Montana MT

Litigation-setback

SB 99 (2023) is an enacted statute, later codified at MCA 50-4-1001 and following, covering puberty blockers and other listed interventions. In Cross v. State, 2024 MT 303, the Montana Supreme Court affirmed a preliminary injunction. The Missoula district court permanently enjoined enforcement on 13 May 2025. The statute exists; a court blocked enforcement.

Last verified: 13 Oct 2026

Medical care for minorsLitigation-setback

Montana Supreme Court (2024 MT 303)

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Medicaid and CHIPCoverage ended (minors)

From 13 Oct 2026, Montana will no longer pay for puberty blockers, cross-sex hormones or surgery for gender transition for Medicaid members under 18 or HMK/CHIP members under 19. Members already on cross-sex hormones may have a limited transition period through 13 Apr 2027. That period does not apply to puberty blockers. Mental health care is unchanged. A federal CMS final rule (13 Aug 2026) prohibits federal Medicaid and CHIP funding for these procedures for patients under 18 (Medicaid) and under 19 (CHIP).

42 C.F.R. 441.800–802, 457.476 (91 Fed. Reg. 52406)

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Stopped

Montana Medicaid provider notice — coverage changes under the federal final rule

State source

State employee coverageCovers

State employee health plans explicitly cover gender-transition procedures.

Medical - Benefits Division | Montana Department of Administration (doa.mt.gov)

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SportsSex-based

State law requires school athletic teams designated for girls or women to be limited to students of the female sex (K-12 and higher education*).

HB112

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FacilitiesSex-based (schools + government buildings) (enjoined)

State law requires multiple-occupancy restrooms and changing facilities in K-12 schools, and government buildings to be designated and used by biological sex. HB 121 is temporarily blocked by a state court (Perkins v. State) while the Montana Supreme Court hears the appeal.

HB121 (2025)

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Pronouns and parent noticeParental consent for names/pronouns

State law or policy requires parental consent before school staff use a name or pronouns that differ from those associated with the student's sex.

SB518

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CurriculumParental opt-in

State law requires advance notice to parents and written parental opt-in before instruction on sexual orientation or gender identity.

Montana HB 471

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Definition of sexDefined by biology

State law defines "sex", "male" and "female" in biological terms for purposes of state law.

SB 437

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Identity documentsBirth-certificate sex changed by self-declaration

Birth-certificate sex changed by self-declaration; driver's licence sex change needs surgery, court order or amended birth certificate.

Gender Designation Form (dphhs.mt.gov)

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Shield lawNone

No shield statute identified.

No shield statute identified

AdultsNo state law

No state law restricts adult access to, or public funding of, gender-transition procedures.

No state law identified (statute review, Oct 2026)

DetransitionUntil age 25 (up to 30 on discovery)

Someone treated as a minor can sue until age 25, or within 2 years of discovering the harm, but no later than age 30.

MCA § 27-2-219 (HB 682, 2025)

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PrisonsCase-by-case (policy); HB 121 sex-separation enjoined

HB 121 (2025) requires prison sleeping quarters, restrooms and changing rooms to be separated by sex. It is temporarily enjoined (Perkins v. State) while the Montana Supreme Court appeal is pending. DOC procedure is case by case.

MSP Operational Procedure 1.1.17; HB 121 (2025, Ch. 33)

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Pending billsNo active bills

No active bills (checked 13 Oct 2026). The 2026 regular session has adjourned (or the legislature does not meet in 2026), so 2025-26 bills are no longer moving. LegiScan search linked.

LegiScan search, checked 13 Oct 2026 (adjourned legislature)

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LitigationActive

Cross v. State: Montana Supreme Court affirmed the preliminary injunction (2024 MT 303); permanent injunction 13 May 2025.

Montana court order (Montana Judicial Branch document service)

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Key datesNone upcoming

No upcoming effective dates or court deadlines were identified.

Review, Oct 2026

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