The federal protections against employment discrimination based on sexual orientation or gender identity, established in 2020 by several landmark cases, apply in Texas.

[20] By September of that year, the Texas Department of State Health Services estimated it had issued 2,500 same-sex marriage licenses in the months following Obergefell.

[24] On April 23, 2014, Judge Barbara Nellermoe, of the 45th Judicial District Court of Bexar County, found that Texas's ban on same-sex marriage was unconstitutional.

Austin,[29] Dallas,[30] Fort Worth,[31] El Paso,[32] Houston,[33] and San Antonio[34] provide health insurance to domestic partners of city workers.

[44] In response, officials in Travis County and Fort Worth defended the legality of their domestic partnership benefits,[45] as did those in other jurisdictions who minimized the significance of the opinion.

[46][47] The Austin Independent School District decided in June 2013 not to offer health benefits to the domestic partners of its employees,[48] but changed its position in August 2013.

These include measures: criminalizing provision of gender-affirming health care to minors; reducing access to gender-affirming treatments for individuals of any age; restricting public performances that include performers deemed to be displaying markers or behavior considered appropriate for a sex other than the one assigned to them at birth; disallowing any alteration of sex (gender) marker on official documents for minors; and further restricting participation in sports for transsexual or gender non-conforming people.

[83] According to an article in the Houston Chronicle, Cantor said that for minors experiencing gender dysphoria, the condition may desist and they may become cisgender gay or lesbian people.

[82] Also in July 2022, Yale University released a point by point rebuttal of the justifications given by Texas and Alabama for their bans on youth gender affirming care, stating that puberty blockers and hormone therapies are in fact safe and effective for treating gender dysphoria, that "these are not close calls or areas of reasonable disagreement", and that both states "ignore established medical authorities and repeat discredited, outdated, and poor-quality information" and repeatedly cite "a fringe group whose listed advisors have limited (or no) scientific and medical credentials and include well known anti-trans activists".

[93][94][79] In February 2022, the Texas Department of Health and Human Services removed a listing for The Trevor Project, a national organization for LGBT youth, from its online suicide prevention resources.

[103] Since at least 1999, no bill prohibiting discrimination by employers based on sexual orientation or gender identity has made it out of the committee stage in the Texas Legislature.

[108][109][110] Judge Lee Rosenthal of the Southern District Court of Texas has ruled that sexual orientation and gender identity fall under Federal Protections.

[112] Texas state law doesn't protect people from housing or public accommodations discrimination based on their sexual orientation or gender identity or expression.

[115] Texas state law also doesn't protect people from insurance discrimination based on their sexual orientation or gender identity or expression.

[125] For example, Section 2400.002 of the unamended version, filed by Bryan Hughes[126] included direct mention of "beliefs regarding marriage" as protected; the bill as passed was amended to exclude that specification.

The final bill also dispensed with language that referred to individuals' "sincerely held" beliefs or convictions; instead, the enacted version enumerates ties to or support of religious organizations.

[183] Aggregated data from two large public opinion polls find that 79% of Texas residents think that LGBTQ people experience a moderate amount to a lot of discrimination in the state.

A "narrative statement" from a doctor or therapist stating the individual has received, in the health professional's opinion, appropriate care, and it is in their best interest that the person's record is changed must be included in the applicant's petition to the court.

[2][184] In December 2022, it was reported by the Washington Post that the Attorney General's office had requested a full list of all gender changes on Texas driver's licenses and other department records.

[188][189][190] When Abbott initially signed the bill, the American Civil Liberties Union, the ACLU of Texas, Lambda Legal and the Transgender Law Center said they were preparing to fight its implementation in court.

[193] Texas Attorney General Ken Paxton subpoenaed the medical records of trans kids from Seattle Children's Hospital and from QueerMed, a Georgia-based telehealth clinic.

On April 22, 2024, Paxton's office announced a court settlement by which it would no longer seek to access transgender people's information from the Washington hospital, whose officials have denied giving gender-affirming care to any Texas minors.

[197] In 2009, the Texas Legislature authorized a court order relating to a person's sex change to be acceptable proof of identity for a marriage license.

[201] In October 2021, the Texas Legislature passed a bill, HB25, to legally ban transgender individuals within any female sports, Olympics, or athletics teams.

[206] The bill requires that students enrolled in public schools may only participate in athletic competitions within the sex (or "gender") category they were assigned at birth.

Against this, the higher production of testosterone that promotes greater muscle and bone mass does not commence until adolescence, before which there is negligible sex-based group differences between boys and girls, in terms of speed, strength, stamina and other sports-related traits.

Additionally, while feminizing hormone therapy itself dramatically reduces testosterone, anti-androgen medication is often used in conjunction with estrogen to suppress masculinizing effects, which leads to decreases in muscle mass.

[209][210] The HB25 bill is more extensive than existing University Interscholastic League (UIL) rules which has the similar requirement of students only being allowed to participate in athletic competitions with the same group of assigned sex.

In October 2024, the city of Odessa passed a bounty ordinance that allows individuals to sue transgender people who use bathrooms that don't correspond to their biological sex, regardless of whether or not they've changed their legal gender.

[242] In addition to offering "cultural competency" seminars, workshops and presentations itself to a variety of organizations,[238] TENT has also collaborated with other research and education initiatives.