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Senate File 538 - 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 if
20the practice is performed for the purpose of attempting to
21alter the appearance of, or affirm the minor’s perception of,
22the minor’s gender or sex, if that appearance or perception is
23inconsistent with the minor’s sex.
24(1) Prescribing or administering gonadotropin-releasing
25hormone analogues or other synthetic drugs used to stop
26luteinizing hormone and follicle-stimulating hormone secretion,
27synthetic antiandrogen drugs used to block the androgen
28receptor, or any drug to suppress or delay normal puberty.
29(2) Prescribing or administering testosterone, estrogen,
30or progesterone to a minor in an amount greater than would
31normally be produced endogenously in a healthy individual of
32that individual’s age and sex.
33(3) Performing surgeries that sterilize, including
34castration, vasectomy, hysterectomy, oophorectomy, orchiectomy,
35and penectomy.
-1- 1(4) Performing surgeries that artificially construct
2tissue with the appearance of genitalia that differs from the
3individual’s sex, including metoidioplasty, phalloplasty, and
4vaginoplasty.
5(5) Removing any healthy or nondiseased body part or tissue.
6b. A health care professional shall not knowingly engage in
7conduct that aids or abets the practices described in paragraph
8“a”. This paragraph shall not be construed to impose liability
9on any speech protected by federal or state law.
10c. Paragraphs “a” and “b” do not apply to any of the
11following:
12(1) Services provided to a minor born with a medically
13verifiable disorder of sex development, including a minor
14with external biological sex characteristics that are
15irresolvably ambiguous, such as a minor born with forty-six
16XX chromosomes with virilization, forty-six XY chromosomes
17with undervirilization, or having both ovarian and testicular
18tissue.
19(2) Services provided to a minor who has otherwise
20been diagnosed with a disorder of sexual development by a
21physician, when the physician has determined through genetic
22or biochemical testing that the minor does not have a normal
23sex chromosome structure, sex steroid hormone production, or
24sex steroid hormone action for a biological male or biological
25female.
26(3) The treatment of any infection, injury, disease, or
27disorder that has been caused or exacerbated by the performance
28of gender transition procedures, whether or not the procedures
29were performed in accordance with state and federal law.
30(4) Any procedure undertaken because a minor suffers from a
31physical disorder, physical injury, or physical illness that
32is certified by a physician and that would place the minor
33in imminent danger of death or impairment of a major bodily
34function unless surgery is performed.
35d. A violation of the prohibitions under paragraph “a” or
-2-1“b” by a health care professional is considered unprofessional
2conduct and subject to licensee discipline by the appropriate
3licensing board or entity.
43. a. A person may assert an actual or threatened violation
5of this section as a claim or defense in a judicial or
6administrative proceeding and may obtain compensatory damages,
7injunctive relief, declaratory relief, or any other appropriate
8relief.
9b. An action brought for a violation of this section shall
10be brought within two years after the cause of action accrues.
11However, a minor may bring an action during the minor’s
12minority through a parent or legal guardian, and may bring an
13action in the minor’s own name upon reaching majority and for
14twenty years after reaching majority.
15c. Notwithstanding any other law to the contrary, an
16action under this section may be commenced, and relief may be
17granted, in a judicial proceeding without regard to whether the
18person commencing the action has sought or exhausted available
19administrative remedies. In an action or proceeding to
20enforce this section, a prevailing party may recover reasonable
21attorney fees.
22d. The attorney general may bring an action to enforce this
23section.
24e. Nothing in this section shall be construed to deny,
25impair, or otherwise affect any right or authority of the
26attorney general, the state, or any agency, officer, or
27employee of the state to institute or intervene in any
28proceeding.
29f. Compliance with, or enforcement or implementation of,
30this section shall not constitute a violation of any provision
31of chapter 216.
32 Sec. 2. EFFECTIVE DATE. This Act, being deemed of immediate
33importance, takes effect upon enactment.
34 Sec. 3. APPLICABILITY. The following applies one hundred
35eighty days after the effective date of this Act:
-3- 1The provisions of the section of this Act enacting section
2147.164, subsection 2, that prohibit a health care professional
3from knowingly engaging in or causing certain practices to
4be performed on a minor if the practice is performed for the
5purpose of attempting to alter the appearance of, or affirm
6the minor’s perception of, the minor’s gender or sex, if that
7appearance or perception is inconsistent with the minor’s sex.
