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House Study Bill 214 - IntroducedA Bill ForAn Act 1relating to prohibited activities regarding gender
2transition procedures relative to minors, and including
3effective date and applicability provisions.
4BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
1 Section 1. NEW SECTION. 147.164 Gender transition
2procedure-related activities — minors — prohibitions.
31. As used in this section:
4a. “Gender” means the psychological, behavioral, social, and
5cultural aspects of being male or female.
6b. “Health care professional” means a person who is
7licensed, certified, or otherwise authorized or permitted by
8the law of this state to administer health care in the ordinary
9course of business or in the practice of a profession.
10c. “Minor” means an unemancipated person under eighteen
11years of age.
12d. “Sex” means the biological indication of male and
13female, including sex chromosomes, naturally occurring sex
14hormones, gonads, and nonambiguous internal and external
15genitalia present at birth without regard to an individual’s
16psychological, chosen, or subjective experience of gender.
172. a. Except as otherwise provided in paragraph “c”, a
18health care professional shall not knowingly engage in or cause
19any of the following practices to be performed on a minor nor
20refer a minor to another health care professional to perform
21any of the following practices on a minor if the practice is
22performed for the purpose of attempting to alter the appearance
23of, or affirm the minor’s perception of, the minor’s gender or
24sex, if that appearance or perception is inconsistent with the
25minor’s sex.
26(1) Prescribing or administering gonadotropin-releasing
27hormone analogues or other synthetic drugs used to stop
28luteinizing hormone and follicle-stimulating hormone secretion,
29synthetic antiandrogen drugs used to block the androgen
30receptor, or any drug to suppress or delay normal puberty.
31(2) Prescribing or administering testosterone, estrogen,
32or progesterone to a minor in an amount greater than would
33normally be produced endogenously in a healthy individual of
34that individual’s age and sex.
35(3) Performing surgeries that sterilize, including
-1-1castration, vasectomy, hysterectomy, oophorectomy, orchiectomy,
2and penectomy.
3(4) Performing surgeries that artificially construct
4tissue with the appearance of genitalia that differs from the
5individual’s sex, including metoidioplasty, phalloplasty, and
6vaginoplasty.
7(5) Removing any healthy or nondiseased body part or tissue.
8b. A health care professional shall not knowingly engage in
9conduct that aids or abets the practices described in paragraph
10“a”. This paragraph shall not be construed to impose liability
11on any speech protected by federal or state law.
12c. Paragraphs “a” and “b” do not apply to any of the
13following:
14(1) Services provided to a minor born with a medically
15verifiable disorder of sex development, including a minor
16with external biological sex characteristics that are
17irresolvably ambiguous, such as a minor born with forty-six
18XX chromosomes with virilization, forty-six XY chromosomes
19with undervirilization, or having both ovarian and testicular
20tissue.
21(2) Services provided to a minor who has otherwise
22been diagnosed with a disorder of sexual development by a
23physician, when the physician has determined through genetic
24or biochemical testing that the minor does not have a normal
25sex chromosome structure, sex steroid hormone production, or
26sex steroid hormone action for a biological male or biological
27female.
28(3) The treatment of any infection, injury, disease, or
29disorder that has been caused or exacerbated by the performance
30of gender transition procedures, whether or not the procedures
31were performed in accordance with state and federal law.
32(4) Any procedure undertaken because a minor suffers from a
33physical disorder, physical injury, or physical illness that
34is certified by a physician and that would place the minor
35in imminent danger of death or impairment of a major bodily
-2-1function unless surgery is performed.
2d. A violation of the prohibitions under paragraph “a” or
3“b” by a health care professional is considered unprofessional
4conduct and subject to licensee discipline by the appropriate
5licensing board or entity.
63. a. A person may assert an actual or threatened violation
7of this section as a claim or defense in a judicial or
8administrative proceeding and may obtain compensatory damages,
9injunctive relief, declaratory relief, or any other appropriate
10relief.
11b. An action brought for a violation of this section shall
12be brought within two years after the cause of action accrues.
13However, a minor may bring an action during the minor’s
14minority through a parent or legal guardian, and may bring an
15action in the minor’s own name upon reaching majority and for
16twenty years after reaching majority.
17c. Notwithstanding any other law to the contrary, an
18action under this section may be commenced, and relief may be
19granted, in a judicial proceeding without regard to whether the
20person commencing the action has sought or exhausted available
21administrative remedies. In an action or proceeding to
22enforce this section, a prevailing party may recover reasonable
23attorney fees.
24d. The attorney general may bring an action to enforce this
25section.
26e. Nothing in this section shall be construed to deny,
27impair, or otherwise affect any right or authority of the
28attorney general, the state, or any agency, officer, or
29employee of the state to institute or intervene in any
30proceeding.
