Text of FL S 254 (2023)

Florida Senate - 2023 SB 254 By Senator Yarborough 4-01859G-23 2023254__ 1 A bill to be entitled 2 An act relating to treatments for sex reassignment; 3 amending s. 61.517, F.S.; granting courts of this 4 state temporary emergency jurisdiction over children 5 present in this state if they are at risk of or are 6 being subjected to the provision of sex-reassignment 7 prescriptions or procedures; amending s. 61.520, F.S.; 8 requiring the court to consider certain information 9 when determining whether the court of another 10 jurisdiction is the more appropriate or convenient 11 forum for child custody determination proceedings; 12 amending s. 61.521, F.S.; requiring courts to consider 13 specified conduct as unjustifiable for purposes of 14 determining jurisdiction in certain proceedings; 15 prohibiting the court from treating a parent’s removal 16 of a child from another parent or from another state 17 as unjustifiable conduct under certain circumstances; 18 amending s. 61.534, F.S.; defining the term “serious 19 physical harm” for purposes of warrants to take 20 physical custody of a child in certain child custody 21 enforcement proceedings; amending s. 61.536, F.S.; 22 providing that the courts of this state have 23 jurisdiction to vacate, stay, or modify child custody 24 determinations made by a court of another state under 25 certain circumstances; requiring that a court do so to 26 the extent necessary to protect the child from certain 27 conduct; creating s. 381.0027, F.S.; prohibiting 28 certain public entities from expending funds for the 29 provision of sex-reassignment prescriptions or 30 procedures; amending s. 395.003, F.S.; requiring 31 certain licensed facilities, by a specified date and 32 as a condition of licensure thereafter, to provide a 33 signed attestation of specified information to the 34 Agency for Health Care Administration; requiring the 35 agency to revoke a facility’s license for failure to 36 provide such attestation, subject to the due process 37 procedures of ch. 120, F.S.; amending s. 456.001, 38 F.S.; defining the terms “sex” and “sex-reassignment 39 prescriptions or procedures”; creating s. 456.52, 40 F.S.; prohibiting sex-reassignment prescriptions and 41 procedures for patients younger than 18 years of age; 42 providing an exception; requiring the Board of 43 Medicine and the Board of Osteopathic Medicine to 44 adopt certain emergency rules; requiring that such 45 prescriptions and procedures for patients older than 46 18 years of age be prescribed, administered, or 47 performed only with the voluntary and informed consent 48 of the patient; providing criteria for what 49 constitutes voluntary and informed consent; providing 50 that only a physician may prescribe, administer, or 51 perform such prescriptions and procedures; defining 52 the term “physician”; providing applicability; 53 providing for disciplinary action; providing criminal 54 penalties; requiring the Department of Health to adopt 55 certain emergency rules; providing that such emergency 56 rules remain in effect until they are replaced by 57 nonemergency rules; amending s. 456.074, F.S.; 58 requiring the department to immediately suspend the 59 license of a health care practitioner who is arrested 60 for committing or attempting, soliciting, or 61 conspiring to commit specified violations related to 62 sex-reassignment prescriptions or procedures for a 63 patient younger than 18 years of age; amending ss. 64 458.328 and 459.0138, F.S.; requiring registered 65 physicians’ offices to provide a signed attestation of 66 specified information to the department by a specified 67 date; beginning on a specified date, requiring 68 physicians’ offices seeking such registration to 69 provide the signed attestation as a condition of 70 registration; providing grounds for disciplinary 71 action; providing severability; providing a directive 72 to the Division of Law Revision; providing an 73 effective date. 74 75 Be It Enacted by the Legislature of the State of Florida: 76 77 Section 1. Subsection (1) of section 61.517, Florida 78 Statutes, is amended to read: 79 61.517 Temporary emergency jurisdiction.— 80 (1) A court of this state has temporary emergency 81 jurisdiction if the child is present in this state and the child 82 has been abandoned or it is necessary in an emergency to protect 83 the child because the child, or a sibling or parent of the 84 child, is subjected to or threatened with mistreatment or abuse 85 or is at risk of or is being subjected to the provision of sex 86 reassignment prescriptions or procedures as defined in s. 87 456.001. 