HB3399 - 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 treatments.

  89R8311 EAS-D     By: Money H.B. No. 3399       A BILL TO BE ENTITLED   AN ACT   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   treatments.          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   read as follows:          Sec. 161.701.  DEFINITIONS.  In this subchapter:                (1)  [ "Child" means an individual who is younger than   18 years of age.                [ (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   practice of a profession.                 (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     [ child ], including:                      (A)  castration;                      (B)  vasectomy;                      (C)  hysterectomy;                      (D)  oophorectomy;                      (E)  metoidioplasty;                      (F)  orchiectomy;                      (G)  penectomy;                      (H)  phalloplasty; and                      (I)  vaginoplasty;                (2)  perform a mastectomy;                (3)  provide, prescribe, administer, or dispense any of   the following prescription drugs that induce transient or permanent   infertility:                      (A)  puberty suppression or blocking prescription   drugs to stop or delay normal puberty;                      (B)  supraphysiologic doses of testosterone to   females; or                      (C)  supraphysiologic doses of estrogen to males;   or                (4)  remove any otherwise healthy or non-diseased body   part or tissue.          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   legal guardian, of:                (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;                            (ii)  46,XY chromosomes with   undervirilization; or                            (iii)  both ovarian and testicular tissue;   or                      (B)  does not have the normal sex chromosome   structure for male or female as determined by a physician through   genetic testing.          (b)  Section 161.702 does not apply to the provision of a   prescription drug to a person [ child ] that is otherwise prohibited   by that section if:                (1)  the prescription drug is part of a continuing   course of treatment that the person [ child ] began before June 1,   2025 [ 2023 ]; and                (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   by Subdivision (1) began.          (c)  A person [ child ] to whom the exception under Subsection   (b) applies:                (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   that section.          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   under Section 161.702.          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   CERTAIN CHILDREN ].          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.