Text of AR HB 1916 (2025)

Stricken language would be deleted from and underlined language would be added to present law. *JMB609* 03/31/2025 12:10:25 PM JMB609 State of Arkansas 1 95th General Assembly A Bill 2 Regular Session, 2025 HOUSE BILL 1916 3 4 By: Representative Bentley 5 6 7 For An Act To Be Entitled 8 AN ACT TO AMEND THE PROTECTING MINORS FROM MEDICAL 9 MALPRACTICE ACT OF 2023; TO INCLUDE GENDER-AFFIRMING 10 INTERVENTIONS AS A RIGHT OF ACTION FOR MEDICAL 11 MALPRACTICE; AND FOR OTHER PURPOSES. 12 13 14 Subtitle 15 TO AMEND THE PROTECTING MINORS FROM 16 MEDICAL MALPRACTICE ACT OF 2023; AND TO 17 INCLUDE GENDER-AFFIRMING INTERVENTIONS 18 AS A RIGHT OF ACTION FOR MEDICAL 19 MALPRACTICE. 20 21 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF ARKANSAS: 22 23 SECTION 1. Arkansas Code § 16-114-401, concerning definitions within 24 the Protecting Minors from Medical Malpractice Act of 2023, is amended to add 25 an additional subdivision to read as follows: 26 (6) "Gender-affirming intervention" means an intervention to 27 support a patient's identification with the gender opposite of his or her 28 biological sex, including without limitation: 29 (A) Puberty blockers; and 30 (B) Cross-sex hormone therapy. 31 32 SECTION 2. Arkansas Code § 16-114-402 and § 16-114-403 are amended to 33 read as follows: 34 16-114-402. Right of action. 35 (a) A healthcare professional who performs a gender transition 36 HB1916 2 03/31/2025 12:10:25 PM JMB609 procedure or a mental health professional who performs gender-affirming 1 intervention on a minor is liable to the minor if the minor is injured, 2 including without limitation any physical, psychological, emotional, or 3 physiological injury, by the gender transition procedure, gender-affirming 4 intervention, related treatment, or the after effects of the gender 5 transition procedure, or gender-affirming intervention, or related treatment. 6 (b)(1) A minor injured as provided under subsection (a) of this 7 section, or a representative of a minor injured as provided under subsection 8 (a) of this section who receives a gender transition procedure or a gender- 9 affirming intervention, including without limitation a parent or legal 10 guardian of a minor injured as provided under subsection (a) of this section 11 who receives a gender transition procedure or a gender-affirming intervention 12 acting on behalf of the minor, may bring a civil action against the 13 healthcare professional who performed the gender transition procedure or 14 gender-affirming intervention on the minor in a court of competent 15 jurisdiction for: 16 (A) Declaratory or injunctive relief; 17 (B) Compensatory damages; 18 (C) Punitive damages; and 19 (D) Attorney's fees and costs. 20 (2) A civil action under subdivision (b)(1) of this section 21 shall be filed not later than fifteen (15) years after the date on which the 22 minor turns eighteen (18) years of age, or would have turned eighteen (18) 23 years of age if the minor died before turning eighteen (18) years of age. 24 25 16-114-403. Safe harbor. 26 (a) It is a defense to a civil action brought under § 16-114-402 that, 27 before performing a gender transition procedure or a gender-affirming 28 intervention on a minor: 29 (1) The healthcare professional documented the minor's perceived 30 gender or perceived sex for two (2) continuous years, and the minor's 31 perceived gender or perceived sex was invariably inconsistent with the 32 minor's biological sex throughout the two (2) years; 33 (2) To the extent that the minor suffered from a mental health 34 concern, at least two (2) healthcare professionals, including at least one 35 (1) mental health professional, certified in writing that the gender 36 HB1916 3 03/31/2025 12:10:25 PM JMB609 transition procedure was the only way to treat the mental health concern; 1 (3) At least two (2) healthcare professionals, including at 2 least one (1) mental health professional, certified in writing that the minor 3 suffered from no other mental health concerns, including without limitation 4 depression, eating disorders, autism, attention deficit hyperactivity 5 disorder, intellectual disability, or psychotic disorders; and 6 (4) The healthcare professional received the voluntary and 7 informed consent of the parent or legal guardian of the minor and the minor 8 as provided in subsection (b) of this section. 9 (b) Consent to a gender transition procedure or a gender-affirming 10 intervention is voluntary and informed only if, at least thirty (30) days 11 before the first treatment of the gender transition procedure or gender- 12 affirming intervention and during every subsequent medical visit for 13 treatment during the following six (6) months, the minor and the minor's 14 parent or legal guardian receive verbal notice and written notice in at least 15 14-point, proportionally spaced typeface that state the following facts, 16 verbatim: 17 “If your child begins one (1) of these treatments, it may 18 actually worsen the discordance and thus increase the likelihood that your 19 child will need additional and more serious interventions to address the 20 worsening condition. For example, if your child begins socially transitioning 21 or taking puberty blockers, that treatment may significantly increase the 22 likelihood that your child's discordance will worsen and lead to your child 23 eventually seeking cross-sex hormones or even surgery to remove some of your 24 child's body parts. 