31 Sec. 2. EFFECTIVE DATE. This Act, being deemed of immediate
32importance, takes effect upon enactment.
33 Sec. 3. APPLICABILITY. The following applies one hundred
34eighty days after the effective date of this Act:
35The provisions of the section of this Act enacting section
-3-1147.164, subsection 2, that prohibit a health care professional
2from knowingly engaging in or causing certain practices to
3be performed on a minor if the practice is performed for the
4purpose of attempting to alter the appearance of, or affirm
5the minor’s perception of, the minor’s gender or sex, if that
6appearance or perception is inconsistent with the minor’s sex.
7EXPLANATION
8The inclusion of this explanation does not constitute agreement with
9the explanation’s substance by the members of the general assembly.
10This bill relates to prohibitions regarding gender
11transition procedure-related activities relating to minors.
12The bill provides definitions used in the bill including
13“gender”, “health care professional”, “minor”, and “sex”.
14The bill prohibits, with some exceptions, a health care
15professional from knowingly engaging in or causing specified
16practices to be performed on a minor or referring a minor
17to another health care professional to perform the specified
18practices if the practice is performed for the purpose of
19attempting to alter the appearance of, or affirm the minor’s
20perception of, the minor’s gender or sex, if that appearance
21or perception is inconsistent with the minor’s sex. These
22prohibited practices include prescribing or administering
23gonadotropin-releasing hormone analogues or other synthetic
24drugs used to stop luteinizing hormone and follicle-stimulating
25hormone secretion, synthetic antiandrogen drugs used to block
26the androgen receptor, or any drug to suppress or delay normal
27puberty; prescribing or administering testosterone, estrogen,
28or progesterone to a minor in an amount greater than would
29normally be produced endogenously in a healthy individual
30of that individual’s age and sex; performing surgeries that
31sterilize, including castration, vasectomy, hysterectomy,
32oophorectomy, orchiectomy, and penectomy; performing surgeries
33that artificially construct tissue with the appearance of
34genitalia that differs from the individual’s sex, including
35metoidioplasty, phalloplasty, and vaginoplasty; and removing
-4-1any healthy or nondiseased body part or tissue.
2The bill also prohibits a health care professional from
3knowingly engaging in conduct that aids or abets the specified
4prohibited practices. However, this prohibition is not to
5be construed to impose liability on any speech protected by
6federal or state law.
7The bill specifies services to which the prohibitions
8of the bill do not apply including: services provided to
9a minor born with a medically verifiable disorder of sex
10development, including a minor with external biological sex
11characteristics that are irresolvably ambiguous, such as a
12minor born with 46 XX chromosomes with virilization, 46 XY
13chromosomes with undervirilization, or having both ovarian
14and testicular tissue; services provided to a minor who has
15otherwise been diagnosed with a disorder of sexual development
16by a physician, when the physician has determined through
17genetic or biochemical testing that the minor does not have
18a normal sex chromosome structure, sex steroid hormone
19production, or sex steroid hormone action for a biological male
20or biological female; the treatment of any infection, injury,
21disease, or disorder that has been caused or exacerbated by
22the performance of gender transition procedures, whether or
23not the procedures were performed in accordance with state and
24federal law; any procedure undertaken because a minor suffers
25from a physical disorder, physical injury, or physical illness
26that is certified by a physician and that would place the minor
27in imminent danger of death or impairment of a major bodily
28function unless surgery is performed.
29A violation of the prohibitions under the bill by a health
30care professional is considered unprofessional conduct and
31subject to licensee discipline by the appropriate licensing
32board or entity.
33The bill provides that a person may assert an actual
34or threatened violation of the bill as a claim or defense
35in a judicial or administrative proceeding and may obtain
-5-1compensatory damages, injunctive relief, declaratory relief, or
2any other appropriate relief. An action for a violation of the
3bill must be brought within two years after the cause of action
4accrues. However, a minor may bring an action during the
5minor’s minority through a parent or legal guardian, and may
6bring an action in the minor’s own name upon reaching majority
7and for 20 years after reaching majority.
8An action may be commenced, and relief may be granted, in
9a judicial proceeding without regard to whether the person
10has sought or exhausted available administrative remedies. A
11prevailing party may recover reasonable attorney fees in an
12action brought under the bill.
13The attorney general may bring an action to enforce the bill.
14The bill is not to be construed to deny, impair, or otherwise
15affect any right or authority of the attorney general, the
16state, or any agency, officer, or employee of the state to
17institute or intervene in any proceeding.
18The bill takes effect upon enactment.
19The provisions of the bill prohibiting certain practices
20by a health care professional performed on a minor if the
21practice is performed for the purpose of attempting to alter
22the appearance of, or affirm the minor’s perception of, the
23minor’s gender or sex, if that appearance or perception is
24inconsistent with the minor’s sex, are applicable 180 days
25after the effective date of the bill.