88 Section 2. Subsection (2) of section 61.520, Florida 89 Statutes, is amended to read: 90 61.520 Inconvenient forum.— 91 (2) Before determining whether it is an inconvenient forum, 92 a court of this state shall consider whether it is appropriate 93 for a court of another state to exercise jurisdiction. For this 94 purpose, the court shall allow the parties to submit information 95 and shall consider all relevant factors, including: 96 (a) Whether domestic violence has occurred and is likely to 97 continue in the future and which state could best protect the 98 parties and the child; 99 (b) The length of time the child has resided outside this 100 state; 101 (c) The distance between the court in this state and the 102 court in the state that would assume jurisdiction; 103 (d) The relative financial circumstances of the parties; 104 (e) Any agreement of the parties as to which state should 105 assume jurisdiction; 106 (f) The nature and location of the evidence required to 107 resolve the pending litigation, including testimony of the 108 child; 109 (g) The ability of the court of each state to decide the 110 issue expeditiously and the procedures necessary to present the 111 evidence; and 112 (h) The familiarity of the court of each state with the 113 facts and issues in the pending litigation; and 114 (i) Whether there is reason to believe that one of the 115 parties is subjecting or is likely to subject the child to the 116 provision of sex-reassignment prescriptions or procedures as 117 defined in s. 456.001. 118 Section 3. Subsection (4) is added to section 61.521, 119 Florida Statutes, to read: 120 61.521 Jurisdiction declined by reason of conduct.— 121 (4)(a) A court of this state shall treat as unjustifiable 122 conduct subjecting or attempting to subject a child to the 123 provision of sex-reassignment prescriptions or procedures as 124 defined in s. 456.001. 125 (b) A court may not treat a parent′s removal of a child 126 from another parent or from another state as unjustifiable 127 conduct or child abuse if the removal was for the purpose of 128 protecting the child from one or more of the prescriptions or 129 procedures referenced in paragraph (a) and if there is reason to 130 believe that the child was at risk of or was being subjected to 131 the provision of such prescriptions or procedures. 132 Section 4. Subsection (1) of section 61.534, Florida 133 Statutes, is amended to read: 134 61.534 Warrant to take physical custody of child.— 135 (1)(a) Upon the filing of a petition seeking enforcement of 136 a child custody determination, the petitioner may file a 137 verified application for the issuance of a warrant to take 138 physical custody of the child if the child is likely to 139 imminently suffer serious physical harm or removal from this 140 state. 141 (b) As used in this subsection, the term “serious physical 142 harm” includes the provision of sex-reassignment prescriptions 143 or procedures as defined in s. 456.001. 144 Section 5. Section 61.536, Florida Statutes, is amended to 145 read: 146 61.536 Recognition and enforcement.— 147 (1) A court of this state shall accord full faith and 148 credit to an order issued by another state and consistent with 149 this part which enforces a child custody determination by a 150 court of another state unless the order has been vacated, 151 stayed, or modified by a court having jurisdiction to do so 152 under ss. 61.514-61.523. 153 (2) A court of this state has jurisdiction to vacate, stay, 154 or modify a child custody determination of a court of another 155 state to protect the child from the risk of being subjected to 156 the provision of sex-reassignment prescriptions or procedures as 157 defined in s. 456.001. The court must vacate, stay, or modify 158 the child custody determination to the extent necessary to 159 protect the child from the provision of such prescriptions or 160 procedures. 161 Section 6. Section 381.0027, Florida Statutes, is created 162 to read: 163 381.0027 Prohibition of expenditure of public funds for 164 sex-reassignment prescriptions and procedures.—A state agency, 165 the state group health insurance program, a local governmental 166 entity, a managing entity as defined in s. 394.9082, or a 167 managed care plan providing services under part IV of chapter 168 409 may not expend funds for sex-reassignment prescriptions or 169 procedures as defined in s. 456.001. 170 Section 7. Present subsections (6) through (10) of section 171 395.003, Florida Statutes, are redesignated as subsections (7) 172 through (11), respectively, a new subsection (6) is added to 173 that section, and present subsections (9) and (10) of that 174 section are amended, to read: 175 395.003 Licensure; denial, suspension, and revocation.