25 Sweden, Finland, and the United Kingdom have conducted systematic 26 reviews of evidence and concluded that there is no evidence that the 27 potential benefits of puberty blockers and cross-sex hormones for this 28 purpose outweigh the known or assumed risks. 29 Medical authorities in Sweden, Finland, and the United Kingdom 30 have since recommended psychotherapy as the first line of treatment for youth 31 gender dysphoria, with drugs and surgeries reserved as a measure of last 32 resort. Medical authorities in France have advised ‘great caution’ when 33 prescribing hormones for gender dysphoria. 34 There are people who underwent gender transition treatments or 35 gender-affirming interventions as minors and later regretted that decision 36 HB1916 4 03/31/2025 12:10:25 PM JMB609 and the physical harm that these treatments caused, and the total percentage 1 of people who experience this regret is unknown. Some estimate that the rate 2 is below two percent (2%), but that estimate is based on studies done on 3 adults who transitioned as adults or on minors who transitioned under highly 4 restrictive and controlled conditions. 5 Sometimes gender transition treatments or gender-affirming 6 interventions have been proposed as a way to reduce the chances of a minor 7 committing suicide due to discordance between the minor's sex and his or her 8 perception, but the rates of actual suicide from this discordance remain 9 extremely low. Furthermore, as recognized by health authorities in Europe, 10 there is no evidence that suicidality is caused by ‘unaffirmed’ gender or 11 that gender transition treatments are causally linked to a reduction in 12 serious suicidal attempts or ideations. 13 For puberty blockers: 14 Puberty blockers are not approved for this purpose by the United 15 States Food and Drug Administration, which is the federal agency that 16 determines which drugs are safe and effective for humans to use. Claims about 17 puberty blockers' safety and efficacy are based on their use for precocious 18 puberty, a different condition in which normal puberty is allowed to resume 19 once the patient reaches the appropriate age. Studies on the benefits of 20 using puberty blockers for gender dysphoria are notoriously weak. Puberty 21 blockers are not fully reversible because, among other risks, puberty 22 blockers may intensify a minor's discordance and cause it to persist. Puberty 23 blockers increase the risk of your child being sterilized, meaning that he or 24 she will never be able to have children. Puberty blockers may also cause 25 diminished bone density for your child, increasing the risk of fracture and 26 early osteoporosis. Puberty blockers may also prevent your child from ever 27 being able to engage in sexual activity or achieve orgasm for the rest of 28 your child's life. There is no research on the long-term risks to minors of 29 persistent exposure to puberty blockers. The full effects of puberty blockers 30 on brain development and cognition are unknown. 31 For cross-sex hormones: 32 The use of cross-sex hormones in males is associated with 33 numerous health risks, such as thromboembolic disease, including without 34 limitation blood clots; cholelithiasis, including gallstones; coronary artery 35 disease, including without limitation heart attacks; macroprolactinoma, which 36 HB1916 5 03/31/2025 12:10:25 PM JMB609 is a tumor of the pituitary gland; cerebrovascular disease, including without 1 limitation strokes; hypertriglyceridemia, which is an elevated level of 2 triglycerides in the blood; breast cancer; and irreversible infertility. The 3 use of cross-sex hormones in females is associated with risks of 4 erythrocytosis, which is an increase in red blood cells; severe liver 5 dysfunction; coronary artery disease, including without limitation heart 6 attacks; hypertension; and increased risk of breast and uterine cancers. Once 7 a minor begins cross-sex hormones, the minor may need to continue taking 8 those hormones for many years and possibly for the remainder of the minor's 9 life. The cost of these hormones may be tens of thousands of dollars. If the 10 use of cross-sex hormones leads to surgery, the total cost of transitioning 11 may exceed one hundred thousand dollars ($100,000). 12 For surgical procedures: 13 The dangers, risks, complications, and long-term concerns 14 associated with these types of procedures are almost entirely unknown. There 15 are no long-term studies on either the effectiveness or safety of these 16 surgical procedures.”. 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36

