89R10317 EAS-D By: Hall S.B. No. 1393 A BILL TO BE ENTITLED AN ACT relating to electronic health record requirements, including the recording of an individual's biological sex. BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: SECTION 1. Subtitle I, Title 2, Health and Safety Code, is amended by adding Chapter 183 to read as follows: CHAPTER 183. ELECTRONIC HEALTH RECORDS Sec. 183.001. DEFINITIONS. In this chapter: (1) "Biological sex" means the biological trait that determines whether a sexually reproducing organism produces male or female gametes. (2) "Female" means an individual whose reproductive system is developed to produce ova. (3) "Health care provider" means an individual who is licensed, certified, or otherwise authorized to provide health care services in this state. (4) "Male" means an individual whose reproductive system is developed to produce sperm. (5) "Sexual development disorder" means a group of congenital conditions associated with atypical development of internal or external genital structures. The term includes chromosomal, gonadal, and anatomic abnormalities. Sec. 183.002. ELECTRONIC HEALTH RECORD REQUIREMENTS. (a) Notwithstanding any other law, the commission, the Texas Medical Board, and the Texas Department of Insurance shall jointly ensure that: (1) each electronic health record prepared or maintained by a health care provider in this state includes a separate space for the health care provider to record: (A) an individual's biological sex as either male or female based on the individual's observed biological sex recorded by a health care provider at birth; and (B) information on an individual's sexual development disorder, if applicable, whether identified at birth or later in the individual's life; and (2) any algorithm or decision tree included in an electronic health record for assisting a health care provider in making medical treatment decisions is based on an individual's biological sex as recorded in the space described by Subdivision (1)(A). (b) This section does not prevent an electronic health record from including spaces for recording other information related to an individual's biological sex or gender identity. Sec. 183.003. AMENDING CERTAIN INFORMATION IN ELECTRONIC HEALTH RECORDS. (a) An individual's biological sex recorded in the space of an electronic health record described by Section 183.002(a)(1)(A) may be amended by a health care provider only if: (1) the amendment is to correct a clerical error; or (2) the individual is diagnosed with a sexual development disorder and the amendment is to record the individual's biological sex as the opposite biological sex. (b) If an individual's biological sex is amended under Subsection (a)(2), the health care provider shall include information on the individual's sexual development disorder in the space of the individual's electronic health record described by Section 183.002(a)(1)(B). Sec. 183.004. RULES. The commission, the Texas Medical Board, and the Texas Department of Insurance shall adopt rules as necessary to implement this chapter. SECTION 2. Chapter 183, Health and Safety Code, as added by this Act, applies only to an electronic health record prepared on or after the effective date of this Act. SECTION 3. This Act takes effect immediately if it receives a vote of two-thirds of all the members elected to each house, as provided by Section 39, Article III, Texas Constitution. If this Act does not receive the vote necessary for immediate effect, this Act takes effect September 1, 2025.