— 176 (6) By July 1, 2023, each licensed facility must provide a 177 signed attestation to the agency stating that the facility does 178 not offer or provide sex-reassignment prescriptions or 179 procedures, as defined in s. 456.001, to patients younger than 180 18 years of age, unless authorized under s. 456.52(1)(b), and 181 does not refer such patients to other providers for such 182 services. Beginning July 1, 2023, each licensed facility shall 183 provide the signed attestation to the agency upon initial 184 licensure and as a requirement for each licensure renewal. Under 185 the due process requirements provided in chapter 120, the agency 186 must revoke the license of any licensed facility that fails to 187 provide the attestation required by this subsection. 188 (10)(9) A hospital licensed as of June 1, 2004, shall be 189 exempt from subsection (9) (8) as long as the hospital maintains 190 the same ownership, facility street address, and range of 191 services that were in existence on June 1, 2004. Any transfer of 192 beds, or other agreements that result in the establishment of a 193 hospital or hospital services within the intent of this section, 194 shall be subject to subsection (9) (8). Unless the hospital is 195 otherwise exempt under subsection (9) (8), the agency shall deny 196 or revoke the license of a hospital that violates any of the 197 criteria set forth in that subsection. 198 (11)(10) The agency may adopt rules implementing the 199 licensure requirements set forth in subsection (9) (8). Within 200 14 days after rendering its decision on a license application or 201 revocation, the agency shall publish its proposed decision in 202 the Florida Administrative Register. Within 21 days after 203 publication of the agency’s decision, any authorized person may 204 file a request for an administrative hearing. In administrative 205 proceedings challenging the approval, denial, or revocation of a 206 license pursuant to subsection (9) (8), the hearing must be 207 based on the facts and law existing at the time of the agency’s 208 proposed agency action. Existing hospitals may initiate or 209 intervene in an administrative hearing to approve, deny, or 210 revoke licensure under subsection (9) (8) based upon a showing 211 that an established program will be substantially affected by 212 the issuance or renewal of a license to a hospital within the 213 same district or service area. 214 Section 8. Subsections (8) and (9) are added to section 215 456.001, Florida Statutes, to read: 216 456.001 Definitions.—As used in this chapter, the term: 217 (8) “Sex” means the classification of a person as either 218 male or female based on the organization of the human body of 219 such person for a specific reproductive role, as indicated by 220 the person’s sex chromosomes, naturally occurring sex hormones, 221 and internal and external genitalia present at birth. 222 (9)(a) “Sex-reassignment prescriptions or procedures” 223 means: 224 1. The prescription or administration of puberty blockers 225 for the purpose of attempting to stop or delay normal puberty in 226 order to affirm a person’s perception of his or her sex if that 227 perception is inconsistent with the person’s sex as defined in 228 subsection (8). 229 2. The prescription or administration of hormones or 230 hormone antagonists to affirm a person’s perception of his or 231 her sex if that perception is inconsistent with the person’s sex 232 as defined in subsection (8). 233 3. Any medical procedure, including a surgical procedure, 234 to affirm a person’s perception of his or her sex if that 235 perception is inconsistent with the person’s sex as defined in 236 subsection (8). 237 (b) The term does not include: 238 1. Prescriptions or procedures for individuals born with a 239 genetically or biochemically verifiable disorder of sex 240 development (DSD), including, but not limited to, 46, XX DSD; 241 46, XY DSD; sex chromosome DSDs; XX or XY sex reversal; and 242 ovotesticular disorder. 243 2. Prescriptions or procedures to treat an infection, an 244 injury, a disease, or a disorder that has been caused or 245 exacerbated by the performance of any sex-reassignment 246 prescription or procedure, regardless of whether such 247 prescription or procedure was performed in accordance with state 248 or federal law or whether such prescription or procedure is 249 covered by the private rights of action under ss. 766.102 and 250 768.042. 