Texas Lets Adult Trans Prisoners Keep Hormones While Under-18s Are Weaned Off, TDCJ Policy Says

A Texas prison health policy document obtained by KXAN says adults with an existing gender dysphoria diagnosis may continue a documented hormone regimen after entering state custody, while some prisoners younger than 18 are subject to tapering requirements under state law.

The document, identified as policy G-51.11, carries a July 2026 review date and replaces a July 2025 version, KXAN reported.

KXAN obtained it through a public information request after the policy disappeared from Texas Department of Criminal Justice's online Correctional Managed Health Care manual.

The document addresses treatment of prisoners with intersex conditions or gender dysphoria. KXAN reported that adult access to hormone therapy was not removed in the revised version.

Adults with an existing gender dysphoria diagnosis are to continue the same documented hormone regimen, if any, when they arrive, with indefinite refills.

A designated speciality clinic provider remains responsible for making or confirming a gender dysphoria diagnosis and monitoring medication.

Texas Rules Differ for Some Prisoners Under 18

The rules are different for certain prisoners younger than 18 because of a 2023 Texas law restricting specified transition-related medical treatment for children.

Under Texas Health and Safety Code Section 161.703, an exception applies to a prescription drug that would otherwise be prohibited if the child began the continuing course of treatment before 1 June 2023, and attended at least 12 sessions of mental health counselling or psychotherapy over at least six months before treatment began.

A child who qualifies under that exception must be weaned off the prescription drug over time in a manner the law describes as safe and medically appropriate and intended to minimise the risk of complications. The child may not switch to or begin another prescription drug prohibited under the same section.

The law also contains separate exceptions. It permits puberty-suppressing medication for precocious puberty and allows medically necessary procedures or treatments for children with certain medically verifiable disorders of sex development or specified chromosome variations. The tapering requirement therefore should not be read as applying to every incarcerated person under 18 who receives hormone-related treatment.

KXAN reported that the July 2026 version of G-51.11 incorporates the under-18 requirements while continuing the adult treatment pathway. It also reported that adults no longer have to undergo a mental health evaluation aimed at identifying certain co-occurring psychiatric disorders, although a designated gender dysphoria speciality provider must still make or confirm the diagnosis and monitor medication.

Why the Texas Prison Policy Drew Scrutiny

Uncertainty over the policy began after G-51.11 disappeared from TDCJ's public policy manual. As of 28 September, the online manual lists G-51.10 followed by G-51.12, with G-51.11 absent.

Transitics reported on 21 August that TDCJ had told it by telephone that G-51.11 was no longer in effect and that no replacement policy was planned. It said more than 1,100 transgender prisoners could be affected, but that figure was based on a 2019 estimate of the transgender population in TDCJ custody rather than a current 2026 count.

The document later supplied to KXAN complicates that earlier account because it describes continued hormone treatment for adults with documented regimens.

KXAN said it asked TDCJ officials whether G-51.11 was currently in effect but had not received a direct answer at the time of publication.

A TDCJ communications director later told the outlet that medical providers evaluate patients and prescribe medication according to medical standards of care.

The policy debate comes alongside a separate Texas law governing prison housing. Government Code Chapter 3002, effective 4 December 2025, defines 'sex' for purposes of the chapter as biological sex, either male or female, and requires TDCJ to house prisoners in correctional facilities, dormitories or cellblocks according to that statutory classification.

The revised document therefore describes continuity of hormone treatment for qualifying adults, while Texas law imposes narrower restrictions on certain treatment for minors. TDCJ's publicly available materials make it less clear whether G-51.11 is formally in effect.