Text of LA HB 648 (2023)

HLS 23RS-1593 ORIGINAL 2023 Regular Session HOUSE BILL NO. 648 (Substitute for House Bill No. 463 by Representative Firment) BY REPRESENTATIVE FIRMENT HEALTH/CHILDREN: Prohibits certain procedures to alter the sex of a minor child 1 AN ACT 2 To enact Part IX of Chapter 5-A of Title 40 of the Louisiana Revised Statutes of 1950, to be 3 comprised of R.S. 40:1098.1 through 1098.4, relative to gender reassignment 4 procedures; to provide for definitions; to exclude certain services, treatments, and 5 procedures relative to gender reassignment; to provide certain restrictions for 6 healthcare professionals; to establish disciplinary procedures; to provide for legal 7 remedies; and to provide for related matters. 8 Be it enacted by the Legislature of Louisiana: 9 Section 1. Part IX of Chapter 5-A of Title 40 of the Louisiana Revised Statutes of 10 1950, comprised of R.S. 40:1098.1 through 1098.4, is hereby enacted to read as follows: 11 PART IX. THE STOP HARMING OUR KIDS ACT 12 §1098.1. Definitions 13 For the purposes of this Part, the following terms have the meaning ascribed 14 to them unless the context clearly indicates otherwise: 15 (1) "Healthcare professional" has the same meaning as the term is defined 16 in R.S. 14:34.8. 17 (2) "Minor" means any person under the age of eighteen. 18 (3) "Sex" means the biological indication of male and female, as evidenced 19 by sex chromosomes, naturally occurring sex hormones, gonads, and nonambiguous 20 internal and external genitalia present at birth. Page 1 of 5 CODING: Words in struck through type are deletions from existing law; words underscored are additions. HLS 23RS-1593 ORIGINAL HB NO. 648 1 §1098.2. Healthcare professionals; restrictions 2 A. A healthcare professional shall not knowingly engage in any act that 3 attempts to alter a minor's appearance or to validate a minor's perception of his sex 4 if the minor's perception is inconsistent with his sex, including but not limited to any 5 of the following: 6 (1) The prescription or administration of gonadotropin-releasing hormone 7 analogues or other synthetic drugs used to stop luteinizing hormone and follicle 8 stimulating hormone secretion, synthetic antiandrogen drugs used to block the 9 androgen receptor, or any drug to suppress or delay normal puberty. 10 (2) The prescription or administration of testosterone, estrogen, or 11 progesterone, in amounts greater than would normally be produced endogenously in 12 a healthy individual of the same age and sex. 13 (3) The performance of any sterilizing surgery, including but not limited to 14 castration, hysterectomy, oophorectomy, orchiectomy, penectomy, and vasectomy. 15 (4) The performance of any surgery that artificially constructs tissue having 16 the appearance of genitalia differing from the minor's sex, including metoidioplasty, 17 phalloplasty, and vaginoplasty. 18 (5) The removal of any healthy or non-diseased body part or tissue. 19 (6) The performance of augmentation mammoplasty, facial feminization 20 surgery, liposuction, lipofilling, pectoral implants, voice surgery, thyroid cartilage 21 reduction, gluteal augmentation, hair reconstruction, or any aesthetic surgical 22 procedure. 23 B. The prohibitions of this Part shall not limit or restrict the provision of 24 services to any of the following: 25 (1) A minor born with a medically verifiable disorder of sex development, 26 including but not limited to external sex characteristics that are irresolvably 27 ambiguous. 28 (2) A minor diagnosed with a disorder of sexual development, if a healthcare 29 provider has determined, through genetic or biochemical testing, that the minor does Page 2 of 5 CODING: Words in struck through type are deletions from existing law; words underscored are additions. HLS 23RS-1593 ORIGINAL HB NO. 648 1 not have a sex chromosome structure, sex steroid hormone production, or sex steroid 2 hormone action, that is normal for a biological male or biological female. 3 (3) A minor needing treatment for an infection, injury, disease, or disorder 4 that has been caused or exacerbated by any action or procedure prohibited by this 5 Part. 6 (4) A minor suffering from a physical disorder, physical injury, or physical 7 illness that is certified by a healthcare provider and that would place the individual 8 in imminent danger of death or impairment of major bodily function unless surgery 9 is performed. 10 C. If, prior to July 1, 2023, a healthcare professional has initiated a course 11 of treatment, for a minor, which includes the prescription or administration of any 12 drug or hormone prohibited by this Part, and if the healthcare professional 13 determines and documents in the minor's medical record that immediately 14 terminating the minor's use of the drug or hormone would cause harm to the minor, 15 the healthcare professional may institute a period during which the minor's use of the 16 drug or hormone is systematically reduced and discontinued. The period may not 17 extend beyond December 31, 2023. 