The bill, H.B. No. 3431, seeks to impose strict prohibitions on the provision of gender transitioning or reassignment procedures, treatments, and gender-affirming therapy and counseling for children in Texas. It amends the Health and Safety Code by adding definitions and establishing criminal penalties for violations. Specifically, it prohibits physicians and health care providers from performing surgeries that sterilize children, administering certain prescription drugs that induce infertility, or removing healthy body parts for the purpose of transitioning a child's biological sex. Additionally, it introduces penalties for non-physician mental health professionals who provide gender-affirming therapy that affirms a gender inconsistent with a child's biological sex.

The bill also includes provisions that prevent health care practitioners from referring children to out-of-state providers for procedures or treatments that would be prohibited if performed in Texas. Violations of these provisions are classified as state jail felonies, emphasizing the seriousness of the offenses. The act is set to take effect on September 1, 2025.