Tennessee House Health Committee advances bill on insurer coverage, data reporting for detransition care

The Tennessee House Health Committee voted 18-5 on HB 754 on a party-line forwarding vote that sends the measure to the Finance, Ways and Means Committee.

HB 754 would require health insurers that cover gender-transition procedures to also cover treatments and procedures for people who later seek to reverse aspects of a transition (commonly described as “detransitioning”), and it would require certain data collection and reporting on gender-related care by entities defined in the bill as “gender clinics.” The sponsor said the measure is intended to ensure parity in coverage and to create a record of outcomes; opponents warned it would jeopardize patient privacy and could promote harmful practices.

The bill drew two invited witnesses. Adam Shoop of Davidson County testified in opposition, saying the reporting requirements would risk identifying patients and providers and would stigmatize transgender people. “This bill further stigmatizes trans people, endangers patient privacy, and puts a target on the back of providers,” Shoop said, citing a 2019 JAMA Psychiatry study he said links conversion therapy to worse mental-health outcomes and referencing an attorney-general inquiry at Vanderbilt that, he said, harmed patients.

A witness identified as JD (legal name Winter Breedlove) described struggles obtaining mental-health evaluations and later corrective care after stopping transition-related treatment. JD said vague coding of services made it difficult to obtain appropriate procedures and billing for restorative care. “My health care was tracked under the vague code of ‘transgender undefined,’” JD testified, saying that made it harder to secure corrective treatment.

Committee members questioned whether the bill would function as an insurance mandate and whether parts of the bill apply to clinics that receive state funds. Legal staff read the bill’s definition of “gender clinic,” which says the term covers licensed health-care entities that “provide or prescribe gender transition procedures” as drafted in the text. Members also reviewed the bill’s fiscal memo, which says TennCare managed-care organizations and the state group insurance plans do not cover gender-transition procedures and that detransition procedures are not broadly covered under the state benchmark plan. Committee members noted that if state plans do not cover transition services, the statutory language targeting clinics that “use funds provided by this state to directly or indirectly pay for gender transition procedures” could be ambiguous or have no immediate effect.

Supporters, including the sponsor, said the measure is not intended to force anyone into transition and framed it as parity for people whose circumstances change after treatment. Opponents said the bill’s reporting and definitions are vague and could lead insurers to exclude coverage entirely.

With legal and fiscal staff present for clarification, the committee voted to advance HB 754 to Finance, Ways and Means for further consideration.

The bill will be heard next in Finance, Ways and Means; the committee record shows the tally 18 ayes, 5 nays.