Abbott signs bill requiring health plans cover detransition, if they cover gender transition
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Diverging Reports Breakdown
Pennsylvania, Texas lawmakers want insurers to cover detransition care
LGBTQ+ advocates warn that such requirements would increase the costs for insurers. Texas House of Representatives passed Senate Bill 1257, which would mandate that insurers cover detransitioning. A similar bill was proposed in Florida last year but did not pass. One study has indicated only about 1 percent of patients regret it, the bill’s sponsor says. The U.S. Department of Health and Human Services cites studies that put transition regret rates at 5 percent to 25 percent, but HHS Secretary Robert F. Kennedy Jr. is anti-trans, as is his boss, Donald Trump.
LGBTQ+ advocates warn that such requirements would increase the costs for insurers and lead many to stop covering gender-affirming care. Detransitioning is extremely rare.
Last week, the Texas House of Representatives passed Senate Bill 1257, which would mandate that insurers cover detransitioning. It has already passed the Senate and is awaiting anti-LGBTQ+ Republican Gov. Greg Abbott’s signature.
The Texas bill’s sponsor, Republican Rep. Jeff Leach, “said he’s heard of Texans receiving gender transition treatment with insurance coverage, but later being denied coverage when they are dealing with adverse effects,” public broadcaster WERA reports.
Brad Pritchett, interim CEO of Equality Texas, speaking at a rally against the bill, called it a “tax on trans existence,” according to WERA.
Austin resident Corrie Thompson testified against the measure earlier in the legislative session. “Requiring unknowable and limitless liability for any possible adverse impacts from trans health care will, practically speaking, prevent most insurers from covering the care.” It could “drive excessive and inflated costs for plans that do insure trans health care,” she added.
Democratic Rep. Gene Wu, who opposed the bill, said it’s a back-door way to ban gender-affirming care for trans adults; the state has already banned it for trans minors. He also noted that transition regret is rare. One study has indicated only about 1 percent of patients regret it. “There is higher rates of regret for just about any other type of surgery,” he said.
In Pennsylvania, Republican Sen. Michele Brooks said she will soon propose legislation calling for detransition coverage. “Regardless of one’s views on transgender drugs or surgeries, there should be no disagreement on providing access to detransition care for those that need it,” she wrote in a Thursday memo to her fellow senators. “If state or private payers funded transition, they must also fund reversal.”
She cited a recent paper from the U.S. Department of Health and Human Services citing studies that put transition regret rates at 5 percent to 25 percent. The report asserts that the issue of detransition “has been minimized with the claim that detransition and regret rates are vanishingly low. In fact, the detransition rate is unknown.” However, HHS Secretary Robert F. Kennedy Jr. is anti-trans, as is his boss, Donald Trump.
A similar bill was proposed in Florida last year but did not pass.
Texas House sends bill that could increase cost of gender transition health care to governor’s desk
The Texas House passed a measure on Monday that opponents say could raise the price of gender-affirming health care for adults in Texas. The bill now heads to Gov. Greg Abbott’s desk for his signature. House Bill 229 would require that Texas government agencies define and collect sex-based data using strict binary terms — as in: man, woman, male or female. The measure is a follow-up to Republicans’ work in the 2023 legislative session, when they passed legislation to ban gender-Affirming care for minors, said Rep. Gene Wu of Houston, who also serves as chair of the Texas House Democratic Caucus. But time is running out for Texas’ HB 229, which is on June 2 — referred to as the last day of the legislative session — to be passed by the state Senate and signed by Gov. Abbott. The Senate is expected to vote on the measure on Tuesday. The House passed the bill 87-58 on Monday, and the Senate will vote on it on June 13.
Since the bill was previously approved by the Texas Senate, it now heads to Gov. Greg Abbott’s desk.
The legislation, Senate Bill 1257, requires any health benefit plan that provides coverage for any gender transition procedures and treatment to also provide coverage related to “adverse effects and reversals.” This includes follow-up procedures and treatment, as well as therapy related to an enrollee’s gender transition procedure or treatment.
The bill defines gender transition as a medical process that alters an individual’s anatomy or physiology for the purpose of assisting the individual’s identification as a member of the opposite biological sex that does not correspond to their biological sex.
Those against the proposal rallied at the state Capitol in Austin on Friday. During the rally, Brad Pritchett, interim CEO of Equality Texas, called SB 1257 a “tax on trans existence.”
Many in opposition agree. Corrie Thompson of Austin testified against the measure earlier this legislative session.
“Requiring unknowable and limitless liability for any possible adverse impacts from trans health care will, practically speaking, prevent most insurers from covering the care,” said Thompson, adding the bill could also “drive excessive and inflated costs for plans that do insure trans health care.”
But speaking on the floor of the Texas House on Monday, the bill’s sponsor, Rep. Jeff Leach (R-Plano), defended his legislation.
“This is certainly a directive to our insurance companies, that if you provide gender transition coverage, you also have to provide detransition coverage,” he said.
Leach also told lawmakers who were against the measure that he authored the bill out of concern. He said he’s heard of Texans receiving gender transition treatment with insurance coverage, but later being denied coverage when they are dealing with adverse effects.
Leach added that his bill “is about giving insurance coverage to the people who need it.”
Among the lawmakers who disputed Leach’s claims was Rep. Gene Wu of Houston, who also serves as chair of the Texas House Democratic Caucus. Wu said the bill is a follow-up to Republicans’ work in the 2023 legislative session, when they passed legislation to ban gender-affirming care for minors.
Wu said lawmakers are now attempting to do the same thing for adults.
Patricia Lim / KUT News Texas Rep. Gene Wu speaks at the All in for Equality Advocacy Day on March 24 at the Capitol.
“Politically, if they just had a bill that says, ‘We’re banning consenting adults from doing something,’ that would be bad politically,” said Wu. “This is the way to get around a ban on adults.”
“You tell the insurance companies, ‘Well, if you provide this care we will make sure you’re on the hook for this care to infinity,’” Wu added.
Rep. Steve Toth (R-Conroe) claimed the reason the issue is being treated this way by lawmakers is because many who undergo gender transition later regret the decision. However, a study published on behalf of The American Society of Plastic Surgeons showed the “prevalence of regret after GAS” was around 1%.
”There is higher rates of regret for just about any other type of surgery,” said Wu.
The bill, which passed its final vote 87-58 in the Texas House on Monday, now heads to Abbott’s desk for his signature.
The Texas House also passed House Bill 229 on Monday. HB 229 would require that Texas government agencies define and collect sex-based data using strict binary terms — as in: man, woman, male, female.
Proponents of the bill say it only defines biological sex. However, opponents of the bill, like Rep. John Bucy (D-Austin) said the proposal’s true purpose is, “to try and attack the transgender community and make them feel unwelcome in the state of Texas.”
Advocates have rallied against the measure, saying it not only targets transgender individuals but allows them to be ignored by the state.
HB 229 now heads over to the Texas Senate for consideration. Whether the legislation will pass in that chamber isn’t clear. But time is running out for Texas’ 2025 legislative session. The last day — referred to as “sine die” — is on Monday, June 2.