Text of AZ SB 1451 (2024)

REFERENCE TITLE: parental consent; gender reassignment drugs State of Arizona Senate Fifty-sixth Legislature Second Regular Session 2024 SB 1451 Introduced by Senator Shope An Act amending title 36, chapter 22, article 1, Arizona Revised Statutes, by adding section 36-2273; relating to the protection of minors. (TEXT OF BILL BEGINS ON NEXT PAGE) Be it enacted by the Legislature of the State of Arizona: Section 1. Title 36, chapter 22, article 1, Arizona Revised Statutes, is amended by adding section 36-2273, to read: START_STATUTE36-2273. Parental consent; gender reassignment drugs; minors; exceptions; violation; classification; definition A. Except as otherwise provided by law and subsection D of this section, a person, this state or any political subdivision of this state may not knowingly engage in or cause any of the following practices to be performed on a minor if the practice is performed for the purpose of changing a minor's appearance or body to no longer correspond to the minor's biological sex without first obtaining written informed consent of a parent or legal guardian of the minor: 1. Prescribing or administering gonadotropin releasing hormone analogues or other synthetic drugs used to stop luteinizing hormone and follicle stimulating hormone secretion, synthetic antiandrogen drugs used to block the androgen receptor or any drug to suppress or delay normal puberty. 2. Prescribing or administering testosterone, estrogen or progesterone to a minor in an amount greater than would normally be produced endogenously in a healthy individual of that minor's age and biological sex. B. A health professional as defined in section 32-3201 may not knowingly engage in conduct that aids the practices described in subsection A of this section being performed on a minor without written informed consent of a parent or legal guardian of the minor. This section may not be construed to impose liability on any speech protected by federal or state law. C. A health care institution as defined in section 36-401 may not allow the practices described in subsection A of this section to be performed on a minor in its facilities without first having received written informed consent from a parent or legal guardian of the minor. D. this section does not apply to: 1. Services provided to a person born with a medically verifiable disorder of sex development, including a person with external biological sex characteristics that are irresolvably ambiguous, such as an individual born with forty-six XX chromosomes with virilization, forty-six XY chromosomes with undervirilization or having both ovarian and testicular tissue. 2. Services provided to a person when a physician has otherwise diagnosed a disorder of sexual development, in which the physician has determined through genetic or biochemical testing that the person does not have normal sex chromosome structure, sex steroid hormone production or sex steroid hormone action for a male or female. 3. The treatment of any infection, injury, disease or disorder that has been caused or exacerbated by the performance of a procedure described in subsection A of this section, whether or not the procedure was performed in accordance with state and federal law. 4. Any procedure undertaken because a person suffers from a physical disorder, physical injury or physical illness that is certified by a physician and that would place the person in imminent danger of death or impairment of a major bodily function unless surgery is performed. E. A person who violates this section is guilty of a class 1 misdemeanor. F. On an adverse decision by the appropriate health profession regulatory board as defined in section 32-3201, the provision of services described in subsections A and B of this section to a minor is considered unprofessional conduct and is subject to discipline by the health profession regulatory board with jurisdiction over the health professional. G. A person may assert an actual or threatened violation of this section as a claim or defense in a judicial or administrative proceeding and obtain compensatory damages, injunctive relief, declaratory relief or any other appropriate relief. H. A person shall bring a claim for a violation of this section not later than two years after the day the cause of action accrues. A minor may bring an action before reaching eighteen years of age through a parent or guardian and may bring an action in the minor's own name on reaching eighteen years of age at any time from that point until twenty years after. I. An action under this section may be commenced and relief may be granted in a judicial proceeding without regard to whether the person commencing the action has sought or exhausted available administrative remedies. J. In any action or proceeding to enforce this section, a prevailing party who establishes a violation of this section is entitled to recover reasonable attorney fees. K. The attorney general or the county attorney for the county in which an alleged violation of this section occurred may bring an action to enforce compliance with this section. This section does not deny, impair or otherwise affect any right or authority of the attorney general, this state or counties in this state or any agency, officer or employee of this state or counties in this state to institute or intervene in any proceeding. L. For the purposes of this section, "biological sex" has the same meaning prescribed in section 32-3230. END_STATUTE Sec. 2. Legislative right of intervention The legislature, by joint resolution, may appoint one or more of its members who sponsored or cosponsored this act in the member's official capacity to intervene or defend the statute as a matter of right in any case in which the constitutionality or enforceability of this act or any portion of this act or any rule adopted pursuant to this act is challenged. Sec. 3. Legislative findings The legislature finds that: 1. This state has a compelling government interest in protecting the health and safety of its citizens, especially vulnerable children, and the best way to protect the health and safety of children is to protect the right and responsibility of parents or legal guardians to make all health care decisions for their minor child. 2. Section 1-602, Arizona Revised Statutes, and the common law recognize that parents or legal guardians have the exclusive right to make all health care decisions for their minor child, including decisions regarding the appropriate treatment for children who experience distress at identifying with their sex. 3. To safeguard this right, families must have a meaningful legal remedy to hold medical professionals accountable when they administer medical drugs and procedures to a minor child without obtaining the written informed consent of the minor's parent or legal guardian. 4. To further safeguard this right, the state must have the authority to take appropriate remedial action against medical professionals who refuse to obtain written informed consent from a minor's parent or legal guardian before administering medical drugs and procedures. 5. Only a tiny percentage of the American population experiences distress at identifying with their sex. According to the American psychiatric association, prevalence ranges from 0.005 to 0.014 percent for natal adult males and from 0.002 to 0.003 percent for natal females. 6. Studies consistently demonstrate that the vast majority of children who are gender nonconforming or experience distress at identifying with their sex come to identify with their sex in adolescence or adulthood, thereby rendering most medical health care interventions unnecessary. 7. Scientific studies show that individuals struggling with distress at identifying with their sex often have already experienced psychopathology, which indicates these individuals should be encouraged to seek mental health care services before undertaking any hormonal intervention. 8. Suicide rates, psychiatric morbidities and mortality rates remain markedly elevated above the background population after inpatient gender reassignment procedures have been performed. 9. Some health care providers are prescribing puberty-blocking drugs in order to delay the onset or progression of normally timed puberty in children who experience distress at identifying with their sex. This is being done despite the lack of any long-term longitudinal studies evaluating the risks and benefits of using these drugs for the treatment of such distress or gender transition. 10. Health care providers are also prescribing cross-sex hormones for children who experience distress at identifying with their sex, despite the fact that no randomized clinical trials have been conducted on the efficacy or safety of the use of cross-sex hormones in adults or children for the purpose of treating such distress or gender transition. 11. The use of cross-sex hormones comes with the following serious known risks: (a) For females, erythrocytosis, severe liver dysfunction, coronary artery disease, cerebrovascular disease, hypertension, increased risk of breast and uterine cancers and irreversible infertility. (b) For males, thromboembolic disease, cholelithiasis, coronary artery disease, macroprolactinoma, cerebrovascular disease, hypertriglyceridemia, breast cancer and irreversible infertility. 12. The risks of gender transition procedures far outweigh any benefit at this stage of clinical study on these procedures.