251 3. Prescriptions or procedures provided to a patient for 252 the treatment of a physical disorder, physical injury, or 253 physical illness that would, as certified by a physician 254 licensed under chapter 458 or chapter 459, place the individual 255 in imminent danger of death or impairment of a major bodily 256 function without the prescription or procedure. 257 Section 9. Section 456.52, Florida Statutes, is created to 258 read: 259 456.52 Sex-reassignment prescriptions and procedures; 260 prohibitions; informed consent.— 261 (1) Sex-reassignment prescriptions and procedures are 262 prohibited for patients younger than 18 years of age, except 263 that: 264 (a) The Board of Medicine and the Board of Osteopathic 265 Medicine shall adopt emergency rules pertaining to standards of 266 practice under which a patient younger than 18 years of age may 267 continue to be treated with a prescription consistent with those 268 referenced under s. 456.001(9)(a)1. or 2. if such treatment for 269 sex reassignment was commenced before, and is still active on, 270 the effective date of this act. 271 (b) A patient meeting the criteria of paragraph (a) may 272 continue to be treated by a physician with such prescriptions 273 according to rules adopted under paragraph (a) or nonemergency 274 rules adopted under paragraph (6)(b). 275 (2) If sex-reassignment prescriptions or procedures are 276 prescribed for or administered or performed on patients 18 years 277 of age or older, consent must be voluntary, informed, and in 278 writing on forms approved by the department. Consent to sex 279 reassignment prescriptions or procedures is voluntary and 280 informed only if the physician who is to prescribe or administer 281 the pharmaceutical product or perform the procedure has, at a 282 minimum, while physically present in the same room: 283 (a) Informed the patient of the nature and risks of the 284 prescription or procedure in order for the patient to make a 285 prudent decision; 286 (b) Provided the informed consent form, as approved by the 287 department, to the patient; and 288 (c) Received the patient’s written acknowledgment, before 289 the prescription or procedure is prescribed, administered, or 290 performed, that the information required to be provided under 291 this subsection has been provided. 292 (3) Sex-reassignment prescriptions or procedures may not be 293 prescribed, administered, or performed except by a physician. 294 For the purposes of this section, the term “physician” is 295 defined as a physician licensed under chapter 458 or chapter 459 296 or a physician practicing medicine or osteopathic medicine in 297 the employment of the Federal Government. 298 (4) Consent required under subsection (2) does not apply to 299 renewals of prescriptions consistent with those referenced under 300 s. 456.001(9)(a)1. and 2. if a physician and his or her patient 301 have met the requirements for consent for the initial 302 prescription or renewal. However, separate consent is required 303 for any new prescription for a pharmaceutical product not 304 previously prescribed to the patient. 305 (5)(a) Violation of this section constitutes grounds for 306 disciplinary action under this chapter and chapter 458 or 307 chapter 459, as applicable. 308 (b) Any person, other than the patient, who willfully or 309 actively participates in a violation of subsection (1) commits a 310 felony of the third degree, punishable as provided in s. 311 775.082, s. 775.083, or s. 775.084. 312 (c) Any person, other than the patient, who violates 313 subsection (2), subsection (3), or subsection (4) commits a 314 misdemeanor of the first degree, punishable as provided in s. 315 775.082 or s. 775.083. 316 (6)(a) The department shall adopt emergency rules to 317 implement this section. 318 (b) Any emergency rules adopted under this section are 319 exempt from s. 120.54(4)(c) and shall remain in effect until 320 replaced by rules adopted under the nonemergency rulemaking 321 procedures of the Administrative Procedure Act. 322 Section 10. Present paragraphs (c) through (gg) of 323 subsection (5) of section 456.074, Florida Statutes, are 324 redesignated as paragraphs (d) through (hh), respectively, and a 325 new paragraph (c) is added to that subsection, to read: 326 456.074 Certain health care practitioners; immediate 327 suspension of license.