What does S.B. 904 do?
S.B. 904 restricts the use of state resources for gender-affirming medical care for minors and adults. The law states that: (1) no public funds may be used to provide or subsidize gender-affirming care, (2) Oklahoma Medicaid (Soonercare) cannot reimburse or cover any gender-affirming care, and (3) no state-owned properties or healthcare facilities may provide gender-affirming care. State employees who intentionally violate this law may face criminal misdemeanor charges.
Is S.B. 904 currently in effect?
Yes. Governor Stitt signed it on May 14, 2026, and it took effect immediately due to an Emergency Clause.
What medical treatments fall within the scope of S.B. 904?
The law defines “gender transition procedures” to include the following procedures when performed for the purpose of affirming a gender identity different than the person’s sex assigned at birth: (1) gender-affirming surgeries, (2) puberty blockers, (3) cross-sex hormones, and (4) any medications used to delay puberty or develop secondary sex characteristics different from the patient’s sex assigned at birth.
What medical treatments fall outside the scope of S.B. 904?
The following treatments are not within S.B. 904’s definition of “gender transition procedures”: (1) mental health counseling or behavioral health services, (2) medications for depression or anxiety, (3) treatment for precocious puberty, (4) treatment for intersex conditions or sex development differentiation, (5) treatment of complications from prior gender-affirming care, (6) emergency treatment to prevent imminent death or major bodily function impairment, (7) gender-affirming surgeries, puberty blockers, and hormones provided to affirm a person’s gender identity consistent with their sex assigned at birth.
Does the law only apply to gender-affirming care for minors?
No. The law expressly applies to gender-affirming care for both minors and adults.
I am a patient who is either currently receiving gender-affirming care or who wishes to receive gender-affirming care in the future. Where can I still get gender-affirming care in Oklahoma?
If you are a patient at a state-run healthcare facility, you likely cannot receive gender-affirming care there anymore. Also, if you are a Medicaid (Soonercare) recipient, Medicaid will no longer reimburse or cover gender-affirming care costs. You may still get gender-affirming care at privately owned healthcare facilities, as long as you do not seek Medicaid coverage or reimbursement.
I am a patient who is either currently receiving gender-affirming care or who wishes to receive gender-affirming care in the future. Can I still get gender-affirming care through private insurance, or if I pay out of pocket?
Yes, you can access gender-affirming care through private insurance or pay out of pocket, but only if you receive treatment at a privately run hospital and no part of your care is covered or reimbursed by Medicaid (Soonercare).
I am a patient who is either currently receiving gender-affirming care or who wishes to receive gender-affirming care in the future. Could I face criminal penalties under S.B. 904?
No. While the law imposes misdemeanor criminal penalties on any state employee who intentionally violates S.B. 904, it does not impose any penalties on patients.
I am a healthcare professional. Am I prohibited from providing gender-affirming care to my patients?
It depends on your employer. If you work at a state-owned healthcare system, you cannot provide treatments defined as “gender transition procedures” unless they meet the exceptions above. Intentionally violating this law is a criminal misdemeanor. If you work at a privately owned healthcare system, you may provide gender-affirming care. However, your facility may not bill Medicaid (Soonercare) or use state funds or state-owned facilities for the treatment.
I am a mental healthcare professional. Does this law prohibit me from prescribing anxiety/depression medication or providing counseling or other behavioral healthcare services to my clients who are transitioning?
No. S.B. 904 expressly exempts behavioral healthcare, mental health counseling, or prescription of anxiety or depression medications from its definition of “gender transition procedures.” Health care professionals who work at state-owned healthcare systems may continue to provide behavioral healthcare, mental health counseling, and anxiety and depression medication to clients who are transitioning. Healthcare professionals may also continue to bill Medicaid (Soonercare) for this care.
What should I do if I am affected by S.B. 904?
Contact the ACLU of Oklahoma at intake@acluok.org. As an organization with limited resources, we cannot guarantee a response or action. With that said, protecting 2SLGBTQ+ rights in Oklahoma is a top priority for us, and we are closely monitoring the implementation of S.B. 904. You may also connect with other 2SLGBTQ+ advocacy groups, such as Freedom Oklahoma, Lambda Legal, the Trevor Project, and Oklahomans for Equality, for support and resources to advocate against harmful laws like S.B. 904.
