House Bill No. 3431 seeks to impose strict prohibitions on the provision of gender transitioning or reassignment procedures, treatments, and gender-affirming therapy and counseling for certain children in Texas. The bill 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 puberty blockers or hormones that induce infertility, and removing healthy body parts. Additionally, it creates a new section that prohibits non-physician mental health professionals from providing 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 illegal in Texas. Violations of these provisions are classified as state jail felonies, emphasizing the seriousness of the offenses. The bill is set to take effect on September 1, 2025.