— 328 (5) The department shall issue an emergency order 329 suspending the license of any health care practitioner who is 330 arrested for committing or attempting, soliciting, or conspiring 331 to commit any act that would constitute a violation of any of 332 the following criminal offenses in this state or similar 333 offenses in another jurisdiction: 334 (c) Section 456.52(5)(b), relating to prescribing, 335 administering, or performing sex-reassignment prescriptions or 336 procedures for a patient younger than 18 years of age. 337 Section 11. Paragraph (c) of subsection (1) of section 338 458.328, Florida Statutes, is amended to read: 339 458.328 Office surgeries.— 340 (1) REGISTRATION.— 341 (c) Each of the following is As a condition of 342 registration:, 343 1. An each office must establish financial responsibility 344 by demonstrating that it has met and continues to maintain, at a 345 minimum, the same requirements applicable to physicians in ss. 346 458.320 and 459.0085. 347 2. Each physician practicing at an office registered under 348 this section or s. 459.0138 must meet the financial 349 responsibility requirements under s. 458.320 or s. 459.0085, as 350 applicable. 351 3. By July 1, 2023, each office registered under this 352 section must provide a signed attestation to the department 353 stating that the office does not offer or provide sex 354 reassignment prescriptions or procedures, as defined in s. 355 456.001, to patients younger than 18 years of age, unless 356 authorized under s. 456.52(1)(b), and does not refer such 357 patients to other providers for such services. Beginning July 1, 358 2023, any office seeking registration must provide such signed 359 attestation to the department. An office’s failure to provide 360 the signed attestation is grounds for denial of registration or 361 the suspension or revocation of registration under paragraph 362 (f). 363 Section 12. Paragraph (c) of subsection (1) of section 364 459.0138, Florida Statutes, is amended to read: 365 459.0138 Office surgeries.— 366 (1) REGISTRATION.— 367 (c) Each of the following is As a condition of 368 registration:, 369 1. An each office must establish financial responsibility 370 by demonstrating that it has met and continues to maintain, at a 371 minimum, the same requirements applicable to physicians in ss. 372 458.320 and 459.0085. 373 2. Each physician practicing at an office registered under 374 this section or s. 458.328 must meet the financial 375 responsibility requirements under s. 458.320 or s. 459.0085, as 376 applicable. 377 3. By July 1, 2023, each office registered under this 378 section must provide a signed attestation to the department 379 stating that the office does not offer or provide sex 380 reassignment prescriptions or procedures, as defined in s. 381 456.001, to patients younger than 18 years of age , unless 382 authorized under s. 456.52(1)(b), and does not refer such 383 patients to other providers for such services. Beginning July 1, 384 2023, any office seeking registration must provide such signed 385 attestation to the department. An office’s failure to provide 386 the signed attestation is grounds for denial of registration or 387 the suspension or revocation of registration under paragraph 388 (f). 389 Section 13. If any provision of this act or its application 390 to any person or circumstance is held invalid, the invalidity 391 does not affect other provisions or applications of this act 392 which can be given effect without the invalid provision or 393 application, and to this end the provisions of this act are 394 severable. 395 Section 14. The Division of Law Revision is directed to 396 replace the phrase “the effective date of this act” wherever it 397 occurs in this act with the date the act becomes a law. 398 Section 15. This act shall take effect upon becoming a law.

ENROLLED 2023 Legislature CS for SB 254, 2nd Engrossed 2023254er 1 2 An act relating to treatments for sex reassignment; 3 amending s. 61.517, F.S.; granting courts of this 4 state temporary emergency jurisdiction over a child 5 present in this state if the child has been subjected 6 to or is threatened with being subjected to sex 7 reassignment prescriptions or procedures; amending s. 8 61.534, F.S.; providing that, for purposes of warrants 9 to take physical custody of a child in certain child 10 custody enforcement proceedings, serious physical harm 11 to the child includes, but is not limited to, being 12 subjected to sex-reassignment prescriptions or 13 procedures; creating s. 286.31, F.S.; defining the 14 term “governmental entity”; prohibiting certain public 15 entities from expending state funds for the provision 16 of sex-reassignment prescriptions or procedures; 17 amending s. 456.001, F.S.; defining the terms “sex” 18 and “sex-reassignment prescriptions or procedures”; 19 creating s. 456.52, F.S.; prohibiting sex-reassignment 20 prescriptions and procedures for