SB 1257 Texas Senate · 89th Legislature (2025)

Relating to required health benefit plan coverage for gender transition adverse effects and reversals.

SB 1257 requires health benefit plans covering gender transition procedures to also cover all related adverse effects (including short- or long-term side effects), annual mental and physical health monitoring regardless of gender identity in medical records, and any necessary reversal or reconstruction procedures. This applies to all health plans providing coverage for gender transition care, including Medicaid, employer-sponsored plans, and insurance policies issued by entities like health maintenance organizations. The law mandates this coverage for enrollees who underwent transition procedures, even if they weren’t enrolled at the time of treatment. It does not apply to self-funded plans governed by federal ERISA law.
Bill status signed all 5 stages cleared
Introduction
Feb 2025
Committee Review
May 2025
Senate Passage
May 2025
House Passage
May 2025
Signed into Law
May 2025
Introduced Feb 13, 2025 Signed May 24, 2025
Maddy AI version diff · 2 comparisons

What changed between versions

Engrossed Enrolled · 4 edits · May 24, 2025
MODERATE
This bill was converted from an 'Engrossed' version to an 'Enrolled' version, which is the final version signed into law. The substantive policy content remains the same, but the formatting was standardized and a new effective date was added. The bill requires health insurance plans to cover gender transition adverse effects and reversals, including side effects and procedures to reverse or recover from gender transition treatments.
Scope change
The bill's scope remains unchanged; it applies to health benefit plans providing medical or surgical coverage in Texas, including various types of insurance plans and government programs.
TECHNICAL

The bill text was reformatted from a draft version to the final enrolled version, removing draft markers and standardizing the layout.

Draft annotations, bill numbers, and placeholder text were removed during the conversion to the enrolled version.

TIMELINE

A new Section 3 was added stating that the coverage requirements apply only to health benefit plans delivered, issued for delivery, or renewed on or after January 1, 2026.

A new Section 4 was added stating that the Act takes effect on September 1, 2025.

Floor votes · Senate Apr 23, 2025 · House May 12, 2025

How they voted

2010
Passed
Total votes 30
Apr 23, 2025
D Democratic10
10 Nay
100% Nay
R Republican20
20 Yea
100% Yea
Vote distribution
All Yea All Nay Mixed No data
Full legislative history

Actions timeline

Total actions
50
Key actions
15
Committee
10
Amendments
2
May 24, 2025
Signed into law
Signed by the Governor
executive
May 13, 2025
Lower · Passed
Signed in the House
lower
May 13, 2025
Upper · Passed
Signed in the Senate
upper
May 12, 2025
Upper · Passed
House passage reported
upper
May 12, 2025
Lower · Passed
Passed
lower
May 10, 2025
Amended
Amendment withdrawn
lower
May 10, 2025
Amended
Amendment fails of adoption
lower
May 10, 2025
Lower · Passed
Committee report sent to Calendars
lower
May 9, 2025
Lower · Passed
Committee report distributed
lower
May 9, 2025
Lower · Passed
Reported favorably w/o amendment(s)
lower
Apr 28, 2025
Committee
Referred to Insurance
lower
Apr 28, 2025
Introduced
Read first time
lower
Apr 25, 2025
Introduced
Received from the Senate
lower
Apr 24, 2025
Upper · Passed
Passed
upper
Apr 23, 2025
Senate · Passed
Senate Vote: pass (20-10)
senate
Apr 7, 2025
Upper · Passed
Committee report printed and distributed
upper
Apr 7, 2025
Upper · Passed
Reported favorably as substituted
upper
Apr 2, 2025
Upper · Passed
Vote taken in committee
upper
Mar 26, 2025
Upper · Passed
Left pending in committee
upper
Mar 26, 2025
Upper · Passed
Testimony taken in committee
upper
Feb 28, 2025
Committee
Referred to Health & Human Services
upper
Feb 28, 2025
Introduced
Read first time
upper
2 primary · 3 co-sponsors

Sponsors