Text of MN SF 4017 (2024)

1.1 A bill for an act​ 1.2 relating to health; providing for interscholastic athletic team designation based on​ 1.3 the sex of the participants; creating private causes of action; prohibiting certain​ 1.4 health care providers from engaging in conduct relating to gender reassignment​ 1.5 surgery and gender transition; authorizing attorney general enforcement of​ 1.6 violations; prohibiting medical assistance coverage for gender transition services​ 1.7 for minors; prohibiting limitations on custody and parenting time based on denial​ 1.8 of gender transition services; requiring designation of intercollegiate athletic teams​ 1.9 and sports based on the sex of the participants; amending Minnesota Statutes 2022,​ 1.10 section 518.17, by adding a subdivision; proposing coding for new law in Minnesota​ 1.11 Statutes, chapters 121A; 145.​ 1.12 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:​ 1.13 Section 1. [121A.0401] INTERSCHOLASTIC SPORTS TEAMS.​ 1.14 Subdivision 1. Sex of the participants. (a) A school that is a member of the Minnesota​ 1.15 State High School League must designate interscholastic athletic teams based on the sex of​ 1.16 the participants as follows:​ 1.17 (1) separate teams for participants of the female sex within female sports divisions;​ 1.18 (2) separate teams for participants of the male sex within male sports divisions; and​ 1.19 (3) if applicable, coed teams for participants of the female and male sexes within coed​ 1.20 sports divisions.​ 1.21 (b) A school, interscholastic conference, or the Minnesota State High School League​ 1.22 must not knowingly permit individuals of the male sex to participate on athletic teams or​ 1.23 in athletic competitions designated only for participants of the female sex.​ 1​ Section 1.​ 24-06300 as introduced​ 02/06/24 REVISOR XX/NS​ SENATE​ STATE OF MINNESOTA​ S.F. No. 4017​ NINETY-THIRD SESSION​ (SENATE AUTHORS: GRUENHAGEN)​ OFFICIAL STATUS​ D-PG​ DATE​ Introduction and first reading​ 02/20/2024​ Referred to Health and Human Services​ 2.1 (c) Nothing in this section shall be construed to restrict the eligibility of any student to​ 2.2 participate on any athletic teams or in athletic competitions that are designated as male or​ 2.3 coed.​ 2.4 (d) An agency or political subdivision of the state and an accrediting organization or​ 2.5 athletic association that operates or has business activities in this state must not process a​ 2.6 complaint, begin an investigation, or take any other adverse action against a school or school​ 2.7 district for maintaining separate single-sex interscholastic athletic teams or sports.​ 2.8 Subd. 2. Private cause of action. (a) A participant who is deprived of an athletic​ 2.9 opportunity or suffers direct or indirect harm because of a violation of this section has a​ 2.10 private cause of action for injunctive relief, damages, and any other relief available against​ 2.11 the school, school district, interscholastic conference, or the Minnesota State High School​ 2.12 League.​ 2.13 (b) A participant who is subject to retaliation or other adverse action by a school, school​ 2.14 district, interscholastic conference, or the Minnesota State High School League because of​ 2.15 reporting a violation of this section has a private cause of action for injunctive relief,​ 2.16 damages, and any other relief available against the entity that takes the retaliatory or other​ 2.17 adverse action.​ 2.18 (c) A school or school district that suffers any direct or indirect harm because of a​ 2.19 violation of subdivision 1, paragraph (d), has a private cause of action for injunctive relief,​ 2.20 damages, and any other relief available against the agency, political subdivision, accrediting​ 2.21 organization, or athletic association that violates that subdivision.​ 2.22 (d) A civil action brought because of a violation of this section must be initiated within​ 2.23 two years after the date on which the violation occurred. A person or organization who​ 2.24 prevails on a claim brought under this section is entitled to monetary damages, including​ 2.25 for any psychological, emotional, or physical harm suffered; reasonable attorney fees and​ 2.26 costs; and any other appropriate relief.​ 2.27 EFFECTIVE DATE. This section is effective for the 2024-2025 school year and later.​ 2.28 Sec. 2. [145.99] DEFINITIONS.​ 2.29 Subdivision 1. Definitions. The definitions in this section apply to sections 145.99 to​ 2.30 145.995.​ 2.31 Subd. 2. Biological sex; birth sex; sex. "Biological sex," "birth sex," and "sex" mean​ 2.32 the biological indication of male and female, including sex chromosomes, naturally occurring​ 2​ Sec. 2.​ 24-06300 as introduced​ 02/06/24 REVISOR XX/NS​ 3.1 sex hormones, gonads, and internal and external genitalia present at birth, without regard​ 3.2 to an individual's psychological, chosen, or subjective experience of gender.