Stricken language would be deleted from and underlined language would be added to present law. Act 979 of the Regular Session *JMB609* 04-02-2025 09:49:07 JMB609 State of Arkansas As Engrossed: H4/2/25 1 95th General Assembly A Bill 2 Regular Session, 2025 HOUSE BILL 1916 3 4 By: Representative Bentley 5 By: Senator A. Clark 6 7 For An Act To Be Entitled 8 AN ACT TO AMEND THE PROTECTING MINORS FROM MEDICAL 9 MALPRACTICE ACT OF 2023; TO INCLUDE GENDER-AFFIRMING 10 INTERVENTIONS AS A RIGHT OF ACTION FOR MEDICAL 11 MALPRACTICE; AND FOR OTHER PURPOSES. 12 13 14 Subtitle 15 TO AMEND THE PROTECTING MINORS FROM 16 MEDICAL MALPRACTICE ACT OF 2023; AND TO 17 INCLUDE GENDER-AFFIRMING INTERVENTIONS 18 AS A RIGHT OF ACTION FOR MEDICAL 19 MALPRACTICE. 20 21 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF ARKANSAS: 22 23 SECTION 1. Arkansas Code § 16-114-401, concerning definitions within 24 the Protecting Minors from Medical Malpractice Act of 2023, is amended to add 25 an additional subdivision to read as follows: 26 (6) "Gender-affirming intervention" means an intervention to 27 support a patient's identification with the gender opposite of his or her 28 biological sex, including without limitation: 29 (A) Puberty blockers; and 30 (B) Cross-sex hormone therapy. 31 32 SECTION 2. Arkansas Code § 16-114-402 and § 16-114-403 are amended to 33 read as follows: 34 16-114-402. Right of action. 35 (a) A healthcare professional who performs a gender transition 36 As Engrossed: H4/2/25 HB1916 2 04-02-2025 09:49:07 JMB609 procedure or a mental health professional who performs gender-affirming 1 intervention on a minor is liable to the minor if the minor is injured, 2 including without limitation any physical, psychological, emotional, or 3 physiological injury, by the gender transition procedure, gender-affirming 4 intervention, related treatment, or the after effects of the gender 5 transition procedure, or gender-affirming intervention, or related treatment. 6 (b)(1) A minor injured as provided under subsection (a) of this 7 section, or a representative of a minor injured as provided under subsection 8 (a) of this section who receives a gender transition procedure or a gender- 9 affirming intervention, including without limitation a parent or legal 10 guardian of a minor injured as provided under subsection (a) of this section 11 who receives a gender transition procedure or a gender-affirming intervention 12 acting on behalf of the minor, may bring a civil action against the 13 healthcare professional who performed the gender transition procedure or 14 gender-affirming intervention on the minor in a court of competent 15 jurisdiction for: 16 (A) Declaratory or injunctive relief; 17 (B) Compensatory damages; 18 (C) Punitive damages; and 19 (D) Attorney's fees and costs. 20 (2) A civil action under subdivision (b)(1) of this section 21 shall be filed not later than fifteen (15) years after the date on which the 22 minor turns eighteen (18) years of age, or would have turned eighteen (18) 23 years of age if the minor died before turning eighteen (18) years of age. 24 25 16-114-403. Safe harbor. 26 (a) It is a defense to a civil action brought under § 16-114-402 that, 27 before performing a gender transition procedure or a gender-affirming 28 intervention on a minor: 29 (1) The healthcare professional documented the minor's perceived 30 gender or perceived sex for two (2) continuous years, and the minor's 31 perceived gender or perceived sex was invariably inconsistent with the 32 minor's biological sex throughout the two (2) years; 33 (2) To the extent that the minor suffered from a mental health 34 concern, at least two (2) healthcare professionals, including at least one 35 (1) mental health professional, certified in writing that the gender 36 As Engrossed: H4/2/25 HB1916 3 04-02-2025 09:49:07 JMB609 transition procedure was the only way to treat the mental health concern; 1 (3) At least two (2) healthcare professionals, including at 2 least one (1) mental health professional, certified in writing that the minor 3 suffered from no other mental health concerns, including without limitation 4 depression, eating disorders, autism, attention deficit hyperactivity 5 disorder, intellectual disability, or psychotic disorders; and 6 (4) The healthcare professional received the voluntary and 7 informed consent of the parent or legal guardian of the minor and the minor 8 as provided in subsection (b) of this section. 9 (b) Consent to a gender transition procedure or a gender-affirming 10 intervention is voluntary and informed only if, at least thirty (30) days 11 before the first treatment of the gender transition procedure or gender- 12 affirming intervention and during every subsequent medical visit for 13 treatment during the following six (6) months, the minor and the minor's 14 parent or legal guardian receive verbal notice and written notice in at least 15 14-point, proportionally spaced typeface that state the following facts, 16 verbatim: 17 “If your child begins one (1) of these treatments, it may 18 actually worsen the discordance and thus increase the likelihood that your 19 child will need additional and more serious interventions to address the 20 worsening condition. For example, if your child begins socially transitioning 21 or taking puberty blockers, that treatment may significantly increase the 22 likelihood that your child's discordance will worsen and lead to your child 23 eventually seeking cross-sex hormones or even surgery to remove some of your 24 child's body parts. 