Tennessee: puberty blocker, cross-sex hormone and surgery laws for minors (verified Oct 2026)

Medical care for minorsBan

SB1 — the statute the Supreme Court upheld in Skrmetti (18 June 2025, 6–3). In force.

Tennessee General Assembly (SB1)

MedicaidFederal funding ended (minors)

Medicaid doesn't pay for sex-change procedures at any age. A federal CMS rule ends federal Medicaid and CHIP money for puberty blockers, cross-sex hormones and surgery for minors.

42 C.F.R. 441.800–802, 457.476 (91 Fed. Reg. 52406)

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State policy: Excludes (all ages)

Official source: publications.tnsosfiles.com

State source

State employeesExcludes

State-employee health plans don't pay for sex-change procedures.

Health Insurance (tn.gov)

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SportsSex-based

Girls' sports are protected: state law keeps males out of girls' and women's teams.

HB1895/SB1861

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FacilitiesSex-based (K-12 schools)

Bathrooms and changing rooms in K-12 schools are separated by sex, so males stay out of women's and girls' spaces.

Tennessee HB1233

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Pronouns and parent noticeParent notice required

Schools must tell parents if their child asks to be treated as the opposite sex. No secret transitions.

HB 2165/SB 1810

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CurriculumSchools restriction

Tenn. Code §49-6-1308 (SB1443 / Public Chapter 353, 2023): 30-day notice and written parental opt-in before sexual-orientation or gender-identity curriculum. Separate from the medical ban (SB1 / Skrmetti).

Tennessee General Assembly (SB1443 / Pub. Ch. 353)

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Sex definitionDefined by biology

State law defines male and female by biology for state purposes.

Bill Information - Tennessee General Assembly (wapp.capitol.tn.gov)

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ID markersBirth-certificate sex cannot be

Birth-certificate sex cannot be changed; licence sex cannot be changed.

2021 version ;

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Shield lawNone

No shield law.

No shield statute identified

AdultsRestricted (funding)

Adults: no taxpayer money for sex-change procedures (Medicaid exclusion at all ages, state-employee plan exclusion).

Tennessee adult-care rule (publications.tnsosfiles.com)

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DetransitionUp to 30 years after turning 18

Detransitioners can sue for up to 30 years after turning 18.

SB 1 (2023)

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PrisonsBy sex (statute)

Public Chapter 1052 (2026; HB 571/SB 468), effective July 1, 2026, requires correctional and juvenile-detention facilities to designate multi-occupancy sleeping quarters, restrooms and changing rooms for one biological sex (T.C.A. § 68-107-109).

T.C.A. § 68-107-109 (Pub. Ch. 1052, 2026)

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Pending billsNo active bills

No active bills (checked 13 Oct 2026). The 2026 regular session has adjourned (or the legislature does not meet in 2026), so 2025-26 bills are no longer moving. LegiScan search linked.

LegiScan search, checked 13 Oct 2026 (adjourned legislature)

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LitigationResolved

United States v. Skrmetti (18 June 2025): U.S. Supreme Court upheld SB 1, 6–3.

23-477 United States v. Skrmetti (06/18/2025) (supremecourt.gov)

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Key datesNone upcoming

No upcoming effective dates or court deadlines identified.

Review, Oct 2026