Text of MD HB 722 (2024)

EXPLANATION: CAPITALS INDICATE MATTER ADDED TO EXISTING LAW. [Brackets] indicate matter deleted from existing law. *hb0722* HOUSE BILL 722 J1 4lr2442 By: Delegates Arikan, Adams, Chisholm, Fisher, Ghrist, Grammer, Hartman, Kipke, Mangione, M. Morgan, Nawrocki, Pippy, Reilly, Sample–Hughes, Simmons, Szeliga, Taylor, Valentine, and Wivell Introduced and read first time: January 26, 2024 Assigned to: Health and Government Operations A BILL ENTITLED AN ACT concerning 1 Health – Minors – Gender and Sex Transition Procedures 2 FOR the purpose of prohibiting a health care provider from knowingly engaging in or 3 causing certain medical or surgical procedures to be performed on a minor without 4 the consent of the parent, guardian, or custodian of the minor if performed for the 5 purpose of attempting to alter the appearance of, or affirm the minor’s perception of, 6 the minor’s gender or sex and the appearance or perception is inconsistent with the 7 minor’s sex, except under certain circumstances; and generally relating to gender 8 and sex transition procedures and minors. 9 BY adding to 10 Article – Health – General 11 Section 20–107 12 Annotated Code of Maryland 13 (2023 Replacement Volume) 14 SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 15 That the Laws of Maryland read as follows: 16 Article – Health – General 17 20–107. 18 (A) (1) IN THIS SECTION THE FOLLOWING WORDS HAVE THE MEANINGS 19 INDICATED. 20 (2) “GENDER” MEANS THE PSYCHOLOGICAL, BEHAVIORAL, SOCIAL, 21 AND CULTURAL ASPECTS OF BEING MALE OR FEMALE. 22 2 HOUSE BILL 722 (3) “HEALTH CARE PROVIDER” HAS THE MEANING STATED IN § 1 20–104 OF THIS SUBTITLE. 2 (4) “SEX” MEANS THE BIOLOGICAL INDICATION OF MALE AND 3 FEMALE, INCLUDING SEX CHROMOSOMES, NATURALLY OCCURRING SEX HORMONES, 4 GONADS, AND NONAMBIGUOUS INTERNAL AND EXTERNAL GENITALIA PRESENT AT 5 BIRTH WITHOUT REGARD TO AN INDIVIDUAL’S PSYCHOLOGICAL, CHOSEN, OR 6 SUBJECTIVE EXPERIENCE OF GENDER. 7 (B) EXCEPT AS PROVIDED IN SUBSECTION (C) OF THIS SECTION, A HEALTH 8 CARE PROVIDER MAY NOT KNOWINGLY AND WITHOUT THE CONSENT OF THE 9 PARENT, GUARDIAN, OR CUSTODIAN OF THE MINOR ENGAGE IN OR CAUSE ANY OF 10 THE FOLLOWING PRACTICES TO BE PERFORMED ON A MINOR IF THE PRACTICE IS 11 PERFORMED FOR THE PURPOSE OF ATTEMPTING TO ALTER THE APPEARANCE OF, 12 OR AFFIRM THE MINOR’S PERCEPTION OF, THE MINOR’S GENDER OR SEX AND THE 13 APPEARANCE OR PERCEPTION IS INCONSISTENT WITH THE MINOR’S SEX: 14 (1) PRESCRIBING OR ADMINISTERING GONADOTROPIN–RELEASING 15 HORMONE ANALOGUES OR OTHER SYNTHETIC DRUGS USED TO STOP LUTEINIZING 16 HORMONE AND FOLLICLE–STIMULATING HORMONE SECRETION, SYNTHETIC 17 ANTIANDROGEN DRUGS USED TO BLOCK THE ANDROGEN RECEPTOR, OR ANY DRUG 18 TO SUPPRESS OR DELAY NORMAL PUBERTY; 19 (2) PRESCRIBING OR ADMINISTERING TESTOSTERONE, ESTROGEN, 