18 §1098.3. Healthcare professionals; disciplinary actions 19 If a professional or occupational licensing board finds, by a preponderance 20 of the evidence, that a healthcare professional licensed or certified by the board has 21 violated the provisions of this Part, the board shall revoke any professional or 22 occupational license or certificate held by the healthcare professional for a minimum 23 of two years. 24 §1098.4. Legal remedies 25 A. A person may bring a civil action for damages, injunctive or declaratory 26 relief, attorney fees, and any other appropriate remedies for injury suffered as a result 27 of a violation of this Part. A civil action shall be commenced before the later of 28 either of the following: 29 (1) The date on which the person reaches the age of forty. Page 3 of 5 CODING: Words in struck through type are deletions from existing law; words underscored are additions. HLS 23RS-1593 ORIGINAL HB NO. 648 1 (2) Within three years from the time the person discovered or reasonably 2 should have discovered that the injury or damages were caused by the violation. 3 B. The attorney general may bring an action to enforce compliance with this 4 Part. Nothing in this Part shall be construed to deny, impair, or otherwise affect any 5 right or authority of the attorney general, the state, or any agency, officer, or 6 employee of the state to institute or intervene in any proceeding. DIGEST The digest printed below was prepared by House Legislative Services. It constitutes no part of the legislative instrument. The keyword, one-liner, abstract, and digest do not constitute part of the law or proof or indicia of legislative intent. [R.S. 1:13(B) and 24:177(E)] HB 648 Original 2023 Regular Session Firment Abstract: Establishes the "Stop Harming Our Kids Act" in Louisiana and prohibits procedures that alter the gender of minors. Proposed law defines "minor" as any person under the age of 18. Proposed law defines "sex" as the biological indication of male and female, as evidenced by sex chromosomes, naturally occurring sex hormones, gonads, and nonambiguous internal and external genitalia present at birth. Proposed law retains the definition of "healthcare professional" in present law. Proposed law prohibits healthcare professionals from knowingly committing any act that attempts to alter a minor's appearance or to validate a minor's perception of his sex if the minor's perception is inconsistent with his biological sex. The prohibited acts provided in proposed law include but are not limited to the following: (1) The prescription or administration of gonadotropin-releasing hormone analogues or other synthetic drugs. (2) The prescription or administration of testosterone, estrogen, or progesterone, in amounts greater than would naturally be produced. (3) The performance of any sterilizing surgery. (4) The performance of any surgery that artificially constructs tissue having the appearance of genitalia differing from the minor's biological sex. (5) The removal of any healthy or non-diseased body part or tissue. (6) The performance of any aesthetic surgical procedure. Proposed law provides that if a healthcare professional has initiated a course of treatment for a minor that violates the provisions of proposed law prior to July 1, 2023, the healthcare professional may institute a period during which the minor's use of the drug or hormone is systematically reduced and discontinued. Proposed law further provides that the period may not extend beyond December 31, 2023. Page 4 of 5 CODING: Words in struck through type are deletions from existing law; words underscored are additions. HLS 23RS-1593 ORIGINAL HB NO. 648 Proposed law provides that if a professional or occupational licensing board finds that a healthcare professional licensed or certified by the board has violated the provisions of proposed law, the board shall revoke any professional or occupational license or certificate held by the healthcare professional for a minimum of two years. Proposed law provides that a person may bring a civil action for any injury suffered as a result of a violation of proposed law. Proposed law further provides that the civil action shall be commenced before the later of either of the following: (1) The date on which the person reaches the age of 40. (2) Within three years from the time the person discovered or reasonably should have discovered that the injury or damages were caused by the violation. Proposed law provides that the attorney general may bring an action to enforce compliance with proposed law. (Adds R.S. 40:1098.1-1098.4) Page 5 of 5 CODING: Words in struck through type are deletions from existing law; words underscored are additions.

