Congressional Bill Aims to Force Insurers to Cover Detransition Care Nationwide

Rep. Diana Harshbarger introduced legislation that would require private insurers to fund restorative treatment for people who reverse gender-transition procedures, extending a Texas law to the entire United States.

A federal proposal called the TRUTH Act, championed by Rep. Diana Harshbarger of Tennessee, seeks to compel private health plans that cover gender-affirming procedures to also finance restorative treatments for patients who later detransition. The measure mirrors a Texas law that already requires such coverage and would apply nationwide once enacted, with a companion Senate version introduced by Sen. Roger Marshall of Kansas.

Proponents point to plaintiffs such as Soren Aldaco, who underwent a mastectomy at 19, and Chloe Cole, both claiming lasting damage from earlier transition care. The legislation would expand insurance obligations to include care for reproductive, endocrine, skeletal, cardiovascular, psychiatric and surgical complications, and would amend major federal statutes, becoming effective for policies starting on Jan. 1, 2027. Critics argue the bill could expose insurers to extensive liability, while supporters claim it provides essential relief for those harmed by what they describe as “sex-rejecting” interventions. The bill also calls for a new ICD-10 code to identify detransition patients, improving visibility for billing and research.