HB 3478, also known as the Save James Act, amends the Texas Family Code to redefine child abuse and neglect to include certain gender-affirming medical and psychological interventions. It classifies gender-transitioning procedures, hormone treatments, and psychological/social interventions affirming a child's perception of gender inconsistent with their biological sex as child abuse. The bill also grants Texas courts emergency jurisdiction to intervene in cases where a child is at risk of receiving gender-transition treatments and ensures that refusal to affirm a child's gender identity or sexual orientation does not constitute abuse or neglect under state law​.