8EXPLANATION
9The inclusion of this explanation does not constitute agreement with
10the explanation’s substance by the members of the general assembly.
11This bill relates to prohibitions regarding gender
12transition procedure-related activities relating to minors.
13The bill provides definitions used in the bill including
14“gender”, “health care professional”, “minor”, and “sex”.
15The bill prohibits, with some exceptions, a health care
16professional from knowingly engaging in or causing specified
17practices to be performed on a minor if the practice is
18performed for the purpose of attempting to alter the appearance
19of, or affirm the minor’s perception of, the minor’s gender or
20sex, if that appearance or perception is inconsistent with the
21minor’s sex. These prohibited practices include prescribing
22or administering gonadotropin-releasing hormone analogues or
23other synthetic drugs used to stop luteinizing hormone and
24follicle-stimulating hormone secretion, synthetic antiandrogen
25drugs used to block the androgen receptor, or any drug to
26suppress or delay normal puberty; prescribing or administering
27testosterone, estrogen, or progesterone to a minor in an amount
28greater than would normally be produced endogenously in a
29healthy individual of that individual’s age and sex; performing
30surgeries that sterilize, including castration, vasectomy,
31hysterectomy, oophorectomy, orchiectomy, and penectomy;
32performing surgeries that artificially construct tissue with
33the appearance of genitalia that differs from the individual’s
34sex, including metoidioplasty, phalloplasty, and vaginoplasty;
35and removing any healthy or nondiseased body part or tissue.
-4- 1The bill also prohibits a health care professional from
2knowingly engaging in conduct that aids or abets the specified
3prohibited practices. However, this prohibition is not to
4be construed to impose liability on any speech protected by
5federal or state law.
6The bill specifies services to which the prohibitions
7of the bill do not apply including: services provided to
8a minor born with a medically verifiable disorder of sex
9development, including a minor with external biological sex
10characteristics that are irresolvably ambiguous, such as a
11minor born with 46 XX chromosomes with virilization, 46 XY
12chromosomes with undervirilization, or having both ovarian
13and testicular tissue; services provided to a minor who has
14otherwise been diagnosed with a disorder of sexual development
15by a physician, when the physician has determined through
16genetic or biochemical testing that the minor does not have
17a normal sex chromosome structure, sex steroid hormone
18production, or sex steroid hormone action for a biological male
19or biological female; the treatment of any infection, injury,
20disease, or disorder that has been caused or exacerbated by
21the performance of gender transition procedures, whether or
22not the procedures were performed in accordance with state and
23federal law; any procedure undertaken because a minor suffers
24from a physical disorder, physical injury, or physical illness
25that is certified by a physician and that would place the minor
26in imminent danger of death or impairment of a major bodily
27function unless surgery is performed.
28A violation of the prohibitions under the bill by a health
29care professional is considered unprofessional conduct and
30subject to licensee discipline by the appropriate licensing
31board or entity.
32The bill provides that a person may assert an actual
33or threatened violation of the bill as a claim or defense
34in a judicial or administrative proceeding and may obtain
35compensatory damages, injunctive relief, declaratory relief, or
-5-1any other appropriate relief. An action for a violation of the
2bill must be brought within two years after the cause of action
3accrues. However, a minor may bring an action during the
4minor’s minority through a parent or legal guardian, and may
5bring an action in the minor’s own name upon reaching majority
6and for 20 years after reaching majority.
7An action may be commenced, and relief may be granted, in
8a judicial proceeding without regard to whether the person
9has sought or exhausted available administrative remedies. A
10prevailing party may recover reasonable attorney fees in an
11action brought under the bill.
12The attorney general may bring an action to enforce the bill.
13The bill is not to be construed to deny, impair, or otherwise
14affect any right or authority of the attorney general, the
15state, or any agency, officer, or employee of the state to
16institute or intervene in any proceeding.
17Compliance with, or enforcement or implementation of, the
18bill shall not constitute a violation of Code chapter 216
19(civil rights commission).
20The bill takes effect upon enactment.
21The provisions of the bill prohibiting certain practices
22by a health care professional performed on a minor if the
23practice is performed for the purpose of attempting to alter
24the appearance of, or affirm the minor’s perception of, the
25minor’s gender or sex, if that appearance or perception is
26inconsistent with the minor’s sex, are applicable 180 days
27after 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 if
20the practice is performed for the purpose of attempting to
21alter the appearance of, or affirm the minor’s perception of,
22the minor’s gender or sex, if that appearance or perception is
23inconsistent with the minor’s sex.
