Trans Resource Navigator

Gender-affirming care in Texas

Care for adults
Allowed
Care for people under 18
Banned
Texas Medicaid (STAR, STAR+PLUS) pays for hormones
Unclear
Texas Medicaid (STAR, STAR+PLUS) pays for surgery
Not covered
Private plans must cover care
No state rule

Hormone therapy and other gender-affirming care are legal for adults in Texas and are offered on an informed-consent basis by Planned Parenthood of Greater Texas and several community clinics. For anyone under 18, puberty blockers, hormones, and surgeries for gender transition are banned (SB 14, in effect since September 2023 and upheld by the Texas Supreme Court in 2024). Texas Medicaid excludes transition care, state law does not stop private plans from excluding it, and there is 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. Health centers near you
  3. Hormones by telehealth
  4. Clinics, programs, and funds
  5. Paying for care
  6. Rules for adults
  7. Laws and court cases
  8. Sources

If you are under 18, or a parent

SB 14 (2023), Health & Safety Code §§ 161.701 to 161.706, took effect September 1, 2023. For anyone under 18, physicians and other licensed providers may not, for the purpose of gender transition, perform sterilizing surgeries or mastectomy, remove healthy tissue, or prescribe puberty blockers or hormones (testosterone or estrogen above natural levels).

  • Exceptions: puberty blockers for precocious puberty, and care for children with a medically verifiable disorder of sex development. Minors who started blockers or hormones before June 1, 2023, after at least 12 counseling sessions over six months, could continue only long enough to be weaned off safely.
  • Penalties: the Texas Medical Board must revoke the license of a physician who violates the law; the Attorney General can sue to stop violations. Medicaid, CHIP, and public money may not pay for prohibited care.
  • Court challenge: the Texas Supreme Court upheld SB 14 in State v. Loe on June 28, 2024, vacating a lower-court injunction. The law is fully in effect.

Families who seek care for a minor usually travel to a state where it is legal. Texas has no shield law protecting patients or providers. Mental health care and social transition (name, clothing, pronouns) are not banned by SB 14, and a parent can still petition to change a child's name (see the name change guide).

[1][2][3]

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

Paying for care

Medicaid (Texas Medicaid (STAR, STAR+PLUS))[6][1][4][7]

Texas Medicaid policy excludes gender transition services, and the Movement Advancement Project classifies Texas as having an explicit Medicaid exclusion. Whether a given Medicaid health plan will pay for adult hormone prescriptions is not clearly stated in the sources we could load; ask your plan in writing before you rely on it. By statute, Medicaid and CHIP may not cover transition care for anyone under 18 (SB 14). SB 1257 (2025) requires Medicaid to cover side effects and reversal of past transition treatment.

Texas did not expand Medicaid, so most adults without children or a disability do not qualify no matter how low their income. Apply at YourTexasBenefits.com or by calling 2-1-1.

Apply for coverage

Private insurance[6][4][8][16]

Texas has no law prohibiting health plans from excluding transition care, and many state-regulated plans do exclude it. Employer plans that are self-funded are regulated federally and may cover it; read your plan's Evidence of Coverage. Under SB 1257 (effective September 1, 2025), any state-regulated plan that covers, or ever covered, transition treatment must also cover its side effects, annual monitoring, and reversal. If a plan denies a claim, file an internal appeal first, then a complaint with the Texas Department of Insurance. A4TE's Trans Health Project has free appeal guides.

File an insurance complaint

The rules in detail

Rules for adultsNo Texas law bans gender-affirming care for adults 18 and older.

No Texas law bans gender-affirming care for adults 18 and older. Planned Parenthood of Greater Texas (which took over the former Planned Parenthood Gulf Coast health centers in Houston in October 2025) prescribes estrogen and testosterone on an informed consent basis, in person or by telehealth, and most patients get a prescription at the first visit. Resource Center Health in Dallas and Legacy Community Health in Houston also provide hormone therapy. Telehealth providers licensed in Texas (Plume, FOLX, QueerMed, Planned Parenthood) can prescribe to adults anywhere in the state.