patients younger than 21 18 years of age; providing an exception; requiring the 22 Board of Medicine and the Board of Osteopathic 23 Medicine to adopt certain emergency rules within a 24 specified timeframe; requiring the boards to consider 25 specified factors in developing such rules; requiring 26 that such prescriptions and procedures for patients 27 older than 18 years of age be prescribed, 28 administered, or performed only with the voluntary and 29 informed consent of the patient; providing criteria 30 for what constitutes voluntary and informed consent; 31 providing that only a physician may prescribe, 32 administer, or perform such prescriptions and 33 procedures; defining the term “physician”; providing 34 applicability; providing for disciplinary action; 35 providing criminal penalties; requiring the Board of 36 Medicine and the Board of Osteopathic Medicine to 37 adopt certain emergency rules; providing that such 38 emergency rules remain in effect until they are 39 replaced by nonemergency rules; amending s. 456.074, 40 F.S.; requiring the department to immediately suspend 41 the license of a health care practitioner who is 42 arrested for committing or attempting, soliciting, or 43 conspiring to commit specified violations related to 44 sex-reassignment prescriptions or procedures for a 45 patient younger than 18 years of age; creating s. 46 766.318, F.S.; creating a cause of action to recover 47 damages for personal injury or death resulting from 48 the provision of sex-reassignment prescriptions or 49 procedures to a minor; providing that certain 50 limitations on punitive damages do not apply to such 51 actions; specifying the timeframe within which such 52 actions may be commenced; providing construction and 53 applicability; providing severability; providing a 54 directive to the Division of Law Revision; providing 55 an effective date. 56 57 Be It Enacted by the Legislature of the State of Florida: 58 59 Section 1. Subsection (1) of section 61.517, Florida 60 Statutes, is amended to read: 61 61.517 Temporary emergency jurisdiction.— 62 (1) A court of this state has temporary emergency 63 jurisdiction if the child is present in this state and: 64 (a) The child has been abandoned; or 65 (b) It is necessary in an emergency to protect the child 66 because the child, or a sibling or parent of the child, is 67 subjected to or threatened with mistreatment or abuse; or 68 (c) It is necessary in an emergency to protect the child 69 because the child has been subjected to or is threatened with 70 being subjected to sex-reassignment prescriptions or procedures, 71 as defined in s. 456.001. 72 Section 2. Subsection (1) of section 61.534, Florida 73 Statutes, is amended to read: 74 61.534 Warrant to take physical custody of child.— 75 (1) Upon the filing of a petition seeking enforcement of a 76 child custody determination, the petitioner may file a verified 77 application for the issuance of a warrant to take physical 78 custody of the child if the child is likely to imminently suffer 79 serious physical harm or removal from this state. Serious 80 physical harm includes, but is not limited to, being subjected 81 to sex-reassignment prescriptions or procedures as defined in s. 82 456.001. 83 Section 3. Section 286.31, Florida Statutes, is created to 84 read: 85 286.31 Prohibited use of state funds.— 86 (1) As used in this section, the term “governmental entity” 87 means the state or any political subdivision thereof, including 88 the executive, legislative, and judicial branches of government; 89 the independent establishments of the state, counties, 90 municipalities, districts, authorities, boards, or commissions; 91 and any agencies that are subject to chapter 286. 92 (2) A governmental entity, a public postsecondary 93 educational institution as described in s. 1000.04, the state 94 group health insurance program, a managing entity as defined in 95 s. 394.9082, or a managed care plan providing services under 96 part IV of chapter 409 may not expend state funds as described 97 in s. 215.31 for sex-reassignment prescriptions or procedures as 98 defined in s. 456.001. 99 Section 4. Subsections (8) and (9) are added to section 100 456.001, Florida Statutes, to read: 101 456.001 Definitions.—As used in this chapter, the term: 102 (8) “Sex” means the classification of a person as either 103 male or female based on the organization of the human body of 104 such person for a specific reproductive role, as indicated by 105 the person’s sex chromosomes, naturally occurring sex hormones, 106 and internal and external genitalia present at birth. 