By Caroline Savoie
The Texas Legislature is considering several bills that are drawing scrutiny from LGBTQ advocates and healthcare professionals who fear they could negatively impact access to care for transgender and queer people. Among these are a new bill proposing felony charges for “gender identity fraud” and two Senate bills that could restrict healthcare access and the accuracy of medical records.
House Bill 3817: creating a criminal offense for “gender identity fraud”
A new bill introduced in the Texas House of Representatives, HB 3817, has recently been referred to the House Committee on State Affairs. Rep. Tom Oliverson, R-Texas, authored the bill, and he filed it on March 5, 2025. Rep. Keresa Richardson, R-Texas, is sponsoring the bill, which aims to create a new criminal offense called “gender identity fraud,” alongside Oliverson.
According to the bill’s text, a person commits an offense if they “knowingly makes a false or misleading verbal or written statement to a governmental entity or the person’s employer by identifying the person’s biological sex as the opposite of the biological sex assigned to the person at birth.” The bill specifies that this offense would be a state jail felony and come with a fine up to $10,000.
This bill follows a pattern of legislation targeting the rights and identities of transgender individuals. Critics argue that such a broad and vaguely defined law could be used to harass and criminalize transgender people for simply living authentically.
SB 619: conscience clause and healthcare refusal
Sen. Bryan Hughes, R-Texas, of District 1 authored SB 619, which would allow healthcare professionals to refuse to provide services to patients based on “severely held moral convictions.” The bill defines “conscience” broadly to include beliefs related to religion, moral philosophy, or ethical positions. Critics argue this could provide a legal basis for healthcare providers to deny care to LGBTQ individuals, particularly those seeking gender-affirming care.
“In order to safeguard ‘life, liberty, and the pursuit of happiness,’ we must guarantee that the quality of health care for all Texans is not determined by who they are or whether or not their doctor agrees with their politics,” Equality Texas said in an analysis of the bills.
The bill includes exceptions for emergency care and, with limitations, life-sustaining treatment. But opponents worry that the broad language could lead to discrimination in various aspects of healthcare, from routine check-ups to specialized treatments.
SB 1188: narrow definition of biological sex in medical records
Sen. Lois Kolkhorst (R- Texas) of District 18 introduced SB 1188, which focuses on electronic health records and mandates a specific definition of “biological sex.” The bill defines “biological sex” as “the biological trait that determines whether a sexually reproducing organism produces male or female gametes.” It further specifies “male” and “female” based on reproductive systems.
This bill requires electronic health records to include a separate field for a healthcare practitioner to document an individual’s biological sex at birth, as well as information on any sexual development disorder. It also restricts the ability to change the recorded biological sex in an electronic health record, only allowing changes to correct clerical errors or when a person gets a sexual development disorder diagnosis that changes the person’s listed biological sex.
Legal experts weigh in: potential barriers to care
Advocates for transgender individuals express concern that such a narrow definition and the restrictions on updating medical records could create significant challenges. LGBTQ legal experts like those at Equality Texas argue that this could lead to misgendering in medical settings and create barriers to accessing appropriate and affirming healthcare, particularly for transgender and non-binary individuals whose gender identity differs from their sex assigned at birth.
“This bill follows the pattern of requiring ‘biological sex’ on all government documents, which can pose challenges for trans Texans who need to access health care or may need to share their records with out-of-state doctors,” Equality Texas’ analysis reads.
Texas legislative process: Where do HB 3817, SB 619 and SB 1188 stand?
As of the latest information from the Texas legislative tracker on March 26, 2025, the status of the bills is as follows:
- HB 3817: Referred to the House Committee on State Affairs on March 26, 2025.
- SB 619 and SB 1188: Both remain pending in the Senate Health & Human Services Committee after being discussed on March 18.
To move these bills forward, the committees must vote to send them to the full chamber (in this case, the Senate). If the committees report the bills, the chambers will then place them on their calendars for debate and a vote by the full Senate. It’s important to watch the committees and legislative calendars for any updates on these bills. Because the bills are currently pending, their future is uncertain, and the committees need to take further action if they want the bills to advance.
Related stories: Texas House bill proposes felony charges for ‘gender identity fraud’
Correction made. Thanks for the heads up.