Text of AL SB 219 (2020)

1 SB219 2 205384-2 3 By Senators Shelnutt, McClendon and Allen 4 RFD: Healthcare 5 First Read: 20-FEB-20 Page 0 1 205384-2:n:02/20/2020:AHP/bm LSA2020-776R1 2 3 4 5 6 7 8 SYNOPSIS: This bill would prohibit the performance of 9 a medical procedure or the prescription or issuance 10 of medication, upon or to a minor child, that is 11 intended to alter the minor child's gender or delay 12 puberty, with certain exceptions. 13 This bill would provide for the disclosure 14 of certain information concerning students to 15 parents by schools. 16 This bill would also establish criminal 17 penalties for violations. 18 Amendment 621 of the Constitution of Alabama 19 of 1901, now appearing as Section 111.05 of the 20 Official Recompilation of the Constitution of 21 Alabama of 1901, as amended, prohibits a general 22 law whose purpose or effect would be to require a 23 new or increased expenditure of local funds from 24 becoming effective with regard to a local 25 governmental entity without enactment by a 2/3 vote 26 unless: it comes within one of a number of 27 specified exceptions; it is approved by the Page 1 1 affected entity; or the Legislature appropriates 2 funds, or provides a local source of revenue, to 3 the entity for the purpose. 4 The purpose or effect of this bill would be 5 to require a new or increased expenditure of local 6 funds within the meaning of the amendment. However, 7 the bill does not require approval of a local 8 governmental entity or enactment by a 2/3 vote to 9 become effective because it comes within one of the 10 specified exceptions contained in the amendment. 11 12 A BILL 13 TO BE ENTITLED 14 AN ACT 15 16 Relating to public health; to prohibit the 17 performance of a medical procedure or the prescription or 18 issuance of medication, upon or to a minor child, that is 19 intended to alter the minor child's gender or delay puberty; 20 to provide for exceptions; to provide for disclosure of 21 certain information concerning students to parents by schools; 22 and to establish criminal penalties for violations; and in 23 connection therewith would have as its purpose or effect the 24 requirement of a new or increased expenditure of local funds 25 within the meaning of Amendment 621 of the Constitution of 26 Alabama of 1901, now appearing as Section 111.05 of the Page 2 1 Official Recompilation of the Constitution of Alabama of 1901, 2 as amended. 3 BE IT ENACTED BY THE LEGISLATURE OF ALABAMA: 4 Section 1. This act shall be known and may be cited 5 as the Alabama Vulnerable Child Compassion and Protection Act 6 (V-CAP). 7 Section 2. The Legislature finds as follows: 8 (1) The long-term effects and safety of the 9 administration of puberty-blocking medications and cross sex 10 hormones to gender incongruent children have not been 11 rigorously studied. Absent rigorous studies showing their 12 long-term safety and positive benefits, their continued 13 administration to children constitutes dangerous and 14 uncontrolled human medical experimentation that may result in 15 grave and irreversible consequences to their physical and 16 mental health. 17 (2) Studies have shown that a substantial majority 18 of pre-pubescent children who claim a gender identity 19 different from their biological sex will ultimately identify 20 with their biological sex by young adulthood or sooner when 21 supported through their natural puberty. There is no 22 psychological or medical test that can differentiate between 23 the majority of children who will desist from their gender 24 incongruence and the minority who will not. Research suggests 25 that the administration of puberty-blocking medications or 26 cross-sex hormones forecloses the possibility of a natural 27 recovery from this condition. Page 3 1 (3) There are no rigorous studies that show that 2 gender changing therapies performed on children, including the 3 administration of puberty blocking medications, the 4 administration of opposite sex hormones, or surgeries intended 5 to approximate the appearance of the opposite sex have any 6 long term beneficial effect, including a reduction in suicide 7 risk. To the contrary, such interventions carry elevated risks 8 for sterility, loss of sexual function, bone fractures, 9 thromboembolic and cardiovascular disease, malignancy, and may 10 even contribute to mental illness and suicide. 11 (4) The continued performing of these therapies upon 12 children constitutes a public health risk. 13 (5) The police power of the state is held to embrace 14 reasonable regulations to protect the public health. That 15 authority over children is broader than that over adults. 16 Jacobson v. Massachusetts, 197 U.S. 11 (1905); Prince v. 17 Massachusetts, 321 U.S. 158 (1944). 