25 Sweden, Finland, and the United Kingdom have conducted systematic 26 reviews of evidence and concluded that there is no evidence that the 27 potential benefits of puberty blockers and cross-sex hormones for this 28 purpose outweigh the known or assumed risks. 29 Medical authorities in Sweden, Finland, and the United Kingdom 30 have since recommended psychotherapy as the first line of treatment for youth 31 gender dysphoria, with drugs and surgeries reserved as a measure of last 32 resort. Medical authorities in France have advised ‘great caution’ when 33 prescribing hormones for gender dysphoria. 34 There are people who underwent gender transition treatments or 35 gender-affirming interventions as minors and later regretted that decision 36 As Engrossed: H4/2/25 HB1916 4 04-02-2025 09:49:07 JMB609 and the physical harm that these treatments caused, and the total percentage 1 of people who experience this regret is unknown. Some estimate that the rate 2 is below two percent (2%), but that estimate is based on studies done on 3 adults who transitioned as adults or on minors who transitioned under highly 4 restrictive and controlled conditions. 5 Sometimes gender transition treatments or gender-affirming 6 interventions have been proposed as a way to reduce the chances of a minor 7 committing suicide due to discordance between the minor's sex and his or her 8 perception, but the rates of actual suicide from this discordance remain 9 extremely low. Furthermore, as recognized by health authorities in Europe, 10 there is no evidence that suicidality is caused by ‘unaffirmed’ gender or 11 that gender transition treatments are causally linked to a reduction in 12 serious suicidal attempts or ideations. 13 For puberty blockers: 14 Puberty blockers are not approved for this purpose by the United 15 States Food and Drug Administration, which is the federal agency that 16 determines which drugs are safe and effective for humans to use. Claims about 17 puberty blockers' safety and efficacy are based on their use for precocious 18 puberty, a different condition in which normal puberty is allowed to resume 19 once the patient reaches the appropriate age. Studies on the benefits of 20 using puberty blockers for gender dysphoria are notoriously weak. Puberty 21 blockers are not fully reversible because, among other risks, puberty 22 blockers may intensify a minor's discordance and cause it to persist. Puberty 23 blockers increase the risk of your child being sterilized, meaning that he or 24 she will never be able to have children. Puberty blockers may also cause 25 diminished bone density for your child, increasing the risk of fracture and 26 early osteoporosis. Puberty blockers may also prevent your child from ever 27 being able to engage in sexual activity or achieve orgasm for the rest of 28 your child's life. There is no research on the long-term risks to minors of 29 persistent exposure to puberty blockers. The full effects of puberty blockers 30 on brain development and cognition are unknown. 31 For cross-sex hormones: 32 The use of cross-sex hormones in males is associated with 33 numerous health risks, such as thromboembolic disease, including without 34 limitation blood clots; cholelithiasis, including gallstones; coronary artery 35 disease, including without limitation heart attacks; macroprolactinoma, which 36 As Engrossed: H4/2/25 HB1916 5 04-02-2025 09:49:07 JMB609 is a tumor of the pituitary gland; cerebrovascular disease, including without 1 limitation strokes; hypertriglyceridemia, which is an elevated level of 2 triglycerides in the blood; breast cancer; and irreversible infertility. The 3 use of cross-sex hormones in females is associated with risks of 4 erythrocytosis, which is an increase in red blood cells; severe liver 5 dysfunction; coronary artery disease, including without limitation heart 6 attacks; hypertension; and increased risk of breast and uterine cancers. Once 7 a minor begins cross-sex hormones, the minor may need to continue taking 8 those hormones for many years and possibly for the remainder of the minor's 9 life. The cost of these hormones may be tens of thousands of dollars. If the 10 use of cross-sex hormones leads to surgery, the total cost of transitioning 11 may exceed one hundred thousand dollars ($100,000). 12 For surgical procedures: 13 The dangers, risks, complications, and long-term concerns 14 associated with these types of procedures are almost entirely unknown. There 15 are no long-term studies on either the effectiveness or safety of these 16 surgical procedures.”. 17 18 /s/Bentley 19 20 21 APPROVED: 4/22/25 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36