ENROLLED ACT No. 466 2023 Regular Session HOUSE BILL NO. 648 (Substitute for House Bill No. 463 by Representative Firment) BY REPRESENTATIVES FIRMENT, AMEDEE, CREWS, GAROFALO, AND HORTON 1 AN ACT 2 To enact Part IX of Chapter 5-A of Title 40 of the Louisiana Revised Statutes of 1950, to be 3 comprised of R.S. 40:1098.1 through 1098.6, relative to certain procedures for minor 4 children; to provide for definitions; to exclude certain services, treatments, and 5 procedures that alter the sex characteristics of a minor; to provide certain restrictions 6 for healthcare professionals; to establish disciplinary procedures; to provide with 7 respect to consent; to provide for legal remedies; and to provide for related matters. 8 Be it enacted by the Legislature of Louisiana: 9 Section 1. Part IX of Chapter 5-A of Title 40 of the Louisiana Revised Statutes of 10 1950, comprised of R.S. 40:1098.1 through 1098.6, is hereby enacted to read as follows: 11 PART IX. THE STOP HARMING OUR KIDS ACT 12 §1098.1. Definitions 13 For the purposes of this Part, the following terms have the meaning ascribed 14 to them unless the context clearly indicates otherwise: 15 (1) "Healthcare professional" shall have the same meaning as the term is 16 defined in R.S. 14:34.8. 17 (2) "Minor" means any natural person who has not reached the age of 18 majority as provided in Civil Code Article 29 and who has not been emancipated 19 pursuant to Title V of Book VII of the Code of Civil Procedure. 20 (3) "Sex" means the biological indication of male or female as evidenced by 21 a medical examination of all of the following: 22 (a) Sex chromosomes. Page 1 of 5 CODING: Words in struck through type are deletions from existing law; words underscored are additions. HB NO. 648 ENROLLED 1 (b) Naturally occurring sex hormones. 2 (c) Gonads. 3 (d) As well as nonambiguous internal and external genitalia present at birth. 4 §1098.2. Healthcare professionals; restrictions 5 A. A healthcare professional shall not knowingly engage in any of the 6 following acts that attempt to alter a minor's appearance in an attempt to validate a 7 minor's perception of the minor's sex, if the minor's perception is inconsistent with 8 the minor's sex: 9 (1) The prescription or administration of gonadotropin-releasing hormone 10 analogues or other synthetic drugs used to stop luteinizing hormone and follicle 11 stimulating hormone secretion, synthetic antiandrogen drugs used to block the 12 androgen receptor, or any drug to suppress or delay normal puberty. 13 (2) The prescription or administration of testosterone, estrogen, or 14 progesterone, in amounts greater than would normally be produced endogenously in 15 a healthy individual of the same age and sex. 16 (3) The performance of any sterilizing surgery, including but not limited to 17 castration, hysterectomy, oophorectomy, orchiectomy, penectomy, and vasectomy. 18 (4) The performance of any surgery that artificially constructs tissue having 19 the appearance of genitalia differing from the minor's sex, including metoidioplasty, 20 phalloplasty, and vaginoplasty. 21 (5) The removal of any healthy or non-diseased body part or tissue. 22 (6) The performance of augmentation mammoplasty, facial feminization 23 surgery, liposuction, lipofilling, pectoral implants, voice surgery, thyroid cartilage 24 reduction, gluteal augmentation, hair reconstruction, or any aesthetic surgical 25 procedure. 26 B. The prohibited acts listed in Subsection A of this Section shall not be 27 considered healthcare services. 28 C. The prohibitions listed in Subsection A of this Section shall not limit or 29 restrict the provision of healthcare: Page 2 of 5 CODING: Words in struck through type are deletions from existing law; words underscored are additions. HB NO. 648 ENROLLED 1 (1) A minor born with a medically verifiable disorder of sex development, 2 including but not limited to external sex characteristics that are irresolvably 3 ambiguous. 4 (2) A minor diagnosed with a disorder of sexual development, if a healthcare 5 professional has determined, through genetic or biochemical testing, that the minor 6 does not have a sex chromosome structure, sex steroid hormone production, or sex 7 steroid hormone action, that is normal for a biological male or biological female. 8 (3) A minor needing treatment for an infection, injury, disease, or disorder 9 that has been caused or exacerbated by any action or procedure prohibited by this 10 Part. 11 (4) A minor suffering from a physical disorder, physical injury, or physical 12 illness that is certified by a healthcare provider and that would place the individual 13 in imminent danger of death or impairment of major bodily function unless surgery 14 is performed. 