-6-pf/rh
2transition procedures relative to minors, and including
3effective date and applicability provisions.
4BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
1 Section 1. NEW SECTION. 147.164 Gender transition
2procedure-related activities — minors — prohibitions.
31. As used in this section:
4a. “Gender” means the psychological, behavioral, social, and
5cultural aspects of being male or female.
6b. “Health care professional” means a person who is
7licensed, certified, or otherwise authorized or permitted by
8the law of this state to administer health care in the ordinary
9course of business or in the practice of a profession.
10c. “Minor” means an unemancipated person under eighteen
11years of age.
12d. “Sex” means the biological indication of male and
13female, including sex chromosomes, naturally occurring sex
14hormones, gonads, and nonambiguous internal and external
15genitalia present at birth without regard to an individual’s
16psychological, chosen, or subjective experience of gender.
172. a. Except as otherwise provided in paragraph “c”, a
18health care professional shall not knowingly engage in or cause
19any of the following practices to be performed on a minor nor
20refer a minor to another health care professional to perform
21any of the following practices on a minor if the practice is
22performed for the purpose of attempting to alter the appearance
23of, or affirm the minor’s perception of, the minor’s gender or
24sex, if that appearance or perception is inconsistent with the
25minor’s sex.
26(1) Prescribing or administering gonadotropin-releasing
27hormone analogues or other synthetic drugs used to stop
28luteinizing hormone and follicle-stimulating hormone secretion,
29synthetic antiandrogen drugs used to block the androgen
30receptor, or any drug to suppress or delay normal puberty.
31(2) Prescribing or administering testosterone, estrogen,
32or progesterone to a minor in an amount greater than would
33normally be produced endogenously in a healthy individual of
34that individual’s age and sex.
35(3) Performing surgeries that sterilize, including
-1-1castration, vasectomy, hysterectomy, oophorectomy, orchiectomy,
2and penectomy.
3(4) Performing surgeries that artificially construct
4tissue with the appearance of genitalia that differs from the
5individual’s sex, including metoidioplasty, phalloplasty, and
6vaginoplasty.
7(5) Removing any healthy or nondiseased body part or tissue.
8b. A health care professional shall not knowingly engage in
9conduct that aids or abets the practices described in paragraph
10“a”. This paragraph shall not be construed to impose liability
11on any speech protected by federal or state law.
12c. Paragraphs “a” and “b” do not apply to any of the
13following:
14(1) Services provided to a minor born with a medically
15verifiable disorder of sex development, including a minor
16with external biological sex characteristics that are
17irresolvably ambiguous, such as a minor born with forty-six
18XX chromosomes with virilization, forty-six XY chromosomes
19with undervirilization, or having both ovarian and testicular
20tissue.
21(2) Services provided to a minor who has otherwise
22been diagnosed with a disorder of sexual development by a
23physician, when the physician has determined through genetic
24or biochemical testing that the minor does not have a normal
25sex chromosome structure, sex steroid hormone production, or
26sex steroid hormone action for a biological male or biological
27female.
28(3) The treatment of any infection, injury, disease, or
29disorder that has been caused or exacerbated by the performance
30of gender transition procedures, whether or not the procedures
31were performed in accordance with state and federal law.
32(4) Any procedure undertaken because a minor suffers from a
33physical disorder, physical injury, or physical illness that
34is certified by a physician and that would place the minor
35in imminent danger of death or impairment of a major bodily
-2-1function unless surgery is performed.
2d. A violation of the prohibitions under paragraph “a” or
3“b” by a health care professional is considered unprofessional
4conduct and subject to licensee discipline by the appropriate
5licensing board or entity.
63. a. A person may assert an actual or threatened violation
7of this section as a claim or defense in a judicial or
8administrative proceeding and may obtain compensatory damages,
9injunctive relief, declaratory relief, or any other appropriate
10relief.
11b. An action brought for a violation of this section shall
12be brought within two years after the cause of action accrues.
13However, a minor may bring an action during the minor’s
14minority through a parent or legal guardian, and may bring an
15action in the minor’s own name upon reaching majority and for
16twenty years after reaching majority.
17c. Notwithstanding any other law to the contrary, an
18action under this section may be commenced, and relief may be
19granted, in a judicial proceeding without regard to whether the
20person commencing the action has sought or exhausted available
21administrative remedies. In an action or proceeding to
22enforce this section, a prevailing party may recover reasonable
23attorney fees.
24d. The attorney general may bring an action to enforce this
25section.
26e. Nothing in this section shall be construed to deny,
27impair, or otherwise affect any right or authority of the
28attorney general, the state, or any agency, officer, or
29employee of the state to institute or intervene in any
30proceeding.
31 Sec. 2. EFFECTIVE DATE. This Act, being deemed of immediate
32importance, takes effect upon enactment.
