89R1535 EAS-D By: Tinderholt H.B. No. 3431 A BILL TO BE ENTITLED AN ACT relating to prohibitions on the provision to certain children of gender transitioning or reassignment procedures and treatments and gender-affirming therapy and counseling; creating criminal offenses. BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: SECTION 1. Section 161.701, Health and Safety Code, as added by Chapter 335 (S.B. 14), Acts of the 88th Legislature, Regular Session, 2023, is amended by adding Subdivision (3-a) to read as follows: (3-a) "Non-physician mental health professional" has the meaning assigned by Section 571.003. SECTION 2. Section 161.702, 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: Sec. 161.702. PROHIBITED PROVISION OF GENDER TRANSITIONING OR GENDER REASSIGNMENT PROCEDURES AND TREATMENTS TO CERTAIN CHILDREN; CRIMINAL PENALTY. (a) For the purpose of transitioning a child's biological sex as determined by the sex organs, chromosomes, and endogenous profiles of the child or affirming the child's perception of the child's sex if that perception is inconsistent with the child's biological sex, a physician or health care provider may not knowingly: (1) perform a surgery that sterilizes the 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. (b) A person who violates this section commits an offense. An offense under this section is a state jail felony. SECTION 3. 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 by adding Sections 161.7035 and 161.7036 to read as follows: Sec. 161.7035. PROHIBITED PROVISION OF GENDER-AFFIRMING THERAPY AND COUNSELING; CRIMINAL PENALTY. (a) A non-physician mental health professional may not provide gender-affirming therapy or counseling to a child to treat gender dysphoria if the purpose of the therapy or counseling is to affirm a gender inconsistent with the child's biological sex, as determined by the sex organs, chromosomes, and endogenous profiles of the child. (b) A person who violates this section commits an offense. An offense under this section is a state jail felony. Sec. 161.7036. PROHIBITED REFERRAL TO HEALTH CARE PRACTITIONER IN ANOTHER STATE; CRIMINAL PENALTY. (a) A physician, health care provider, or non-physician mental health professional may not refer a child to a health care practitioner licensed or otherwise authorized to provide health care in another state for provision of: (1) a procedure or treatment that violates Section 161.702 if performed in this state; or (2) therapy or counseling that violates Section 161.7035 if performed in this state. (b) A person who violates this section commits an offense. An offense under this section is a state jail felony. SECTION 4. This Act takes effect September 1, 2025.