Texas Gov. Greg Abbott signed SB 1188, requiring an unalterable 'biological sex' field in every electronic health record
On June 20, 2025, Texas Gov. Greg Abbott signed Senate Bill 1188, which requires every electronic health record in the state to include a "distinct, unalterable" field for a person's biological sex as defined at birth, changeable only to correct a clerical error or for a diagnosed disorder of sexual development. The measure, part of a broader electronic-health-records law, is enforceable by the Texas attorney general with civil penalties of up to $250,000 per violation and grants parents access to their minor children's records. Most provisions take effect September 1, 2025.
Actors
- Greg Abbott (Governor of Texas)
- Texas Legislature
- Lois Kolkhorst (State Senator)
On June 20, 2025, Texas Gov. Greg Abbott signed Senate Bill 1188, authored by state Sen. Lois Kolkhorst, which requires that every electronic health record maintained in Texas contain a "distinct, unalterable" field recording a person's biological sex, defined by the individual's production of sperm or ova. The field may be corrected only for a clerical error or for a person with a medically verifiable disorder of sexual development, meaning that transgender and nonbinary patients' records permanently display the sex they were assigned at birth regardless of their gender identity or medical transition.
SB 1188 is a broader electronic-health-records statute that also imposes data-localization and access requirements, but this provision fixes an immutable sex marker in the medical files of a protected group. The Texas attorney general may enforce the law with civil penalties ranging from $5,000 to $250,000 per violation, and a separate provision grants parents access to their minor children's health records. Most of the law's provisions took effect September 1, 2025.
Why we recorded this
Civil rights require that government not disadvantage people because of who they are. Texas enacted SB 1188, which requires every electronic health record in the state to carry a distinct, effectively unchangeable field for a person's biological sex as determined at birth, so that transgender and nonbinary patients' records display a sex marker that contradicts their gender identity regardless of their medical transition. The law is enforced by the attorney general with civil penalties and grants parents access to their minor children's records. Fixing an immutable identity marker that singles out a protected group, and backing it with state enforcement, uses health data to disadvantage people on the basis of a protected characteristic.
Sources
- S.B. 1188, 89th Legislature (Enrolled version) — Texas Legislature primary accessed July 14, 2026
- Texas bill requires health records list sex assigned at birth — The Texas Tribune investigative accessed July 14, 2026
- Texas Enacts Electronic Health Record Data Localization Law — Hunton Andrews Kurth investigative accessed July 14, 2026
- SB 1188 — Equality Texas secondary accessed July 14, 2026
See also
- Texas enacted SB 1257 requiring plans that cover gender-transition care to also cover detransition and lifelong monitoring
- Texas enacted SB 12 barring public-school instruction and student clubs on sexual orientation or gender identity
- Texas Gov. Abbott signed HB1106, excluding refusal to affirm a child's gender identity from the state's child-abuse definition
- Texas Gov. Abbott signed HB 229 writing a binary biological-sex definition into state government code and excluding gender identity from recognition
- Texas enacted SB 8 requiring birth-sex use of restrooms in government buildings, schools, and prisons
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