​ 3.3 Subd. 3. Cross-sex hormone. "Cross-sex hormone" means testosterone, estrogen, or​ 3.4 progesterone given to a minor individual in an amount greater than would normally be​ 3.5 produced endogenously in a healthy individual of the minor individual's age and sex.​ 3.6 Subd. 4. Gender reassignment surgery. "Gender reassignment surgery" means any​ 3.7 surgery performed for the purpose of assisting an individual with gender transition that​ 3.8 seeks to surgically alter or remove healthy physical or anatomical characteristics or features​ 3.9 that are typical for the individual's biological sex in order to instill or create physiological​ 3.10 or anatomical characteristics that resemble a sex different from the individual's birth sex,​ 3.11 including genital or nongenital gender reassignment surgery.​ 3.12 Subd. 5. Gender-related condition. "Gender-related condition" means any condition​ 3.13 where an individual feels an incongruence between the individual's gender identity and​ 3.14 biological sex. "Gender-related condition" includes gender dysphoria.​ 3.15 Subd. 6. Gender transition. "Gender transition" means the process in which an individual​ 3.16 transitions from identifying with and living as a gender that corresponds to the individual's​ 3.17 biological sex to identifying with and living as a gender different from the individual's​ 3.18 biological sex, including social, legal, or physical changes.​ 3.19 Subd. 7. Gender transition services. "Gender transition services" means any medical​ 3.20 or surgical service, including physician services, inpatient and outpatient hospital services,​ 3.21 or prescription drugs or hormones provided for the purpose of assisting an individual with​ 3.22 gender transition that seeks to alter or remove physical or anatomical characteristics or​ 3.23 features that are typical for the individual's biological sex, or to instill or create physiological​ 3.24 or anatomical characteristics that resemble a sex different from the individual's birth sex,​ 3.25 including medical services that provide puberty-blocking drugs, cross-sex hormones, or​ 3.26 other mechanisms to promote the development of feminizing or masculinizing features in​ 3.27 the opposite sex, or genital or nongenital gender reassignment surgery.​ 3.28 Subd. 8. Genital gender reassignment surgery. "Genital gender reassignment surgery"​ 3.29 means surgery performed for the purpose of assisting an individual with gender transition​ 3.30 and includes both of the following:​ 3.31 (1) surgeries that sterilize, such as castration, vasectomy, hysterectomy, oophorectomy,​ 3.32 orchiectomy, and penectomy; and​ 3​ Sec. 2.​ 24-06300 as introduced​ 02/06/24 REVISOR XX/NS​ 4.1 (2) surgeries that artificially construct tissue with the appearance of genitalia that differs​ 4.2 from the individual's biological sex, such as metoidiplasty, phalloplasty, and vaginoplasty.​ 4.3 Subd. 9. Mental health professional. "Mental health professional" means an individual​ 4.4 providing clinical services in the treatment of mental illness who meets one of the​ 4.5 qualifications under section 245I.04, subdivision 2.​ 4.6 Subd. 10. Minor individual. "Minor individual" means an individual under 18 years of​ 4.7 age.​ 4.8 Subd. 11. Nongenital gender reassignment surgery. "Nongenital gender reassignment​ 4.9 surgery" means surgery performed for the purpose of assisting an individual with gender​ 4.10 transition such as augmentation mammoplasty, facial feminization surgery, liposuction,​ 4.11 lipofilling, voice surgery, thyroid cartilage reduction, gluteal augmentation, pectoral implants,​ 4.12 or other aesthetic procedures.​ 4.13 Subd. 12. Physician. "Physician" means an individual licensed to practice medicine by​ 4.14 the board of medical practice pursuant to chapter 147.​ 4.15 Subd. 13. Puberty-blocking drugs. "Puberty-blocking drugs" means​ 4.16 gonadotropin-releasing hormone analogs or other synthetic drugs used to stop luteinizing​ 4.17 hormone and follicle stimulating hormone secretion, synthetic antiandrogen drugs used to​ 4.18 block the androgen receptor, or any drug to delay or suppress normal puberty.​ 4.19 Sec. 3. [145.991] PROHIBITIONS ON GENDER REASSIGNMENT SURGERY​ 4.20 AND CERTAIN PRESCRIPTIONS FOR MINOR INDIVIDUALS.​ 4.21 (a) A physician must not knowingly do any of the following:​ 4.22 (1) perform gender reassignment surgery on a minor individual;​ 4.23 (2) prescribe a cross-sex hormone or puberty-blocking drug for a minor individual for​ 4.24 the purpose of assisting the minor individual with gender transition; and​ 4.25 (3) engage in conduct that aids or abets in the practices described in clause (1) or (2),​ 4.26 provided that this section may not be construed to impose liability on any speech protected​ 4.27 by federal or state law.