20 OR PROGESTERONE IN AN AMOUNT GREATER THAN WOULD NORMALLY BE 21 PRODUCED ENDOGENOUSLY IN A HEALTHY INDIVIDUAL OF THAT INDIVIDUAL’S AGE 22 AND SEX; 23 (3) PERFORMING SURGERIES THAT STERILIZE, INCLUDING 24 CASTRATION, VASECTOMY, HYSTERECTOMY, OOPHORECTOMY, ORCHIECTOMY, AND 25 PENECTOMY; 26 (4) PERFORMING SURGERIES THAT ARTIFICIALLY CONSTRUCT 27 TISSUE WITH THE APPEARANCE OF GENITALIA THAT DIFFERS FROM THE 28 INDIVIDUAL’S SEX, INCLUDING METOIDIOPLASTY, PHALLOPLASTY, AND 29 VAGINOPLASTY; OR 30 (5) REMOVING ANY HEALTHY OR NONDISEASED BODY PART OR 31 TISSUE. 32 (C) THE PROVISIONS OF SUBSECTION (B) OF THIS SECTION DO NOT APPLY 33 TO A HEALTH CARE PROVIDER ENGAGING IN OR CAUSING ANY OF THE FOLLOWING 34 PRACTICES TO BE PERFORMED ON A MINOR BASED ON A GOOD FAITH MEDICAL 35 HOUSE BILL 722 3 DECISION OF THE HEALTH CARE PROVIDER AND A PARENT, GUARDIAN, OR 1 CUSTODIAN THAT THE MINOR HAS A MEDICALLY VERIFIABLE GENETIC DISORDER 2 OF SEX DEVELOPMENT: 3 (1) SERVICES PROVIDED TO A MINOR BORN WITH A MEDICALLY 4 VERIFIABLE DISORDER OF SEX DEVELOPMENT, INCLUDING A MINOR WITH 5 EXTERNAL BIOLOGICAL SEX CHARACTERISTICS THAT ARE IRRESOLVABLY 6 AMBIGUOUS, SUCH AS A MINOR BORN WITH 46 XX CHROMOSOMES WITH 7 VIRILIZATION, 46 XY CHROMOSOMES WITH UNDERVIRILIZATION, OR HAVING BOTH 8 OVARIAN AND TESTICULAR TISSUE; 9 (2) SERVICES PROVIDED TO A MINOR WHO HAS OTHERWISE BEEN 10 DIAGNOSED WITH A DISORDER OF SEXUAL DEVELOPMENT BY A PHYSICIAN, WHEN 11 THE PHYSICIAN HAS DETERMINED THROUGH GENETIC OR BIOCHEMICAL TESTING 12 THAT THE MINOR DOES NOT HAVE A NORMAL SEX CHROMOSOME STRUCTURE, SEX 13 STEROID HORMONE PRODUCTION, OR SEX STEROID HORMONE ACTION FOR A 14 BIOLOGICAL MALE OR BIOLOGICAL FEMALE; 15 (3) THE TREATMENT OF ANY INFECTION, INJURY, DISEASE, OR 16 DISORDER THAT HAS BEEN CAUSED OR EXACERBATED BY THE PERFORMANCE OF 17 GENDER TRANSITION PROCEDURES, WHETHER OR NOT THE PROCEDURES WERE 18 PERFORMED IN ACCORDANCE WITH FEDERAL AND STATE LAW; AND 19 (4) ANY PROCEDURE UNDERTAKEN BECAUSE A MINOR SUFFERS 20 FROM A PHYSICAL DISORDER, PHYSICAL INJURY, OR PHYSICAL ILLNESS THAT IS 21 CERTIFIED BY A PHYSICIAN AND THAT WOULD PLACE THE MINOR IN IMMINENT 22 DANGER OF DEATH OR IMPAIRMENT OF A MAJOR BODILY FUNCTION UNLESS 23 SURGERY IS PERFORMED. 24 (D) (1) A PERSON WHO VIOLATES THIS SECTION IS GUILTY OF A 25 MISDEMEANOR AND ON CONVICTION IS SUBJECT TO IMPRISONMENT FOR NOT LESS 26 THAN 1 YEAR AND NOT EXCEEDING 3 YEARS. 27 (2) NOTWITHSTANDING § 14–102 OF THE CRIMINAL LAW ARTICLE, A 28 COURT MAY NOT IMPOSE LESS THAN THE MANDATORY MINIMUM SENTENCE OF 1 29 YEAR. 30 (3) A COURT MAY NOT SUSPEND ANY PART OF THE MANDATORY 31 MINIMUM SENTENCE OF 1 YEAR. 32 (E) THE SECRETARY MAY ADOPT REGULATIONS TO CARRY OUT THIS 33 SECTION. 34 4 HOUSE BILL 722 SECTION 2. AND BE IT FURTHER ENACTED, That this Act shall take effect 1 October 1, 2024. 2