Texas transgender laws now cover medical care for minors, school and college athletics, restrooms in public buildings, gender markers on state IDs and birth certificates, electronic health records, and the underlying definition of “sex” used throughout state statutes. Most of the framework was built through the 88th Legislature in 2023 and expanded through the 89th Legislature in 2025, and it is reinforced by federal policy changes since January 2025. The short version: Texas law treats sex as biological and recorded at or near birth, and it has closed most of the pathways that previously allowed transgender residents to align official records with their gender identity.
How Texas Defines Sex Across All State Laws
House Bill 229, passed in 2025, sets baseline definitions for “sex,” “female,” “male,” “woman,” and “man” wherever those terms appear in Texas statutes that do not already define them. Under HB 229, “sex” means an individual’s biological sex, classified as either male or female. Statutes that already carry their own definitions are unaffected, but every provision that previously left the term open now reads on a biological standard. That single definitional move underpins nearly every other law described below.
Gender-Affirming Care for Minors
Senate Bill 14, signed in 2023, prohibits physicians and other healthcare providers from performing surgeries or prescribing certain medications to transition a child’s biological sex or to affirm a gender identity different from the sex recorded at birth. The ban reaches sterilizing surgeries, mastectomies, puberty-blocking drugs, and cross-sex hormones when prescribed for gender transition.1State of Texas. Texas Health and Safety Code 161.702 – Prohibited Provision of Gender Transitioning or Gender Reassignment Procedures and Treatments to Certain Children The same medications remain legal for unrelated conditions, such as precocious puberty or hormonal disorders with a distinct medical basis.
Enforcement runs through two channels. The Attorney General can sue providers to stop violations and obtain court orders against continued treatment.2State of Texas. Texas Health and Safety Code 161.706 – Attorney General Enforcement The Texas Medical Board must revoke the license of any provider found in violation, and Texas Medicaid and CHIP cannot reimburse prohibited care.3Texas Legislature. Texas Senate Bill 14 – Relating to Prohibitions on the Provision to Certain Children of Procedures and Treatments for Gender Transitioning
Minors already on puberty blockers or cross-sex hormones when the law took effect are not cut off. Their doctors must wean them off the prohibited medications in a way that is safe and minimizes health risks.3Texas Legislature. Texas Senate Bill 14 – Relating to Prohibitions on the Provision to Certain Children of Procedures and Treatments for Gender Transitioning Patients cannot switch to a different prohibited medication or begin any new restricted treatment during that wind-down.
A group of families and physicians challenged SB 14 under the Texas Constitution. The Texas Supreme Court upheld the law in June 2024, finding it did not violate parental rights, physicians’ occupational freedom, or Texas equal protection.4State Court Report. Loe v. State of Texas – Supreme Court of Texas Opinion SB 14 is fully in effect.
Student Athletics
Texas requires student athletes at every level of public education to compete on teams matching the biological sex recorded on their birth certificate at or near the time of birth. A birth certificate amended later for any reason other than fixing a clerical error does not satisfy the requirement.
K–12 Schools
House Bill 25 bars public school and open-enrollment charter school students from competing on interscholastic teams designated for the opposite biological sex.5State of Texas. Texas Education Code 33.0834 – Interscholastic Athletic Competition Based on Biological Sex If the original birth certificate cannot be obtained, another government record may be used.
Public Colleges and Universities
Senate Bill 15, the Save Women’s Sports Act, extends the same rule to intercollegiate athletics at public institutions. A student cannot compete in a position designated for the opposite biological sex, and male students cannot compete in female-designated positions in mixed-sex events.6State of Texas. Texas Education Code 51.980 – Intercollegiate Athletic Competition Based on Biological Sex Only a birth certificate entry from near the time of birth counts for eligibility.
Changing Gender Markers on Texas IDs and Birth Certificates
The standard legal pathway for changing a sex designation on Texas-issued documents is effectively closed. Two agency policy shifts in 2024, followed by a 2025 Attorney General opinion, together produced that result.
Driver’s Licenses and State IDs
On August 20, 2024, the Texas Department of Public Safety directed employees to stop updating gender markers on driver’s licenses and state ID cards, even when presented with a court order. Internal policy now rejects court orders and amended birth certificates unless the original entry contained a clerical error. Before the change, an individual with a court order for a sex change could take it to DPS and receive an updated license.
Birth Certificates
The Vital Statistics Unit at the Department of State Health Services revised its amendment form around the same time. A sex designation update is no longer a standard amendment. DSHS will change the sex field only if the original entry was “incomplete” or “inaccurate” at the time of birth, which in practice requires medical records documenting a condition present at birth such as a diagnosed disorder of sexual development.7Texas Department of State Health Services. Requirements for Changing Vital Records
Attorney General Opinion KP-0489
In March 2025, Attorney General Ken Paxton issued Opinion KP-0489, concluding that Texas district courts have no authority to order state agencies to change the sex listed on driver’s licenses or birth certificates. The opinion reasons that neither the Transportation Code nor the Health and Safety Code gives courts jurisdiction over those records, and that the agencies were never parties to the underlying proceedings. The opinion also directs DPS and DSHS to reverse any past changes made under those court orders, treating the orders as void.8Texas Attorney General. Attorney General Opinion KP-0489
An AG opinion does not carry the force of statute or a court ruling, but Texas agencies generally follow them. The practical outcome is that no functioning pathway currently exists to change a sex designation on Texas state documents for the purpose of gender transition.