107 (9)(a) “Sex-reassignment prescriptions or procedures” 108 means: 109 1. The prescription or administration of puberty blockers 110 for the purpose of attempting to stop or delay normal puberty in 111 order to affirm a person’s perception of his or her sex if that 112 perception is inconsistent with the person’s sex as defined in 113 subsection (8). 114 2. The prescription or administration of hormones or 115 hormone antagonists to affirm a person’s perception of his or 116 her sex if that perception is inconsistent with the person’s sex 117 as defined in subsection (8). 118 3. Any medical procedure, including a surgical procedure, 119 to affirm a person’s perception of his or her sex if that 120 perception is inconsistent with the person’s sex as defined in 121 subsection (8). 122 (b) The term does not include: 123 1. Treatment provided by a physician who, in his or her 124 good faith clinical judgment, performs procedures upon or 125 provides therapies to a minor born with a medically verifiable 126 genetic disorder of sexual development, including any of the 127 following: 128 a. External biological sex characteristics that are 129 unresolvably ambiguous. 130 b. A disorder of sexual development in which the physician 131 has determined through genetic or biochemical testing that the 132 patient does not have a normal sex chromosome structure, sex 133 steroid hormone production, or sex steroid hormone action for a 134 male or female, as applicable. 135 2. Prescriptions or procedures to treat an infection, an 136 injury, a disease, or a disorder that has been caused or 137 exacerbated by the performance of any sex-reassignment 138 prescription or procedure, regardless of whether such 139 prescription or procedure was performed in accordance with state 140 or federal law. 141 3. Prescriptions or procedures provided to a patient for 142 the treatment of a physical disorder, physical injury, or 143 physical illness that would, as certified by a physician 144 licensed under chapter 458 or chapter 459, place the individual 145 in imminent danger of death or impairment of a major bodily 146 function without the prescription or procedure. 147 Section 5. Section 456.52, Florida Statutes, is created to 148 read: 149 456.52 Sex-reassignment prescriptions and procedures; 150 prohibitions; informed consent.— 151 (1) Sex-reassignment prescriptions and procedures are 152 prohibited for patients younger than 18 years of age, except 153 that: 154 (a) The Board of Medicine and the Board of Osteopathic 155 Medicine shall, within 60 days after the effective date of this 156 act, adopt emergency rules pertaining to standards of practice 157 under which a patient younger than 18 years of age may continue 158 to be treated with a prescription consistent with those 159 referenced under s. 456.001(9)(a)1. or 2. if such treatment for 160 sex reassignment was commenced before, and is still active on, 161 the effective date of this act. In developing rules under this 162 paragraph, the boards shall consider requirements for physicians 163 to obtain informed consent from such patient′s parent or legal 164 guardian, consistent with the parameters of informed consent 165 under subsections (2) and (4), for such prescription treatment, 166 and shall consider the provision of professional counseling 167 services for such patient by a board-certified psychiatrist 168 licensed under chapter 458 or chapter 459 or a psychologist 169 licensed under chapter 490 in conjunction with such prescription 170 treatment. 171 (b) A patient meeting the criteria of paragraph (a) may 172 continue to be treated by a physician with such prescriptions 173 according to rules adopted under paragraph (a) or nonemergency 174 rules adopted under paragraph (6)(b). 175 (2) If sex-reassignment prescriptions or procedures are 176 prescribed for or administered or performed on patients 18 years 177 of age or older, consent must be voluntary, informed, and in 178 writing on forms adopted in rule by the Board of Medicine and 179 the Board of Osteopathic Medicine. Consent to sex-reassignment 180 prescriptions or procedures is voluntary and informed only if 181 the physician who is to prescribe or administer the 182 pharmaceutical product or perform the procedure has, at a 183 minimum, while physically present in the same room: 184 (a) Informed the patient of the nature and risks of the 185 prescription or procedure in order for the patient to make a 186 prudent decision; 187 (b) Provided the informed consent form, as adopted in rule 188 by the Board of Medicine and the Board of Osteopathic Medicine, 189 to the patient; and 190 (c) Received the patient’s written acknowledgment, before 191 the prescription or procedure is prescribed, administered, or 192 performed, that the information required to be provided under 193 this subsection has been provided. 