Accountability.
AUSTIN, Texas — Transgender and intersex adults in Texas prisons can keep receiving the hormone therapy they were already on, under a revised Texas Department of Criminal Justice health policy obtained by KXAN, while people under 18 in state custody must be tapered off.
The policy, known as G-51.11, quietly disappeared from TDCJ’s online Correctional Managed Health Care manual this summer, prompting advocates to warn that the state had ended gender-affirming care in its prisons. In response to a public records request, TDCJ gave KXAN a revised version with a July 2026 review date that replaces the July 2025 version. KXAN reported the policy on Sept. 23.
What the revised policy says
- Adults who arrive with an existing gender dysphoria diagnosis are to continue the same documented hormone regimen, with refills indefinitely.
- Adults no longer need a separate mental health evaluation before treatment continues, but a provider at a designated Gender Dysphoria Specialty Clinic must still confirm the diagnosis and monitor medication.
- People under 18 must be weaned off hormone medications in a way that is safe and medically appropriate, in line with the 2023 Texas law banning transition-related care for minors.
The KXAN report does not say whether people diagnosed after entering prison can still begin hormone therapy. A 2016 version of the policy had allowed that.
Still not confirmed as in effect
The revised policy is still not posted in TDCJ’s online manual, and the agency has not said whether it is currently being followed. TDCJ’s communications director told KXAN that “medical providers evaluate patients and prescribe medication in accordance with medical standards of care,” but the agency did not directly answer whether G-51.11 is in effect.
KXAN also found that TDCJ’s 2026 disease management guidelines dropped gender dysphoria monitoring guidance that appeared in the 2025 edition.
Fewer than 2,000 transgender people were held in Texas prisons as of Aug. 1, about 0.11% of the more than 144,000 people in TDCJ custody, according to the agency. Since a 2025 state law, Senate Bill 8, transgender people in Texas prisons are housed according to their sex assigned at birth.
Families with concerns about a loved one’s medical care can contact the TDCJ Office of the Independent Ombudsman at (936) 437-5620 or toll-free at (833) 598-2700.
Texas Prison News will update this story if TDCJ confirms the policy’s status.