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Gender-affirming care in Tennessee

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  • Page changed: Tenn. Code Ann. § 68-33-103 (2026-10-12) · #245
  • Page changed: TennCare Medicaid eligibility (2026-10-05) · #180
  • Page changed: File a complaint (Insurance) (2026-09-28) · #73
  • Page changed: Tenn. Code Ann. § 68-33-103 (2026-09-28) · #47
Care for adults
Limited
Care for people under 18
Banned
TennCare pays for hormones
Not covered
TennCare pays for surgery
Not covered
Private plans must cover care
No state rule

Adults in Tennessee can still legally get hormone therapy, including by informed consent at Planned Parenthood and through telehealth. Since July 1, 2026, TennCare (Medicaid) may not pay for hormones, puberty blockers, or surgery for gender transition at any age, and gender clinics must report their prescriptions to the state. Hormones, puberty blockers, and surgery for gender transition are banned for everyone under 18; the US Supreme Court upheld that ban in June 2025. Tennessee has no shield law.

Draft from official sources, September 24, 2026. Not yet checked by a person. How we verify

On this page
  1. If you are under 18, or a parent
  2. Rules for adults
  3. Health centers near you
  4. Hormones by telehealth
  5. Clinics, programs, and funds
  6. Paying for care
  7. Laws and court cases
  8. Sources

If you are under 18, or a parent

Banned since July 1, 2023 (SB 1, Public Chapter 1; Tenn. Code Ann. § 68-33-101 et seq.). Health care providers may not give anyone under 18 puberty blockers, hormones, or surgery for the purpose of living as a gender different from their sex at birth or treating distress about it. Treatment that began before the law had to end by March 31, 2024. Exceptions cover only congenital conditions, precocious puberty, disease (not including gender dysphoria), or injury.

Penalties: the Attorney General can seek a $25,000 civil penalty per violation within 20 years; patients or parents can sue providers up to 30 years after the patient turns 18; licensing boards must act against violators.

The ban is in full effect. The US Supreme Court upheld it in United States v. Skrmetti on June 18, 2025. Tennessee has no shield law. Mental health care and social support remain legal, but a 2026 law (Public Chapter 748, effective October 1, 2026) bars providers from asking a minor about gender identity unless a parent is present and consents in writing and the question relates to a condition being evaluated. Planned Parenthood of Tennessee and North Mississippi sees minors for other sexual health care but not hormone therapy. Families considering care in another state should talk to a lawyer first.

[1][2][3][7][11]

Rules for adults

Hormone therapy is legal for adults 18 and older, but state law now limits how it is paid for and tracked:

  • TennCare will not pay for estrogen, testosterone, puberty blockers, or surgery for gender transition, from July 1, 2026, including care delivered by telehealth to someone in Tennessee (Public Chapter 765). Care already underway can be covered only until March 31, 2027, and only if your treating physician certifies in writing that stopping would harm you.
  • Gender clinics must report each transition-related prescription or surgery to the Department of Health (date, age, sex, drug and dose, state of residence, prescriber, and mental health diagnoses), without names; the state publishes only aggregate numbers (Public Chapter 932, 2026).
  • A 2026 law (Public Chapter 794) lets adults sue a provider for up to 18 years if they were coerced into transition care.

If you have no insurance and little money, in rough order of what to try:

  1. Planned Parenthood of Tennessee and North Mississippi prescribes hormones by informed consent (no therapist letter) to patients 18 and older, in person at its Tennessee health centers (Nashville, Memphis, Knoxville) and by telehealth. It offers prompt-pay discounts. Call 866-711-1717.
  2. Telehealth: Plume and FOLX serve Tennessee. Point of Pride's HRT Access Fund pays for 18 months of telehealth care through partners like these.
  3. Community health centers charge on a sliding scale; find one at findahealthcenter.hrsa.gov and ask whether they prescribe hormones.
  4. For the medications themselves, generic estradiol tablets and spironolactone are inexpensive with a pharmacy discount coupon; testosterone prices vary more, so compare cash prices.
[4][5][6][11][17][19]

Community health centers near you

These federally funded centers must see you whether or not you have insurance, and charge based on income. Many, but not all, prescribe hormone therapy. Call and ask for "gender-affirming care" or "hormone therapy."

Sorting by distance uses your location only on this device. It is never sent anywhere.