33 Sec. 3. APPLICABILITY. The following applies one hundred
34eighty days after the effective date of this Act:
35The provisions of the section of this Act enacting section
-3-1147.164, subsection 2, that prohibit a health care professional
2from knowingly engaging in or causing certain practices to
3be performed on a minor if the practice is performed for the
4purpose of attempting to alter the appearance of, or affirm
5the minor’s perception of, the minor’s gender or sex, if that
6appearance or perception is inconsistent with the minor’s sex.
7EXPLANATION
8The inclusion of this explanation does not constitute agreement with
9the explanation’s substance by the members of the general assembly.
10This bill relates to prohibitions regarding gender
11transition procedure-related activities relating to minors.
12The bill provides definitions used in the bill including
13“gender”, “health care professional”, “minor”, and “sex”.
14The bill prohibits, with some exceptions, a health care
15professional from knowingly engaging in or causing specified
16practices to be performed on a minor or referring a minor
17to another health care professional to perform the specified
18practices if the practice is performed for the purpose of
19attempting to alter the appearance of, or affirm the minor’s
20perception of, the minor’s gender or sex, if that appearance
21or perception is inconsistent with the minor’s sex. These
22prohibited practices include prescribing or administering
23gonadotropin-releasing hormone analogues or other synthetic
24drugs used to stop luteinizing hormone and follicle-stimulating
25hormone secretion, synthetic antiandrogen drugs used to block
26the androgen receptor, or any drug to suppress or delay normal
27puberty; prescribing or administering testosterone, estrogen,
28or progesterone to a minor in an amount greater than would
29normally be produced endogenously in a healthy individual
30of that individual’s age and sex; performing surgeries that
31sterilize, including castration, vasectomy, hysterectomy,
32oophorectomy, orchiectomy, and penectomy; performing surgeries
33that artificially construct tissue with the appearance of
34genitalia that differs from the individual’s sex, including
35metoidioplasty, phalloplasty, and vaginoplasty; and removing
-4-1any healthy or nondiseased body part or tissue.
2The bill also prohibits a health care professional from
3knowingly engaging in conduct that aids or abets the specified
4prohibited practices. However, this prohibition is not to
5be construed to impose liability on any speech protected by
6federal or state law.
7The bill specifies services to which the prohibitions
8of the bill do not apply including: services provided to
9a minor born with a medically verifiable disorder of sex
10development, including a minor with external biological sex
11characteristics that are irresolvably ambiguous, such as a
12minor born with 46 XX chromosomes with virilization, 46 XY
13chromosomes with undervirilization, or having both ovarian
14and testicular tissue; services provided to a minor who has
15otherwise been diagnosed with a disorder of sexual development
16by a physician, when the physician has determined through
17genetic or biochemical testing that the minor does not have
18a normal sex chromosome structure, sex steroid hormone
19production, or sex steroid hormone action for a biological male
20or biological female; the treatment of any infection, injury,
21disease, or disorder that has been caused or exacerbated by
22the performance of gender transition procedures, whether or
23not the procedures were performed in accordance with state and
24federal law; any procedure undertaken because a minor suffers
25from a physical disorder, physical injury, or physical illness
26that is certified by a physician and that would place the minor
27in imminent danger of death or impairment of a major bodily
28function unless surgery is performed.
29A violation of the prohibitions under the bill by a health
30care professional is considered unprofessional conduct and
31subject to licensee discipline by the appropriate licensing
32board or entity.
33The bill provides that a person may assert an actual
34or threatened violation of the bill as a claim or defense
35in a judicial or administrative proceeding and may obtain
-5-1compensatory damages, injunctive relief, declaratory relief, or
2any other appropriate relief. An action for a violation of the
3bill must be brought within two years after the cause of action
4accrues. However, a minor may bring an action during the
5minor’s minority through a parent or legal guardian, and may
6bring an action in the minor’s own name upon reaching majority
7and for 20 years after reaching majority.
8An action may be commenced, and relief may be granted, in
9a judicial proceeding without regard to whether the person
10has sought or exhausted available administrative remedies. A
11prevailing party may recover reasonable attorney fees in an
12action brought under the bill.
13The attorney general may bring an action to enforce the bill.
14The bill is not to be construed to deny, impair, or otherwise
15affect any right or authority of the attorney general, the
16state, or any agency, officer, or employee of the state to
17institute or intervene in any proceeding.
18The bill takes effect upon enactment.
19The provisions of the bill prohibiting certain practices
20by a health care professional performed on a minor if the
21practice is performed for the purpose of attempting to alter
22the appearance of, or affirm the minor’s perception of, the
23minor’s gender or sex, if that appearance or perception is
24inconsistent with the minor’s sex, are applicable 180 days
25after the effective date of the bill.
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