194 (3) Sex-reassignment prescriptions or procedures may not be 195 prescribed, administered, or performed except by a physician. 196 For the purposes of this section, the term “physician” is 197 defined as a physician licensed under chapter 458 or chapter 459 198 or a physician practicing medicine or osteopathic medicine in 199 the employment of the Federal Government. 200 (4) Consent required under subsection (2) does not apply to 201 renewals of prescriptions consistent with those referenced under 202 s. 456.001(9)(a)1. and 2. if a physician and his or her patient 203 have met the requirements for consent for the initial 204 prescription or renewal. However, separate consent is required 205 for any new prescription for a pharmaceutical product not 206 previously prescribed to the patient. 207 (5)(a) Violation of this section constitutes grounds for 208 disciplinary action under this chapter and chapter 458 or 209 chapter 459, as applicable. 210 (b) Any health care practitioner who willfully or actively 211 participates in a violation of subsection (1) commits a felony 212 of the third degree, punishable as provided in s. 775.082, s. 213 775.083, or s. 775.084. 214 (c) Any health care practitioner who violates subsection 215 (2), subsection (3), or subsection (4) commits a misdemeanor of 216 the first degree, punishable as provided in s. 775.082 or s. 217 775.083. 218 (6)(a) The Board of Medicine and the Board of Osteopathic 219 Medicine shall adopt emergency rules to implement this section. 220 (b) Any emergency rules adopted under this section are 221 exempt from s. 120.54(4)(c) and shall remain in effect until 222 replaced by rules adopted under the nonemergency rulemaking 223 procedures of the Administrative Procedure Act. 224 Section 6. Present paragraphs (c) through (gg) of 225 subsection (5) of section 456.074, Florida Statutes, are 226 redesignated as paragraphs (d) through (hh), respectively, and a 227 new paragraph (c) is added to that subsection, to read: 228 456.074 Certain health care practitioners; immediate 229 suspension of license.— 230 (5) The department shall issue an emergency order 231 suspending the license of any health care practitioner who is 232 arrested for committing or attempting, soliciting, or conspiring 233 to commit any act that would constitute a violation of any of 234 the following criminal offenses in this state or similar 235 offenses in another jurisdiction: 236 (c) Section 456.52(5)(b), relating to prescribing, 237 administering, or performing sex-reassignment prescriptions or 238 procedures for a patient younger than 18 years of age. 239 Section 7. Section 766.318, Florida Statutes, is created to 240 read: 241 766.318 Civil liability for provision of sex-reassignment 242 prescriptions or procedures to minors.— 243 (1) A cause of action exists to recover damages for 244 personal injury or death resulting from the provision of sex 245 reassignment prescriptions or procedures, as defined in s. 246 456.001, to a person younger than 18 years of age which are 247 prohibited by s. 456.52(1). 248 (2) The limitations on punitive damages in s. 768.73(1) do 249 not apply to actions brought under this section. 250 (3) An action brought under this section: 251 (a) May be commenced within 20 years after the cessation or 252 completion of the sex-reassignment prescription or procedure. 253 (b) Is in addition to any other remedy authorized by law. 254 (4) The cause of action created by this section does not 255 apply to: 256 (a) Treatment with sex-reassignment prescriptions if such 257 treatment is consistent with s. 456.001(9)(a)1. or 2. and was 258 commenced on or before, and is still active on, the effective 259 date of this act. 260 (b) Sex-reassignment prescriptions or procedures that were 261 ceased or completed on or before the effective date of this act. 262 Section 8. If any provision of this act or its application 263 to any person or circumstance is held invalid, the invalidity 264 does not affect other provisions or applications of this act 265 which can be given effect without the invalid provision or 266 application, and to this end the provisions of this act are 267 severable. 268 Section 9. The Division of Law Revision is directed to 269 replace the phrase “the effective date of this act” wherever it 270 occurs in this act with the date this act becomes a law. 271 Section 10. This act shall take effect upon becoming a law.