Health Care

Plain English Breakdown

The bill does not explicitly mention the cost of health insurance premiums due to mandated coverage of detransition procedures.

Health Care Act for Gender Transition and Detransition Procedures

This bill changes Tennessee's health care laws by requiring gender clinics receiving state funds to provide detransition procedures if they offer gender transition procedures, mandating insurance coverage for detransition procedures, and enforcing reporting requirements on these procedures.

What This Bill Does

• Prohibits local governments from restricting parents or guardians' ability to consent to mental health therapy for minors dealing with gender identity issues.
• Requires gender clinics receiving state funding to provide detransition procedures if they offer gender transition procedures.
• Mandates insurance policies covering gender transition procedures also cover detransition procedures.
• Necessitates that gender clinics and insurance providers report detailed statistics about gender transition and detransition procedures to the Department of Health annually.

Who It Names or Affects

• Gender clinics receiving state funds
• Insurance companies providing health coverage in Tennessee
• Healthcare professionals
• Parents or guardians of minors seeking mental health therapy

Terms To Know

Detransition procedure

Treatment that stops, reverses, or helps an individual cope with the effects of a gender transition.

Gender clinic

A healthcare entity licensed to provide or prescribe gender transition procedures.

Limits and Unknowns

• The bill does not specify how much funding will be provided by the state for these clinics.
• It is unclear what specific penalties insurance companies might face if they do not comply with reporting requirements.

Official Summary Text

RIGHT TO EFFECTIVE CARE

This bill prohibits a county or municipality from (i) prohibiting the provision of mental health therapy to help a minor address an inconsistency between the minor's sex and the minor's perceived gender or perceived sex, and (ii) prohibiting a parent or
legal guardian from consenting to, or withholding consent from, the provision of mental health therapy to help a minor address an inconsistency between the minor's sex and the minor's perceived gender or perceived sex. A gender clinic that uses funds pro
vi
ded by this state to directly or indirectly provide or pay for gender transition procedures must, as a condition of receiving such funds, agree to provide or pay for the performance of detransition procedures.

Reporting

This bill requires a gender clinic operating in this state to report statistics regarding all gender transition procedures to the department of health on a form provided by the department. The department must develop a form for so reporting and determin
e the statistics to be reported, which must include all of the following:



The date on which the gender transition procedure was prescribed or the referral was made for the gender transition procedure.



The age and sex of the person for whom the gender transition procedure was prescribed or the gender transition procedure referral was made.



For a drug prescribed as part of a gender transition procedure, the name of the drug, the dosage of the drug, the dosage frequency and duration, and the method by which the drug will be administered.



For a surgical intervention provided or a referral made for a surgical intervention as part of a gender transition procedure, the type of surgical procedure identified by the current procedural terminology (CPT) code.



The state and county of residence of the person receiving the gender transition procedure.



The name, contact information, and medical specialty of the healthcare professional who prescribed the gender transition procedure or made the referral for the gender transition procedure.



A list of any diagnoses that the person receiving or referred for a gender transition procedure has received of neurological, behavioral, or mental health conditions.

This bill requires the form to be (i) completed by each gender clinic at which a gender transition procedure is prescribed or a referral is made for a gender transition procedure; (ii) signed by the healthcare professional who prescribes the gender transi
tion procedure or makes a referral for a gender transition procedure; and (iii) transmitted by the gender clinic to the department no later than 15 days after the end of the calendar month during which the gender transition procedure was prescribed or the
r
eferral was made. Forms must not contain individually identifiable health information.

Annual Statistical Report

This bill requires the department to submit a comprehensive annual statistical report by December 31 of each year, to the speaker of the senate, the speaker of the house of representatives, and the legislative librarian based on all data obtained from fo
rms required by this bill. The department must make the statistical report available to the public on the department's public website in a downloadable format.

Enforcement

If a healthcare professional fails to comply with this bill, then (i) the healthcare professional has engaged in unprofessional conduct and is subject to discipline by the appropriate licensing entity or disciplinary review board with competent jurisdict
ion in this state. Disciplinary action must include suspension of the ability to administer health care or practice medicine for at least six months and (ii) the gender clinic where the healthcare professional is employed must pay a civil fine not to exc
ee
d $150,000. The attorney general may investigate a potential violation, seek production of documents or testimony through a civil investigative demand, and bring an action to enforce compliance.

INSURANCE COVERAGE FOR DETRANSITION PROCEDURES

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.

Reporting

This bill requires an entity providing such coverage for detransition procedures to provide statistics regarding insurance claims for detransition procedures in this state to the department of health on a form provided by the department. The department
must develop a form for the reporting and determine the statistics to be reported, which must include (i) the number of insurance claims made for detransition procedures; (ii) the age and sex of an individual receiving a detransition procedure; (iii) if k
no
wn, the date that the individual initially began a gender transition procedure; and (iv) the state and county of residence of the person receiving the gender transition procedure. Reporting forms must not contain individually identifiable health informat
ion.

This bill requires the entity providing such coverage to transmit the form to the department no later than 15 days after the end of the calendar month during which a claim for the gender transition procedure was approved.