24(1) Prescribing or administering gonadotropin-releasing
25hormone analogues or other synthetic drugs used to stop
26luteinizing hormone and follicle-stimulating hormone secretion,
27synthetic antiandrogen drugs used to block the androgen
28receptor, or any drug to suppress or delay normal puberty.
29(2) Prescribing or administering testosterone, estrogen,
30or progesterone to a minor in an amount greater than would
31normally be produced endogenously in a healthy individual of
32that individual’s age and sex.
33(3) Performing surgeries that sterilize, including
34castration, vasectomy, hysterectomy, oophorectomy, orchiectomy,
35and penectomy.
-1- 1(4) Performing surgeries that artificially construct
2tissue with the appearance of genitalia that differs from the
3individual’s sex, including metoidioplasty, phalloplasty, and
4vaginoplasty.
5(5) Removing any healthy or nondiseased body part or tissue.
6b. A health care professional shall not knowingly engage in
7conduct that aids or abets the practices described in paragraph
8“a”. This paragraph shall not be construed to impose liability
9on any speech protected by federal or state law.
10c. Paragraphs “a” and “b” do not apply to any of the
11following:
12(1) Services provided to a minor born with a medically
13verifiable disorder of sex development, including a minor
14with external biological sex characteristics that are
15irresolvably ambiguous, such as a minor born with forty-six
16XX chromosomes with virilization, forty-six XY chromosomes
17with undervirilization, or having both ovarian and testicular
18tissue.
19(2) Services provided to a minor who has otherwise
20been diagnosed with a disorder of sexual development by a
21physician, when the physician has determined through genetic
22or biochemical testing that the minor does not have a normal
23sex chromosome structure, sex steroid hormone production, or
24sex steroid hormone action for a biological male or biological
25female.
26(3) The treatment of any infection, injury, disease, or
27disorder that has been caused or exacerbated by the performance
28of gender transition procedures, whether or not the procedures
29were performed in accordance with state and federal law.
30(4) Any procedure undertaken because a minor suffers from a
31physical disorder, physical injury, or physical illness that
32is certified by a physician and that would place the minor
33in imminent danger of death or impairment of a major bodily
34function unless surgery is performed.
35d. A violation of the prohibitions under paragraph “a” or
-2-1“b” by a health care professional is considered unprofessional
2conduct and subject to licensee discipline by the appropriate
3licensing board or entity.
43. a. A person may assert an actual or threatened violation
5of this section as a claim or defense in a judicial or
6administrative proceeding and may obtain compensatory damages,
7injunctive relief, declaratory relief, or any other appropriate
8relief.
9b. An action brought for a violation of this section shall
10be brought within two years after the cause of action accrues.
11However, a minor may bring an action during the minor’s
12minority through a parent or legal guardian, and may bring an
13action in the minor’s own name upon reaching majority and for
14twenty years after reaching majority.
15c. Notwithstanding any other law to the contrary, an
16action under this section may be commenced, and relief may be
17granted, in a judicial proceeding without regard to whether the
18person commencing the action has sought or exhausted available
19administrative remedies. In an action or proceeding to
20enforce this section, a prevailing party may recover reasonable
21attorney fees.
22d. The attorney general may bring an action to enforce this
23section.
24e. Nothing in this section shall be construed to deny,
25impair, or otherwise affect any right or authority of the
26attorney general, the state, or any agency, officer, or
27employee of the state to institute or intervene in any
28proceeding.
29f. Compliance with, or enforcement or implementation of,
30this section shall not constitute a violation of any provision
31of chapter 216.
32 Sec. 2. EFFECTIVE DATE. This Act, being deemed of immediate
33importance, takes effect upon enactment.
34 Sec. 3. APPLICABILITY. The following applies one hundred
35eighty days after the effective date of this Act:
-3- 1The provisions of the section of this Act enacting section
2147.164, subsection 2, that prohibit a health care professional
3from knowingly engaging in or causing certain practices to
4be performed on a minor if the practice is performed for the
5purpose of attempting to alter the appearance of, or affirm
6the minor’s perception of, the minor’s gender or sex, if that
7appearance or perception is inconsistent with the minor’s sex.