15 D. If, prior to January 1, 2024, a healthcare professional has initiated a 16 course of treatment, for a minor, which includes the prescription or administration 17 of any drug or hormone prohibited by this Part, and if the healthcare professional 18 determines and documents in the minor's medical record that immediately 19 terminating the minor's use of the drug or hormone would cause harm to the minor, 20 the healthcare professional may institute a period during which the minor's use of the 21 drug or hormone is systematically reduced and discontinued. The period may not 22 extend beyond December 31, 2024. 23 §1098.3. Healthcare professionals; disciplinary actions 24 If a professional or occupational licensing board finds, by a preponderance 25 of the evidence, that a healthcare professional licensed or certified by the board has 26 violated the provisions of this Part, the board shall revoke any professional or 27 occupational license or certificate held by the healthcare professional for a minimum 28 of two years. Page 3 of 5 CODING: Words in struck through type are deletions from existing law; words underscored are additions. HB NO. 648 ENROLLED 1 §1098.4. Minors' lack of consent 2 A. Notwithstanding the provisions of R.S. 40:1079.1 and notwithstanding any 3 other provision of law to the contrary, a minor may not consent to any procedures or 4 services that are prohibited in R.S. 40:1098.2(A). 5 B. The provisions of this Section shall not apply to a minor who is subject to the provisions of R.S. 40:1098.2(D). 6 7 §1098.5. Civil actions; remedies 8 A. Notwithstanding any other provision of law to the contrary, a person who 9 has been harmed as a result of acts which are prohibited by this Part or who has been 10 subjected to acts which are prohibited by this Part with or without consent, shall have 11 a cause of action for damages in a court of competent jurisdiction. 12 B. The cause of action for damages shall be commenced before the later of 13 either of the following: 14 (1) The lapse of a twelve-year liberative prescription once the minor reaches 15 the age of majority. 16 (2) Within three years from the time the person discovered or reasonably 17 should have discovered that the injury or damages were caused by the violation. 18 C. Venue pursuant to this Section may be brought pursuant to Code of Civil 19 Procedure Article 42 or in the parish of domicile of the petitioner. 20 D.(1) If a court finds that a person is entitled judgment pursuant to this 21 Section, the court shall award damages, attorney fees, and all costs of the proceeding 22 against the defendant for violation of this Part. 23 (2) Damages awarded by the court pursuant to this Section may include but 24 is not to be limited to damages for infertility or sterility that is suffered by the minor 25 as a result of the acts prohibited by this Part. 26 E. Consent shall not operate as defense to a petitioner's claim that is filed 27 pursuant to this Section. 28 §1098.6. Attorney general; injunctive or declaratory relief 29 A. The attorney general may bring a civil action to enforce compliance with 30 this Part in a court of competent jurisdiction. Page 4 of 5 CODING: Words in struck through type are deletions from existing law; words underscored are additions. HB NO. 648 ENROLLED 1 B. The attorney general may seek injunctive or declaratory relief and any 2 other appropriate remedy from in order to protect a minor from those harms resulting 3 from conduct that is prohibited pursuant to this Part. 4 C. Venue pursuant to this Section shall be that same venue which is provided 5 in R.S. 40:1098.5. 6 D. If the court grants relief pursuant to this Section, the court shall award 7 attorney fees and all costs of the proceeding against the defendant for violation of 8 this Part. 9 E. Nothing in this Part shall be construed to deny, impair, or otherwise affect 10 any right or authority of the attorney general, the state, or any agency, officer, or 11 employee of the state to institute or intervene in any proceeding. 12 Section 2. If any provision or item of this Act, or the application thereof, is held 13 invalid, such invalidity shall not affect other provisions, items, or applications of the Act 14 which can be given effect without the invalid provision, item, or application and to this end 15 the provisions of this Act are hereby declared severable. 16 Section 3. This Act shall become effective on January 1, 2024; if vetoed by the 17 governor and subsequently approved by the legislature, this Act shall become effective on 18 the day following such approval by the legislature or January 1, 2024, whichever is later. SPEAKER OF THE HOUSE OF REPRESENTATIVES PRESIDENT OF THE SENATE GOVERNOR OF THE STATE OF LOUISIANA APPROVED: Page 5 of 5 CODING: Words in struck through type are deletions from existing law; words underscored are additions.