Annual Statistical Report

This bill requires the department to submit a comprehensive annual statistical report by December 31 of each year, to the speaker of the senate, the speaker of the house of representatives, and the legislative librarian based on all data obtained from fo
rms required by this bill. The department must make the statistical report available to the public on the department's public website in a downloadable format.

Enforcement

This bill authorizes the attorney general to investigate a potential violation, seek production of documents or testimony through a civil investigative demand, and bring an action to enforce compliance with the provisions under this heading.

ON MARCH 26, 2026, THE HOUSE ADOPTED AMENDMENTS #1 AND
#2 AND PASSED HOUSE BILL 754, AS AMENDED.

AMENDMENT #1 makes the following changes and additions to this bill:

(1) Removes healthcare entities that provide referrals for gender transition procedures but do not provide or prescribe such
procedures from regulation as a gender clinic under this bill;

(2) Removes reporting requirements concerning referrals;

(3) Specifies that the annual statistical reports to the speaker of the senate, the speaker of the house of representatives, and the legislative librarian must not identify individual gender clinics but must aggregate such data and the statistical repor
ts published on the department's website must not include aggregated data.

AMENDMENT #2 adds a requirement that t
he department of commerce and insurance, within 90 days of the date that this bill becomes a law, apply to the federal centers for medicare and medicaid services for a waiver to allow the department to add detransition procedures to the state's essential
health benefits for qualified health plans offered on the marketplace exchange. Upon approval and implementation of the waiver, if an insurance policy that is offered on the marketplace exchange and that is issued, re
newed, or amended in this state on or after the effective date of the approved change to the state's EHB, includes coverage for gender transition procedures, then this amendment requires that the policy must also include coverage for detransition procedur
es.

If an insurance policy that is offered outside of the marketplace exchange and that is issued, renewed, or amended in this state on or after the date that this bill becomes a law, includes coverage for gender transition procedures, then this amendment re
quires that the policy must also include coverage for detransition procedures.

This amendment changes the deadline for submission of the initial statistical reports required by this bill from December 31, 2025, to December 31, 2026.

ON APRIL 13, 2026, THE SENATE SUBSTITUTED HOUSE BILL 754 FOR SENATE BILL 676, ADOPTED AMENDMENTS #2 AND #4, AND PASSED HOUSE BILL 754, AS AMENDED.

AMENDMENT #2 r
emoves authorization for the attorney general and reporter to seek production of documents or testimony through a civil investigative demand and bring an action to enforce compliance with this bill. This amendment retains authorization for the attorney g
eneral and reporter to investigate a potential violation of this bill.

AMENDMENT #4 r
emoves the patient's county of residence from the information required on the reporting form and prohibits identifying individual providers in the published statistical report.

Current Bill Text

SENATE BILL 676
By Taylor

HOUSE BILL 754
By Faison

HB0754
001799
- 1 -

AN ACT to amend Tennessee Code Annotated, Title 1;
Title 4; Title 33; Title 56; Title 63; Title 68 and Title
71, relative to health care.

BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF TENNESSEE:
SECTION 1. Tennessee Code Annotated, Title 68, Chapter 1, is amended by adding
the following as a new part:
68-1-2501. Part definitions.
As used in this part:
(1) ''Department'' means the department of health;
(2) ''Detransition procedure'' means treatment, including mental health
treatment, medical interventions, and surgeries that stop, reverse, or help an
individual cope with the effects of a gender transition procedure due to the
resolution of any inconsistency between the individual's sex and the individual's
perceived sex or perceived gender;
(3) ''Gender'' means the psychological, behavioral, social, and cultural
aspects of being male or female;
(4) ''Gender clinic'' means a healthcare entity licensed under this title that
provides or prescribes gender transition procedures or refers individuals for
gender transition procedures;
(5) ''Gender transition procedure'' means any pharmaceutical or surgical
intervention to alter an individual's body to address an inconsistency between a
minor's sex and minor's perceived gender or perceived sex;

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(6) ''Healthcare professional'' means a healthcare provider,
establishment, or facility licensed, registered, certified, or permitted pursuant to
this title or title 63 and regulated under the authority of:
(A) The department of health;
(B) An agency, board, council, or committee attached to the
department of health; or
(C) The health facilities commission;
(7) ''Minor'' means an individual under eighteen (18) years of age;
(8) ''Perceived gender'' means an individual's internal sense of the
individual's gender;
(9) ''Perceived sex'' means an individual's internal sense of the
individual's sex; and
(10) ''Sex'' means a person's immutable characteristics of the
reproductive system that define the individual as male or female, as determined
by anatomy and genetics existing at the time of birth.
68-1-2502. Right to effective care.
(a) A county or municipality shall not prohibit the provision of mental health
therapy to help a minor address an inconsistency between the minor's sex and the
minor's perceived gender or perceived sex.
(b) A county or municipality shall not prohibit a parent or legal guardian from
consenting to, or withholding consent from, the provision of mental health therapy to help
a minor address an inconsistency between the minor's sex and the minor's perceived
gender or perceived sex.