Hormones by telehealth

These services prescribe hormones through video visits for people in this state. Point of Pride pays for a year and a half of care with several of them each spring.

  • Plume

    PaidNo Medicaid18+

    Trans-led telehealth service providing informed-consent hormone therapy, lab orders, prescriptions, and letters for surgery and documents, by app and video visit. Self-pay only since January 2026. A Point of Pride HRT Access Fund partner.

    About $99 per month ($90 in NY and NJ), which includes visits, messaging, prescriptions, and document letters. Labs and medications are billed separately and are often cheap with GoodRx or at a community pharmacy. Free for 18 months if you win a Point of Pride HRT Access Fund grant.

  • FOLX Health

    InsuranceTakes insuranceNo Medicaid18+

    LGBTQ-focused telehealth offering hormone therapy, PrEP, primary care, and mental health visits. Accepts major commercial insurance (Aetna, Blue Cross Blue Shield, Cigna, UnitedHealthcare) but not Medicaid or Medicare. A Point of Pride HRT Access Fund partner.

    In-network with many commercial plans; self-pay membership about $69 to $98 per month all-inclusive.

  • Planned Parenthood

    Sliding scaleTakes insurance

    Many Planned Parenthood affiliates provide informed-consent gender-affirming hormone therapy alongside sexual and reproductive health care, on a sliding scale and with Medicaid. Most affiliates see adults 18 and older; a few see 16- and 17-year-olds with parental consent and a readiness letter. Many start hormone care by telehealth. Self-pay initial consults typically run about $120 to $250 before sliding-scale discounts.

Clinics, programs, and funds

  • Planned Parenthood of Tennessee and North Mississippi[11][12]

    Gender-affirming hormone care by informed consent for patients 18 and older, in person at Tennessee health centers and by telehealth. Accepts many insurance plans; prompt-pay discounts for uninsured patients. Call 866-711-1717.

    • Cost varies
    • Telehealth
    866-711-1717

  • CARES 360 (Nashville CARES clinic)[13]

    HIV care, PrEP, PEP, doxyPEP, STI testing, primary care, and LGBTQ+ informed care in Nashville and Memphis. No insurance required for STI testing and PrEP.

    • Cost varies
    • Telehealth
    • Sees uninsured patients

    Serves: Nashville; Memphis clinic at 806 Cooper St (901-896-0739)

    615-499-7406633 Thompson Lane, Nashville, TN 37204

  • Choice Health Network[14]

    HIV prevention (PrEP and PEP), testing, HIV care, mental health, and case management at sites in Knoxville, Chattanooga, Memphis, the Upper Cumberland, and West Tennessee.

    • Cost varies
    865-525-15401925 Ailor Avenue, Knoxville, TN 37921

  • OUTMemphis[15]

    Memphis LGBTQ community center with free HIV, hepatitis C, and syphilis testing during walk-in hours, case management, and a Youth Empowerment Center for young people.

    • Free
    901-278-6422892 S. Cooper Street, Memphis, TN 38104

  • Tennessee Justice Center[16]

    Free help for Tennesseans with TennCare applications, denials, and appeals.

    • Free
    615-255-0331155 Lafayette St., Nashville, TN 37210

  • Point of Pride HRT Access Fund[17]

    Pays for 18 months of telehealth hormone care (visits, labs, and letters) through partners including Plume and FOLX, for people 18 and older.

    • Free

  • A4TE Trans Health Project[18]

    Free help appealing insurance denials for gender-affirming care, with templates and guides.

    • Free

  • HRSA Find a Health Center[19]

    Federal search tool for community health centers, which charge on a sliding scale based on income.

    • Sliding scale

Paying for care

Medicaid (TennCare)[4][8][16]

Public Chapter 765 (2026) bars TennCare from covering or reimbursing surgery, puberty blockers, androgens, or estrogens for gender transition or to treat gender dysphoria, for people of any age, starting July 1, 2026. The only exceptions are treatment for a congenital defect, precocious puberty, disease, or injury, and a transition period: care that started before the law may be covered until March 31, 2027 if your treating physician puts a written certification in your record that stopping would be harmful. TennCare still covers other health care, including mental health.

Who qualifies for TennCare: Tennessee has not expanded Medicaid. Coverage is mainly for children under 21, pregnant people, parents or caretakers of a minor child who lives with them, people receiving SSI, and some older or disabled people. Most adults without children do not qualify. Apply at tenncareconnect.tn.gov; the Tennessee Justice Center helps people for free with TennCare problems.