Legal Name Changes
Name changes remain available. Texas Family Code Chapter 45 governs the process: an adult files a petition in district court, submits fingerprint cards, and undergoes a DPS background check.9Justia Law. Texas Family Code Title 2, Subtitle C, Chapter 45, Subchapter B – Change of Name of Adult Fingerprinting costs $20 and the DPS background check costs $27. Court filing fees vary by county.
A judge can deny a petition if the requested name is vulgar or offensive, but not because the petitioner is transgender. A felony conviction triggers a two-year waiting period after completion of sentence and discharge from probation. Anyone on the sex offender registry must file a notification form with local law enforcement before petitioning.
One practical warning: DPS has reportedly refused to process court orders that combine a name change with a gender marker change. Filing a standalone name-change petition, rather than a combined order, avoids that snag. Once the judge signs the order, certified copies can be used to update bank accounts and other records, subject to federal restrictions on the gender-marker side.
Bathrooms, Locker Rooms, and Changing Areas
Senate Bill 8, signed on September 22, 2025, and effective December 4, 2025, requires that multi-occupancy restrooms, locker rooms, and changing areas in government-owned buildings be designated for use by one biological sex. Coverage is broad: public schools, open-enrollment charter schools, junior colleges, public universities, and buildings owned by state agencies, counties, municipalities, and special-purpose districts. The law also places restrictions on correctional facilities and certain family violence shelters.
Penalties are steep. A facility that violates SB 8 faces a $25,000 fine for the first offense and $125,000 for each subsequent offense, and the law can also be enforced through civil suits. Single-occupancy facilities are generally the only alternative for anyone who does not want to use a restroom designated for their biological sex at birth. The law does not reach privately owned buildings.
Electronic Health Records
Senate Bill 1188, also enacted in 2025, requires electronic health records in Texas to list a patient’s biological sex at birth. The sex field may be amended only to correct a clerical error or to reflect a diagnosed disorder of sexual development. Even in a clinical setting, the record will show sex as assigned at birth rather than a later transition. The stated purpose is to keep clinical decisions aligned with biological factors that affect drug metabolism, disease risk, and treatment protocols.
Federal Policies That Reach Into Texas
Federal changes since January 2025 have narrowed the options that were previously available through federal channels.
Federal Definition of Sex
Executive Order 14168, signed January 20, 2025, directs federal agencies to define “sex” as an immutable biological classification of male or female. The order states that sex “is not a synonym for and does not include the concept of ‘gender identity,'” and it requires agencies to remove related policies and to limit sex fields on federal forms to male or female.10The White House. Defending Women From Gender Ideology Extremism and Restoring Biological Truth to the Federal Government
Passports and Federal Documents
The State Department no longer issues passports with an “X” marker, and issues “M” or “F” markers only to match biological sex at birth.11U.S. Department of State. Sex Marker in Passports Social Security records do not display sex on the card, but the underlying file contains a sex designation now subject to the same federal policy. Visas and Global Entry cards follow suit.
Title IX
A federal court vacated the 2024 Title IX Final Rule nationwide in January 2025. That rule would have expanded sex discrimination in education to include gender identity. Under the current framework, sex discrimination in educational programs means discrimination based on being male or female, and the court held that the Supreme Court’s employment ruling in Bostock v. Clayton County does not extend to Title IX in schools. Federal law, as currently applied, does not require Texas schools to accommodate students based on gender identity.
Performances and Public Spaces
Senate Bill 12, passed in 2023, restricts sexually oriented performances on public property and in the presence of anyone under 18. The law defines a “sexually oriented performance” as a visual performance featuring nudity or sexual conduct that appeals to a prurient interest in sex, with a broad definition of sexual conduct that reaches simulated sex acts, display of genitals in a state of arousal, and prosthetics exaggerating sexual characteristics.12State of Texas. Texas Penal Code 43.28 – Certain Sexually Oriented Performances Prohibited Business operators who allow such performances in front of minors face civil penalties of up to $10,000 per violation, and performers themselves can be charged with a Class A misdemeanor.13Texas Legislature Online. Texas Senate Bill 12 – Sexually Oriented Performances
A federal district court initially blocked the law in September 2023, but the Fifth Circuit reversed in November 2025 and denied rehearing in February 2026, lifting the statewide injunction. As of 2026, SB 12 is enforceable across most of Texas. Separate district court injunctions still bar enforcement against prosecutors in Travis County and Bexar County.