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(c) A gender clinic that uses funds provided by this state to directly or indirectly
provide or pay for gender transition procedures must, as a condition of receiving such
funds, agree to provide or pay for the performance of detransition procedures.
68-1-2503. Right to public transparency.
(a) A gender clinic operating in this state shall report statistics regarding all
gender transition procedures to the department on a form provided by the department.
(b) The department shall develop a form for reporting under subsection (a) and
determine the statistics to be reported, which must include:
(1) The date on which the gender transition procedure was prescribed or
the referral was made for the gender transition procedure;
(2) The age and sex of the person for whom the gender transition
procedure was prescribed or the gender transition procedure referral was made;
(3) For a drug prescribed as part of a gender transition procedure:
(A) The name of the drug;
(B) The dosage of the drug;
(C) The dosage frequency and duration; and
(D) The method by which the drug will be administered;
(4) For a surgical intervention provided or a referral made for a surgical
intervention as part of a gender transition procedure, the type of surgical
procedure identified by the current procedural terminology (CPT) code;
(5) The state and county of residence of the person receiving the gender
transition procedure;
(6) The name, contact information, and medical specialty of the
healthcare professional who prescribed the gender transition procedure or made
the referral for the gender transition procedure; and

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(7) A list of any diagnoses that the person receiving or referred for a
gender transition procedure has received of neurological, behavioral, or mental
health conditions.
(c) The form developed by the department must be:
(1) Completed by each gender clinic at which a gender transition
procedure is prescribed or a referral is made for a gender transition procedure;
(2) Signed by the healthcare professional who prescribes the gender
transition procedure or makes a referral for a gender transition procedure; and
(3) Transmitted by the gender clinic to the department no later than
fifteen (15) days after the end of the calendar month during which the gender
transition procedure was prescribed or the referral was made.
(d) Forms required under this section must not contain individually identifiable
health information as defined in 45 CFR § 160.103.
(e) The department shall submit a comprehensive annual statistical report by
December 31, 2025, and by December 31 of each year thereafter, to the speaker of the
senate, the speaker of the house of representatives, and the legislative librarian based
on all data obtained from forms required by this section. The department shall make the
statistical report available to the public on the department's public website in a
downloadable format.
(f) If a healthcare professional fails to comply with this section, then:
(1) The healthcare professional has engaged in unprofessional conduct
and is subject to discipline by the appropriate licensing entity or disciplinary
review board with competent jurisdiction in this state. Disciplinary action must
include suspension of the ability to administer health care or practice medicine
for at least six (6) months; and

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(2) The gender clinic where the healthcare professional is employed shall
pay a civil fine not to exceed one hundred fifty thousand dollars ($150,000).
(g) The attorney general and reporter may investigate a potential violation of this
part, seek production of documents or testimony through a civil investigative demand,
and bring an action to enforce compliance with this section.
SECTION 2. Tennessee Code Annotated, Title 56, Chapter 7, Part 23, is amended by
adding the following as a new section:
(a) As used in this section:
(1) ''Department'' means the department of health; and
(2) ''Detransition procedure'', "gender", "gender clinic", "gender transition
procedure", "health professional", "minor", "perceived gender", "perceived sex",
and "sex" have the same meanings as defined in § 68-1-2501.
(b) If an insurance policy issued, renewed, or amended in this state on or after
the effective date of this act, includes coverage for gender transition procedures, then
the policy must also include coverage for detransition procedures.
(c) An entity providing insurance coverage for detransition procedures must
provide statistics regarding insurance claims for detransition procedures in this state to
the department on a form provided by the department.
(d) The department shall develop a form for the reporting required by subsection
(c) and determine the statistics to be reported, which must include:
(1) The number of insurance claims made for detransition procedures;
(2) The age and sex of an individual receiving a detransition procedure;
(3) If known, the date that the individual initially began a gender transition
procedure; and

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(4) The state and county of residence of the person receiving the gender
transition procedure.
(e) The entity providing insurance coverage shall transmit the form to the
department no later than fifteen (15) days after the end of the calendar month during
which a claim for the gender transition procedure was approved.
(f) Reporting forms required under this section must not contain individually
identifiable health information as defined in 45 CFR § 160.103.
(g) The department shall submit a comprehensive annual statistical report by
December 31, 2025, and by December 31 of each year thereafter, to the speaker of the
senate, the speaker of the house of representatives, and the legislative librarian based
on all data obtained from forms required by this section. The department shall make the
statistical report available to the public on the department's public website in a
downloadable format.
(h) The attorney general and reporter may investigate a potential violation of this
section, seek production of documents or testimony through a civil investigative demand,
and bring an action to enforce compliance with this section.
SECTION 3. If any provision of this act or its application to any person or circumstance
is held invalid, then the invalidity does not affect other provisions or applications of the act that
can be given effect without the invalid provision or application, and to that end, the provisions of
this act are severable.
SECTION 4. The headings in this act are for reference purposes only and do not
constitute a part of the law enacted by this act. However, the Tennessee Code Commission is
requested to include the headings in any compilation or publication containing this act.
SECTION 5. This act takes effect upon becoming a law, the public welfare requiring it,
and applies to contracts for insurance entered into, amended, or renewed on or after that date.