Apply for coverage

Private insurance[10][5][9][18]

Tennessee has no law stopping private insurers from excluding gender-affirming care, and many plans do exclude it. Since 2026 (Public Chapter 932), any policy issued, renewed, or amended in Tennessee that covers gender transition procedures must also cover detransition procedures, and insurers must report detransition claims to the state. If your plan denies care, appeal with the plan first; A4TE's Trans Health Project has free appeal help and templates. You can also file a complaint with the Tennessee Department of Commerce and Insurance, although no state law requires coverage.

File an insurance complaint

The rules in detail

Laws and court cases1 court case, 5 laws

United States v. Skrmetti, No. 23-477

The minors' ban is fully in force in Tennessee. No court order limits it.[3]

Challenge to SB 1's ban on puberty blockers and hormones for minors. On June 18, 2025, the Court held that the ban does not violate the Equal Protection Clause. Last update 2025-06-18.

Sources

19 sources. Numbers in the text, like [1], point here.Show all
  1. SB 1 (2023), Public Chapter 1Tennessee General Assembly, Law. accessed
    “authorizes the attorney general and reporter to bring an action against a healthcare provider ... to recover a civil penalty of $25,000 per violation.”
  2. Tenn. Code Ann. § 68-33-103FindLaw (Tennessee Code), Law. accessed
    “A healthcare provider shall not knowingly perform or offer to perform on a minor, or administer or offer to administer to a minor, a medical procedure if the performance or administration of the procedure is for the purpose of ...”
  3. United States v. Skrmetti, No. 23-477 (June 18, 2025)Supreme Court of the United States, Court. accessed
    “SB1 prohibits healthcare providers from prescribing, administering, or dispensing puberty blockers or hormones to any minor for the purpose of (1) enabling the minor to identify with, or live as, a purported identity inconsistent with the minor's biological sex”
  4. SB 2118 / HB 2498 (2026), Public Chapter 765Tennessee General Assembly, Law. accessed
    “This bill prohibits the division of TennCare from providing coverage or reimbursement for a medical procedure if the performance or administration of the procedure is for the purpose of (i) enabling an individual to identify with, or live as, a purported identity inconsistent with the individual's sex”
  5. SB 676 / HB 754 (2026), Public Chapter 932Tennessee General Assembly, Law. accessed
    “If an insurance policy issued, renewed, or amended in this state on or after the effective date of this bill, includes coverage for gender transition procedures, then this bill requires the policy to also include coverage for detransition procedures.”
  6. SB 2031 / HB 1872 (2026), Public Chapter 794Tennessee General Assembly, Law. accessed
  7. SB 1664 / HB 1665 (2026), Public Chapter 748Tennessee General Assembly, Law. accessed
  8. TennCare Medicaid eligibilityDivision of TennCare, Official page. accessed
    “It provides healthcare to mostly low-income pregnant women, parents or caretakers of a minor child, children, and individuals who are elderly or have a disability.”
  9. File a complaint (Insurance)Tennessee Department of Commerce and Insurance, Official page. accessed
  10. Tennessee equality profileMovement Advancement Project, Organization. accessed
  11. Gender Affirming Hormone CarePlanned Parenthood of Tennessee and North Mississippi, Organization. accessed
    “GAH treatment is only available to patients 18 and older. ... No visit with a mental health professional is required.”
  12. Find Health Centers in TennesseePlanned Parenthood Federation of America, Organization. accessed
  13. CARES 360 servicesNashville CARES, Organization. accessed
    “No insurance required, even for STI testing and PrEP.”
  14. Choice Health NetworkOrganization. accessed
  15. OUTMemphisOrganization. accessed
    “FREE HIV, HepC, & Syphilis testing during walk-in hours at both locations”
  16. Tennessee Justice CenterOrganization. accessed
  17. HRT Access FundPoint of Pride, Organization. accessed
    “We have proudly partnered with Plume, Folx, QueerMed, QueerDoc, TrueU, Spectrum ... to provide recipients with 18 months of HRT-related care”
  18. Trans Health ProjectAdvocates for Trans Equality, Organization. accessed
  19. Find a Health CenterHealth Resources and Services Administration, Official page. accessed