Things that affect adults:

  • Medical records: SB 1188 (2025) requires electronic health records in Texas to include a separate field for the biological sex observed at birth. It does not restrict care, but your chart will show it.
  • Insurance: Texas Medicaid excludes transition care, and no state law prevents private plans from excluding it (see below).
  • Documents: your ID and birth certificate cannot be changed to match your gender (see the ID guides), so bring your chosen name and pronouns to intake forms.

If you have no insurance and little money:

  1. Try a community health center (FQHC) such as Legacy Community Health (Houston) on a sliding fee scale. Find others at findahealthcenter.hrsa.gov.
  2. Planned Parenthood of Greater Texas offers hormone therapy with several payment options; call 1-800-230-7526.
  3. Point of Pride's HRT Access Fund pays for telehealth hormone care for a limited number of applicants each year.
  4. Generic estradiol and spironolactone are inexpensive with pharmacy discount coupons; ask the pharmacy for its cash price.
[9][10][5][12][11][6][17]
Laws and court cases1 court case, 4 laws

State of Texas v. Loe, No. 23-0697

SB 14 is fully enforceable. Providers in Texas cannot prescribe blockers or hormones to minors for gender transition.[3]

Families and physicians challenged SB 14 under the Texas Constitution. A Travis County district court (No. D-1-GN-23-003616) temporarily enjoined the law in 2023; the State took a direct appeal to the Supreme Court, and SB 14 took effect on schedule. On June 28, 2024 the Supreme Court of Texas reversed and vacated the injunction, holding the ban constitutional. Last update 2024-10-02.

Sources

17 sources. Numbers in the text, like [1], point here.Show all
  1. SB 14 (88th Legislature), enrolled textTexas Legislature Online, Law. accessed
    “The board shall revoke the license or other authorization to practice medicine of a physician who violates Section 161.702.”
  2. SB 14 (88th Legislature), bill historyTexas Legislature Online, Law. accessed
    “Signed by the Governor 06/02/2023. Effective on 9/1/23.”
  3. Case 23-0697, State of Texas et al. v. Loe et al.Supreme Court of Texas, Court. accessed
    “06/28/2024 Opinion issued: Direct Appeal/Trial court order reversed and vacated. 10/02/2024 Mandate issued.”
  4. SB 1257 (89th Legislature), required coverage for gender transition adverse effects and reversalsTexas Legislature Online, Law. accessed
    “A health benefit plan that provides or has ever provided coverage for an enrollee's gender transition procedure or treatment shall provide coverage for all possible adverse consequences.”
  5. SB 1188 (89th Legislature), electronic health recordsTexas Legislature Online, Law. accessed
    “Each electronic health record includes a separate space to document an individual's biological sex as either male or female based on the individual's observed biological sex recorded by a health care practitioner at birth.”
  6. Texas state profileMovement Advancement Project, Organization. accessed
    “State Medicaid Policy Related to Coverage for Transgender People: Negative Law.”
  7. Your Texas BenefitsTexas Health and Human Services Commission, Official page. accessed
  8. File a complaintTexas Department of Insurance, Official page. accessed
  9. Gender affirming healthcarePlanned Parenthood of Greater Texas, Organization. accessed
    “Planned Parenthood of Greater Texas provides Gender Affirming Hormone Therapy for patients 18 and up.”
  10. Planned Parenthood Gulf Coast, important updatePlanned Parenthood, Organization. accessed
    “Planned Parenthood Gulf Coast (PPGC) is no longer operating. Effective October 1, 2025, Planned Parenthood of Greater Texas...”
  11. Transgender specialty careLegacy Community Health, Organization. accessed
    “For Transgender Medical Services, please call (832) 548 5000.”
  12. Resource Center HealthResource Center (Dallas), Organization. accessed
    “Resource Center Health offers a wide range of services for individuals 18 and older: PrEP Care Program, Primary Healthcare (15+), Mental Healthcare, HRT (18+).”
  13. LocationsQueerMed, Organization. accessed
  14. Point of PrideOrganization. accessed
  15. GenderBandsOrganization. accessed
  16. Trans Health ProjectAdvocates for Trans Equality, Organization. accessed
  17. Find a Health CenterHealth Resources and Services Administration, Official page. accessed