undermined completely, please contact us at support@transtexas.org.

For additional information about the current state of DLs, IDs, and birth certificates in Texas, you can reference our DPS Information Page.

Worsening Healthcare Access Disparities
Because so much essential funding and infrastructure assistance is tied up in this bill, rural health care systems and providers may proceed with greater caution regarding the services they provide (namely those relating to gender identity) in an effort to avoid risking noncompliance. This reluctance to provide care to people in the communities in which they live may exacerbate already existing disparities in access to affirming services for youth in rural areas, as well as strain the relationship between families and their health care providers.

We can anticipate that harassment of both cisgender and transgender people who are suspected to be in the “incorrect” bathroom will increase across the board, both in public and private facilities. It continues to be important to establish safe spaces and safeguard non-discrimination practices in all facilities to prevent harassment and discourage escalation of violence in the name of enforcing the law.

SB 8 is widely recognized as an attempt to escalate the application of discriminatory law to state agencies and other state institutions. We have seen a consistent pattern of encroachment on the rights of transgender people in policies applied through agencies such as DFPS and DPS. The goal of these attacks is to instill fear and manufacture consent for widespread discrimination against transgender, intersex, and non binary people – and all people who do not conform to traditional gender presentations.

While SB 8 applies only to public institutions, we have seen with other efforts to strip TGE people of their rights that private institutions and entities even when not subject to the same laws and policies as their public counterparts, have chosen to align their policies with those of the state despite there being no legal requirement for them to do so. We also know from other bills passed in Texas private individuals take it upon themselves to enforce the law beyond its scope.

If you experience harassment, discrimination, or violence when using or attempting to use an essential facility, please reach out to us at support@transtexas.org.

State Agencies

• Departments, commissions, boards, offices, councils, authorities or other agencies in the executive, legislative, or judicial branches of state government that are created by the constitution or a statute of this state. 

Detention facilities (state prisons and county jails)*

• Dormitories and cell blocks in:
  • Municipal and county jails
  • Confinement facilities operated by the Texas Department of Criminal Justice (TDCJ)
  • Confinement facilities operated under contract with any division of TDCJ
  • Community corrections facilities operated by a community supervision and corrections department 

*** SB 8’s requirements concerning incarcerated individuals is at odds with established federal protections against cruel and unusual punishment, namely the Prison Rape Elimination Act (PREA). 

State-contracted family violence shelters that are “designed for females”

• Both residential and nonresidential shelters and shelter centers
• SB 8 would only allow these shelters to provide services to cisgender women and, if fleeing an interpersonal/domestic violence scenario with their dependent(s), would only allow dependents who are 17 years of age or younger. 

Political Subdivisions

• Public schools and public school district buildings
• Open-enrollment charter schools
• County buildings 
• Municipal (city) buildings 
• Special purpose district or authority buildings (i.e.,services and utilities controlled by local governments):
• Hospitals
• Libraries 
• Water conservation, waste management, fire control, energy facilities, etc.

Institutions of higher education

• Junior college districts (considered political subdivisions)
• Public Colleges and Universities (considered to be their own category)
• Any public technical institute, public junior college, public senior college or university, medical or dental unit, public state college, or other agency of higher education
• Dorms/campus housing
• All associated campus buildings