8EXPLANATION
9The inclusion of this explanation does not constitute agreement with
10the explanation’s substance by the members of the general assembly.
11This bill relates to prohibitions regarding gender
12transition procedure-related activities relating to minors.
13The bill provides definitions used in the bill including
14“gender”, “health care professional”, “minor”, and “sex”.
15The bill prohibits, with some exceptions, a health care
16professional from knowingly engaging in or causing specified
17practices to be performed on a minor if the practice is
18performed for the purpose of attempting to alter the appearance
19of, or affirm the minor’s perception of, the minor’s gender or
20sex, if that appearance or perception is inconsistent with the
21minor’s sex. These prohibited practices include prescribing
22or administering gonadotropin-releasing hormone analogues or
23other synthetic drugs used to stop luteinizing hormone and
24follicle-stimulating hormone secretion, synthetic antiandrogen
25drugs used to block the androgen receptor, or any drug to
26suppress or delay normal puberty; prescribing or administering
27testosterone, estrogen, or progesterone to a minor in an amount
28greater than would normally be produced endogenously in a
29healthy individual of that individual’s age and sex; performing
30surgeries that sterilize, including castration, vasectomy,
31hysterectomy, oophorectomy, orchiectomy, and penectomy;
32performing surgeries that artificially construct tissue with
33the appearance of genitalia that differs from the individual’s
34sex, including metoidioplasty, phalloplasty, and vaginoplasty;
35and removing any healthy or nondiseased body part or tissue.
-4- 1The bill also prohibits a health care professional from
2knowingly engaging in conduct that aids or abets the specified
3prohibited practices. However, this prohibition is not to
4be construed to impose liability on any speech protected by
5federal or state law.
6The bill specifies services to which the prohibitions
7of the bill do not apply including: services provided to
8a minor born with a medically verifiable disorder of sex
9development, including a minor with external biological sex
10characteristics that are irresolvably ambiguous, such as a
11minor born with 46 XX chromosomes with virilization, 46 XY
12chromosomes with undervirilization, or having both ovarian
13and testicular tissue; services provided to a minor who has
14otherwise been diagnosed with a disorder of sexual development
15by a physician, when the physician has determined through
16genetic or biochemical testing that the minor does not have
17a normal sex chromosome structure, sex steroid hormone
18production, or sex steroid hormone action for a biological male
19or biological female; the treatment of any infection, injury,
20disease, or disorder that has been caused or exacerbated by
21the performance of gender transition procedures, whether or
22not the procedures were performed in accordance with state and
23federal law; any procedure undertaken because a minor suffers
24from a physical disorder, physical injury, or physical illness
25that is certified by a physician and that would place the minor
26in imminent danger of death or impairment of a major bodily
27function unless surgery is performed.
28A violation of the prohibitions under the bill by a health
29care professional is considered unprofessional conduct and
30subject to licensee discipline by the appropriate licensing
31board or entity.
32The bill provides that a person may assert an actual
33or threatened violation of the bill as a claim or defense
34in a judicial or administrative proceeding and may obtain
35compensatory damages, injunctive relief, declaratory relief, or
-5-1any other appropriate relief. An action for a violation of the
2bill must be brought within two years after the cause of action
3accrues. However, a minor may bring an action during the
4minor’s minority through a parent or legal guardian, and may
5bring an action in the minor’s own name upon reaching majority
6and for 20 years after reaching majority.
7An action may be commenced, and relief may be granted, in
8a judicial proceeding without regard to whether the person
9has sought or exhausted available administrative remedies. A
10prevailing party may recover reasonable attorney fees in an
11action brought under the bill.
12The attorney general may bring an action to enforce the bill.
13The bill is not to be construed to deny, impair, or otherwise
14affect any right or authority of the attorney general, the
15state, or any agency, officer, or employee of the state to
16institute or intervene in any proceeding.
17Compliance with, or enforcement or implementation of, the
18bill shall not constitute a violation of Code chapter 216
19(civil rights commission).
20The bill takes effect upon enactment.
21The provisions of the bill prohibiting certain practices
22by a health care professional performed on a minor if the
23practice is performed for the purpose of attempting to alter
24the appearance of, or affirm the minor’s perception of, the
25minor’s gender or sex, if that appearance or perception is
26inconsistent with the minor’s sex, are applicable 180 days
27after the effective date of the bill.
-6-pf/rh