The Texas House has advanced two bills targeting “transgender” issues, sparking heated debates over health care coverage.
Senate Bill 1257, carried in the House by Rep. Jeff Leach (R-Plano), requires health insurance providers covering gender transition therapies, medications, or surgeries to also cover treatments to “manage, reverse, reconstruct from, or recover from” such transitions.
“If you take somebody to the dance and they want to go home, then you have to take them home,” Leach said. “If an insurance company is paying thousands and thousands of dollars to pay for someone to transition — which they have the right to do, all this bill does is say that if you do that, you also have to provide coverage if that person wants to come home from the dance.”
Democratic lawmakers raised concerns about potential cost increases, the classification of mental health therapy as a transition-related treatment, and a possible chilling effect that could lead providers to drop transition coverage.
Rep. Christian Manuel (D-Nederland) questioned whether the bill equates transition surgeries with cosmetic procedures.
“Going outside of the scope of this, if someone has a facelift, if someone gets hair transplant, if someone gets a BBL — a Brazilian butt lift — if someone gets rhinoplasty surgery, anything that is cosmetic — if they get breast implants would they now be covered under this?” Manuel asked, per KXAN. “Am I now covered because I transitioned one part of my body?”
SB 1257 passed the House on Monday by a vote of 87-58. Once the vote is certified, the bill will head to Gov. Greg Abbott’s desk for his signature.
House Bill 229, dubbed the “Women’s Bill of Rights” by its author, Rep. Ellen Troxclair (R-Marble Falls), requires state agencies to recognize only two genders — male and female — based on an individual’s reproductive organs at birth. It mandates that all Texans be assigned one of these genders on official records and defines terms like “female” as an individual whose biological reproductive system was developed to produce ova and “male” as one developed to fertilize ova.
“This is the women’s bill of rights. It’s a simple yet critical piece of legislation that defines once and for all what a woman is,” Troxclair said.
Opponents argued the bill excludes Texans who don’t fit its binary definition.
“Does that mean that a woman who cannot have children — because there are many — are not women?” asked Rep. Jessica González (D-Dallas).
Troxclair responded, “The definition relates to what our biological systems are designed and organized to produce at birth. They’re not depended on following through on a reproductive capacity.”
The debate grew contentious as González accused the bill of attempting to erase “transgender” individuals.
“You’re essentially just putting folks in a situation where you’re trying to erase them from existence,” she said. “They’re not going anywhere, no matter how much you try to erase them.”
Troxclair countered, “You are right, we have concerns that women are being erased, that girls are being erased. [When] we cannot fully define what a woman is, that leads to an erosion of our rights that are foundationally created to protect women and girls.”
HB 229 would apply to vital statistics collected for antidiscrimination laws, public health, crime, or economic data, adding definitions like “boy,” “girl,” “father,” and “mother” to the Code Construction Act. It would take effect September 1, 2025, with a projected $2.6 million negative impact on general revenue through the biennium, according to the Legislative Budget Board.
If the bill passes in the House, it would then be sent to the Senate for consideration.