18 Section 3. For the purposes of this act, the 19 following terms shall have the following meanings: 20 (1) MINOR. The same meaning as in Section 43-8-1, 21 Code of Alabama 1975. 22 (2) PERSON. Includes any of the following: 23 a. Any individual. 24 b. Any agent, employee, official, or contractor of 25 any legal entity. Page 4 1 c. Any agent, employee, official, or contractor of a 2 school district or the state or any of its political 3 subdivisions or agencies. 4 (3) SEX. The biological state of being male or 5 female, based on the individual's sex organs, chromosomes, and 6 endogenous hormone profiles. 7 Section 4. (a) Except as provided in subsection (b), 8 no person shall engage in, counsel, or make a referral for any 9 of the following practices upon a minor, and no person shall 10 cause any of the practices in this subsection to be performed 11 upon a minor if the practice is performed for the purpose of 12 attempting to affirm the minor's perception of his or her 13 gender or sex, if that perception is inconsistent with the 14 minor's biological sex as defined in this act: 15 (1) Prescribing, dispensing, administering, or 16 otherwise supplying puberty blocking medication to stop or 17 delay normal puberty. 18 (2) Prescribing, dispensing, administering, or 19 otherwise supplying supraphysiologic doses of testosterone or 20 other androgens to females. 21 (3) Prescribing, dispensing, administering, or 22 otherwise supplying supraphysiologic doses of estrogen to 23 males. 24 (4) Performing surgeries that sterilize, including 25 castration, vasectomy, hysterectomy, oophorectomy, 26 orchiectomy, and penectomy. Page 5 1 (5) Performing surgeries that artificially construct 2 tissue with the appearance of genitalia that differs from the 3 individual's biological sex, including metoidioplasty, 4 phalloplasty, and vaginoplasty. 5 (6) Removing any healthy or non-diseased body part 6 or tissue. 7 (b) Subsection (a) does not apply to a procedure 8 undertaken to treat a minor born with a medically verifiable 9 disorder of sex development, including either of the 10 following: 11 (1) An individual born with external biological sex 12 characteristics that are irresolvably ambiguous, including an 13 individual born with 46 XX chromosomes with virilization, 46 14 XY chromosomes with under virilization, or having both ovarian 15 and testicular tissue. 16 (2) An individual whom a physician has otherwise 17 diagnosed with a disorder of sexual development, in which the 18 physician has determined through genetic or biochemical 19 testing that the person does not have normal sex chromosome 20 structure, sex steroid hormone production, or sex steroid 21 hormone action for a male or female. 22 (c) A violation of this section is a Class C felony. 23 Section 5. (a) No nurse, counselor, teacher, 24 principal, or other administrative official at a public or 25 private school attended by a minor shall do either of the 26 following: Page 6 1 (1) Encourage or coerce a minor to withhold from the 2 minor's parent or legal guardian the fact that the minor's 3 perception of his or her gender or sex is inconsistent with 4 the minor's sex. 5 (2) Withhold from a minor's parent or legal guardian 6 information that is relevant to the physical or mental health 7 of the minor, including information related to a minor's 8 perception that his or her gender or sex is inconsistent with 9 his or her sex. 10 (b) A violation of this section is a Class A 11 misdemeanor. 12 Section 6. Nothing in this section shall be 13 construed to establish a new or separate standard of care for 14 hospitals or physicians and their patients or otherwise 15 modify, amend, or supersede any provision of the Alabama 16 Medical Liability Act of 1987 or the Alabama Medical Liability 17 Act of 1996, or any amendment or judicial interpretation of 18 either act. 19 Section 7. If any part, section, or subsection of 20 this act or the application thereof to any person or 21 circumstances is held invalid, the invalidity shall not affect 22 parts, sections, subsections, or applications of this act that 23 can be given effect without the invalid part, section, 24 subsection, or application. 25 Section 8. Although this bill would have as its 26 purpose or effect the requirement of a new or increased 27 expenditure of local funds, the bill is excluded from further Page 7 1 requirements and application under Amendment 621, now 2 appearing as Section 111.05 of the Official Recompilation of 3 the Constitution of Alabama of 1901, as amended, because the 4 bill defines a new crime or amends the definition of an 5 existing crime. 6 Section 9. This act shall become effective 30 days 7 following its passage and approval by the Governor, or its 8 otherwise becoming law. Page 8