Like in South Carolina, lawmakers in Texas have proposed a bill that would prohibit state funds from being used for health benefits covering gender-affirming treatments — without specifying age requirements for that restriction. 

One bill slated for Texas’ legislature to take up later this month stands out, since it bars gender-affirming care for minors while carving out an exception for youth who had already begun hormone treatment or puberty-blocking medication prior to the bill’s potential effective date. 

Arizona

A prefiled Arizona bill directs school district employees to address all students under 18 years old using pronouns that match their sex assigned at birth, effectively ordering the misgendering of transgender or nonbinary children unless a parent provides written permission. The Republican Party controls both chambers of the state legislature, although the state has just elected a Democrat for governor — and some GOP lawmakers in the state put up resistance against their own party when debating anti-trans bills last year. 

Oklahoma

Oklahoma, which convenes its GOP-controlled legislature in February, will consider a bill to ban gender-affirming care for anyone under 21 years old — an effort that failed in the state in 2021. Notably, lawmakers have also brought a bill that would ban physicians from administering any gender-affirming care to transgender adults who are under 26 years old and ban them from referring their patients to receive such care. The legislation also aims to keep gender-affirming care from being covered through the state’s Medicaid program. Such a prohibition has precedent, as multiple states exclude trans health care coverage from their Medicaid policies.

Doctors found guilty under Oklahoma’s proposed bill, if it became law, would be guilty of a felony for administering medical care to adults. The far-reaching legislation seeks to block care at a higher age than most other states have considered. 

“We haven’t seen these types of bills in previous years. This is a startling new evolution of what these bills can be,” said Vivian Topping, director of advocacy and civic engagement of the Equality Federation. 

Oklahoma lawmakers also prefiled a bill setting terms on the use of names and pronouns. Like the bill in Arizona, it effectively asks school adults to misgender trans and nonbinary students by default until informed otherwise by a parent. It also sets terms on the use of names, saying that minors must be addressed by names found on or derived from their birth certificate unless parents provide written consent. Following the format of Florida’s “Don’t Say Gay” bill, the legislation would also ban classroom instruction on sexual orientation and gender identity from kindergarten through sixth grade.  

Missouri

In prefiled bills that seek to ban gender-affirming care for trans youth, Missouri lawmakers aim to penalize any adult who “coerces” a minor into undergoing gender-affirming care. The bill would classify this as child abuse or neglect — a felony in the state. The proposal is unclear on how it defines coercion of gender-affirming care for minors. Republicans have also reintroduced a bill from 2020 that would report parents to the state for obtaining such care. The state’s legislature, which is controlled by Republicans in both chambers, has also proposed a ban on public funds being used in gender transition procedures for minors.  

Tennessee

Tennessee’s bill to ban gender-affirming care for trans youth makes a point to tie the provision of such care to Planned Parenthood clinics, which are key resources of hormone therapy and other treatments for many transgender adults. Republicans control both of the state legislature’s chambers, and the state’s GOP governor — who has previously signed anti-trans bills into law — called for an investigation last fall into gender-affirming care for minors at Vanderbilt University Medical Center.