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~tate of \!Cennessee
PUBLIC CHAPTER NO. 932
HOUSE BILL NO. 754
By Representatives Faison, Moody, Haston, Maberry, McCalmon, Carringer, Reeves,
Howell, Cochran, Todd
Substituted for: Senate Bill No. 676
By Senators Taylor, Johnson, Jackson, Yager, Rose, Seal
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;
(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;
(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
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(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.
(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;
(2) The age and sex of the person for whom the gender transition
procedure was prescribed;
(3) For a drug prescribed as part of a gender transition procedure:
(A) The name of the drug;
(8) 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 as part of a gender transition
procedure, the type of surgical procedure identified by the current procedural
terminology (CPT) code;
(5) The state 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; and
(7) A list of any diagnoses that the person receiving 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;
(2) Signed by the healthcare professional who prescribes the gender
transition procedure; and
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(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.
(d) Forms required under this section must not contain individually identifiable
health information as defined in 45 CFR § 160.103.
(e)
(1) The department shall submit a comprehensive annual statistical report
by December 31, 2026, 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 annual statistical report 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.
(2) The department shall make the statistical report available to the public
on the department's public website in a downloadable format; provided, the data
in the report on the department's public website is not aggregated. The data
contained in such report must not identify individual providers.
(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
(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.
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;
(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; and
(3) "Marketplace exchange" means the federal health insurance
marketplace or federal health benefit exchange.
(b)
(1) 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
effective date of this act, includes coverage for gender transition procedures,
then the policy must also include coverage for detransition procedures.
(2) Upon approval and implementation of the waiver sought in subsection
(i), if an insurance policy that is offered on the marketplace exchange and that is
issued, renewed, 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 the policy must also include coverage for detransition
procedures.
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(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
(4) The state 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)
(1) The department shall submit a comprehensive annual statistical report
by December 31, 2026, 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 annual statistical report 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.
(2) The department shall make the statistical report available to the public
on the department's public website in a downloadable format; provided, the data
in the report on the department's public website is not aggregated. The data
contained in such report must not identify individual providers.
(h) The attorney general and reporter may investigate a potential violation of this
section.
(i) The department of commerce and insurance shall, within ninety (90) days of
the effective date of this act, apply to the federal centers for medicare and medicaid
services (CMS) for a waiver pursuant to 45 CFR § 156.111 to allow the department to
add detransition procedures to the state's essential health benefits (EHB) for qualified
health plans (QHPs) offered on the marketplace exchange.
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.
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HOUSE BILL NO. 754
PASSED: April 15, 2026
CAMERON""S'EXTON,SPEAKER
HOUSE OF REPRESENTATIVES
RANDY MCNAL'Y
EAKER OF THE SENATE
APPROVED this TJf:R.. day of ~o 2026
lee. &
BILL LEE, GOVERNOREvery fact on this page links to its source, starting with the official bill record.