The Texas Department of Criminal Justice will continue providing documented hormone therapy to adult inmates who were receiving it before incarceration, unless the treatment is medically contraindicated, under a revised correctional health care policy effective July 29, 2025. Policy G-51.11 requires an adult entering TDCJ with a reported history of gender dysphoria to receive medical and mental health evaluations. Health officials are instructed to seek records from the person’s prior providers and request hormone treatment through the department’s non-formulary process, with indefinite refills intended to maintain continuity of care during the initial evaluation. The policy says treatment decisions must be made individually by qualified medical and mental health professionals and in accordance with current law. A designated gender dysphoria specialty provider is the only clinician authorized to confirm the diagnosis. That provider is also responsible for monitoring patients receiving hormones, watching for adverse effects and adjusting dosages when necessary. New or suspected cases require a medical history, physical examination and baseline laboratory testing when clinically appropriate. Patients may then be referred to the designated specialty clinic for further evaluation and treatment. Mental health services may be offered for associated emotional or behavioral concerns, with follow-up care focused on supportive treatment. The rules are more restrictive for inmates younger than 18. They may receive prescription drugs only if the treatment began before June 1, 2023, and followed at least 12 mental health counseling or psychotherapy sessions over a minimum of six months. Even then, the policy requires the medication to be tapered safely and prohibits starting a new prescription-based treatment or receiving procedures barred under Texas law. The policy also establishes procedures for inmates with suspected intersex conditions, including prompt referral for medical evaluation, efforts to obtain prior records and updates to the person’s electronic health record as additional information becomes available. It defines intersex conditions as variations in sexual or reproductive anatomy or chromosomal patterns that do not fit typical definitions of male or female. The revised document replaces a July 2025 version and was reviewed in July 2026. It cites federal prison standards, correctional health care guidance, the Prison Rape Elimination Act and provisions of Texas law governing treatment for minors and medical licensing.