Transgender rights in Texas have narrowed sharply over the past three legislative sessions, and the practical picture as of 2026 is this: gender-affirming care for minors is banned, state-regulated insurance will not cover transition care for adults, driver’s licenses and birth certificates can no longer be updated to reflect gender identity, federal passports and Social Security records are locked to biological sex, multi-occupancy restrooms in government buildings are sex-segregated by statute, and school athletics follow the original birth certificate. Federal employment law still protects transgender workers at larger employers. A legal name change is still available through the courts.
How Texas Defines Sex
House Bill 229, from the 89th Legislative Session in 2025, sets a statewide legal definition of sex as an individual’s biological sex, either male or female, and assigns fixed meanings to “female,” “woman,” “male,” and “man” wherever those terms appear in Texas statutes that lack their own definition.1Texas State Law Library. Transgender Law – LGBT Law Every other restriction below sits on top of this definition. When a Texas court or agency applies a law that refers to sex, the default reading is now the sex recorded at birth.
Updating Gender Markers on ID Documents
This is where the change has been most abrupt.
In August 2024, the Texas Department of Public Safety stopped accepting court orders that change the sex listed on a driver’s license or state ID. DPS will now update a gender marker only to correct a clerical error, meaning a case where the document never matched the person’s biological sex to begin with.2Texas State Law Library. Correcting Errors Combined court orders that bundle a name change with a gender marker change are rejected.
Shortly after, the Department of State Health Services stopped processing gender marker amendments on birth certificates. The prior pathway of obtaining a court order and submitting it to DSHS no longer functions. DSHS will amend the sex field on a birth certificate only to correct a hospital error or omission at the time of birth.
Federal documents have moved the same direction. An executive order issued January 20, 2025 directs federal agencies to ensure government-issued identification reflects the holder’s biological sex and defines sex as biological classification at birth.3The White House. Defending Women From Gender Ideology Extremism and Restoring Biological Truth to the Federal Government The State Department no longer issues passports with an X marker and requires the M or F marker to match biological sex at birth.4U.S. Department of State. Sex Marker in Passports Social Security Administration guidance issued January 31, 2025 prohibits changes to the sex listed on Social Security records.
The practical result: there is currently no functioning state or federal process to update a gender marker to reflect gender identity on a Texas driver’s license, Texas birth certificate, U.S. passport, or Social Security record.
Changing Your Legal Name
The name change process under Texas Family Code Chapter 45 remains available and is not conditioned on the reason for the change. You file a petition with the district clerk in the county where you live, in person or through eFileTexas.5eFileTexas.Gov. Official E-Filing System for Texas The petition requires fingerprints for a DPS and FBI background check, disclosure of any felony convictions, and disclosure of sex offender registry status.6Justia Law. Texas Family Code Chapter 45 – Change of Name If you cannot afford the filing fee, a Statement of Inability to Afford Payment of Court Costs can be submitted to request a waiver.7Texas State Law Library. Adults – Name Changes in Texas
A judge reviews the petition at a hearing and, if approved, signs a final order. Request several certified copies from the clerk. You will need them for banks, employers, schools, and every other record that has to be updated. Note the boundary: the resulting order will let you update your name on a Texas ID, but under current DPS policy it will not let you change the sex designation.
Medical Care
Minors
Senate Bill 14, from the 88th Legislative Session, prohibits physicians and healthcare providers from performing transition-related surgeries on anyone under 18 and from prescribing puberty blockers or cross-sex hormones to minors for gender transition.8Texas Legislature Online. Texas Senate Bill 14 – 88th Legislature Public funds cannot be used to pay for a prohibited treatment, and neither Medicaid nor the state’s child health plan may reimburse providers for these procedures on minors.
Enforcement is nondiscretionary. Under Texas Occupations Code Section 164.0552, the Texas Medical Board is required to revoke the license of any physician who provides a prohibited treatment to a minor and must refuse to issue or renew a license for anyone who has violated the prohibition.9State of Texas. Texas Occupations Code Section 164.0552 – Prohibited Acts Regarding Gender Transitioning or Gender Reassignment Procedures and Treatments on Certain Children
SB 14 includes a narrow grandfathering provision for minors who were already on hormone therapy or puberty blockers before June 1, 2023, and who had completed at least 12 mental health counseling sessions over a minimum of six months before starting the medication. Even those patients must be weaned off in a medically safe manner, and switching to a different prohibited drug or beginning any new prohibited treatment is not permitted. The provision produces a managed wind-down, not continued access.
Adults
Texas prohibits state-regulated health plans from covering what the state calls gender modification procedures or treatments. The exclusion applies to the state employee health plan, the public school employee plan, the university employee plan, and Medicaid. The only exception is for individuals with a medically verifiable genetic disorder of sex development. Adults seeking transition-related care in Texas generally pay out of pocket unless a private employer plan that is not subject to state insurance regulation covers the treatment.
Senate Bill 1188, from the 89th Legislative Session in 2025, adds a records rule: electronic health records in Texas must list the patient’s biological sex at birth, and those records can be amended only to correct a clerical error or to reflect a diagnosed disorder of sex development.1Texas State Law Library. Transgender Law – LGBT Law
Restrooms in Government Buildings
Senate Bill 8, from the 89th Legislative Session in 2025, requires that multi-occupancy restrooms and locker rooms in government-owned buildings be designated for use by individuals of one biological sex only. Coverage includes public schools, charter schools, junior colleges, public universities, and buildings owned by state agencies, counties, municipalities, and special-purpose districts. The law also imposes restrictions on correctional facilities and certain family violence shelters. Violations can be enforced through civil penalties or private lawsuits.1Texas State Law Library. Transgender Law – LGBT Law
School and College Athletics
Senate Bill 2, from the 87th Legislature, requires K-12 students to compete on athletic teams matching the sex listed on their original birth certificate, meaning one issued at or near the time of birth. A later-amended certificate does not change the eligibility category. The University Interscholastic League enforces the rule across public school competition.10Texas Legislature Online. Texas Senate Bill 2 – 87th Legislature
Senate Bill 15, from the 88th Legislature, extended the same rule to public colleges and universities, with no exception for students who have undergone medical transition.11Texas Legislature Online. Texas Senate Bill 15 – 88th Legislature
Employment
Federal law is where transgender Texans retain the most enforceable protection. In Bostock v. Clayton County, the U.S. Supreme Court held that firing an employee for being transgender violates Title VII of the Civil Rights Act because such treatment is a form of sex discrimination.12Legal Information Institute. Bostock v. Clayton County
Two limits matter. Title VII applies only to employers with 15 or more employees, so workers at smaller employers do not have the federal claim. Texas state law, under Chapter 21 of the Texas Labor Code, prohibits employment discrimination based on sex but does not explicitly list gender identity or sexual orientation. Bostock also directly governs hiring, firing, and terms of employment; questions about restroom access, dress codes, and health benefits involve additional legal analysis that continues to develop. If you face a workplace issue, keep a written record of communications from the start.
Campus Resources
Senate Bill 17, from the 88th Legislature, prohibits public colleges and universities from establishing or maintaining diversity, equity, and inclusion offices, and institutions cannot hire staff or contract with outside organizations to perform DEI functions.13Texas Legislature Online. Texas Code – SB 17 – Diversity, Equity, and Inclusion Initiatives In practice, LGBTQ+ resource centers and gender-inclusive housing programs at many Texas universities have closed. Some institutions have moved services into general student affairs offices, but the dedicated model is largely gone.