​ 4.28 (b) Notwithstanding paragraph (a), clause (2), of this section, a physician may continue​ 4.29 to prescribe a cross-sex hormone or puberty-blocking drug to a minor individual if the minor​ 4.30 individual has been a continuous Minnesota resident since the effective date of this section​ 4.31 and the physician has done both of the following:​ 4​ Sec. 3.​ 24-06300 as introduced​ 02/06/24 REVISOR XX/NS​ 5.1 (1) initiated a course of treatment for the minor individual prior to the effective date of​ 5.2 this section that includes the prescription of a cross-sex hormone or puberty-blocking drug​ 5.3 prohibited by paragraph (a), clause (2); and​ 5.4 (2) determined and documented in the minor individual's medical record that terminating​ 5.5 the minor individual's prescription for the cross-sex hormone or puberty-blocking drug​ 5.6 would cause harm to the minor individual.​ 5.7 Sec. 4. [145.992] MENTAL HEALTH SERVICE PROVISION REQUIREMENTS.​ 5.8 (a) Notwithstanding section 144.3431, a mental health professional must not diagnose​ 5.9 or treat a minor individual, except if the minor is a person having the status of a legally​ 5.10 emancipated minor, who presents for the diagnosis or treatment of a gender-related condition​ 5.11 without first obtaining the consent of one of the following:​ 5.12 (1) at least one parent of the minor individual;​ 5.13 (2) at least one legal custodian of the minor individual; or​ 5.14 (3) the minor individual's guardian.​ 5.15 (b) No mental health professional shall diagnose or treat a minor individual without the​ 5.16 consent required in paragraph (a) who presents for the diagnosis or treatment of a​ 5.17 gender-related condition without screening the minor individual for both of the following​ 5.18 during the course of diagnosis and treatment:​ 5.19 (1) other comorbidities that may be influencing the minor individual's gender-related​ 5.20 condition, including depression, anxiety, attention deficit hyperactivity disorder, autism​ 5.21 spectrum disorder, and other mental health conditions; and​ 5.22 (2) physical, sexual, mental, and emotional abuse and other traumas.​ 5.23 Sec. 5. [145.993] EXCEPTIONS.​ 5.24 Sections 145.99 to 145.995 do not prohibit a physician from treating, including by​ 5.25 performing surgery on or prescribing drugs or hormones for, a minor individual who meets​ 5.26 any of the following:​ 5.27 (1) was born with a medically verifiable disorder of sex development, including an​ 5.28 individual with external biological sex characteristics that are irresolvably ambiguous, such​ 5.29 an as individual born with 46 XX chromosomes with virilization, 46 XY chromosomes with​ 5.30 undervirilization, or having both ovarian and testicular tissue;​ 5​ Sec. 5.​ 24-06300 as introduced​ 02/06/24 REVISOR XX/NS​ 6.1 (2) received a diagnosis of a disorder of sexual development, in which a physician has​ 6.2 determined through genetic or biochemical testing that the individual does not have normal​ 6.3 sex chromosome structure, sex steroid hormone production, or sex steroid hormone action​ 6.4 for a biological male or biological female; or​ 6.5 (3) needs treatment for any infection, injury, disease, or disorder that has been caused​ 6.6 or exacerbated by the performance of gender transition services, whether or not the services​ 6.7 were performed in accordance with state or federal law.​ 6.8 Sec. 6. [145.994] PENALTIES; ENFORCEMENT.​ 6.9 (a) A violation of sections 145.99 to 145.995 is unprofessional conduct and is subject​ 6.10 to discipline by the Board of Medical Practice under chapter 147.​ 6.11 (b) Nothing in sections 145.99 to 145.995 shall be construed to preempt any other private​ 6.12 cause of action arising under the common law of this state.​ 6.13 (c) The attorney general may bring an action to enforce compliance with section 145.991​ 6.14 or 145.992. Nothing in sections 145.99 to 145.995 shall be construed to deny, impair, or​ 6.15 otherwise affect any right or authority of the attorney general, the state, or any agency,​ 6.16 officer, or employee of the state, acting under any provision of Minnesota Statutes, to​ 6.17 institute or intervene in any proceeding.​ 6.18 Sec. 7. [145.995] MEDICAL ASSISTANCE PROHIBITION.​ 6.19 Medical assistance under chapter 256B must not include coverage for gender transition​ 6.20 services for minor individuals. This section does not apply to any of the following:​ 6.21 (1) the circumstances described in section 145.993;​ 6.22 (2) mental health services provided for a gender-related condition; and​ 6.23 (3) any services that are not gender transition services.​ 6.24 Sec. 8. Minnesota Statutes 2022, section 518.17, is amended by adding a subdivision to​ 6.25 read:​ 6.26 Subd. 7. Gender transition services. When determining issues of custody or parenting​ 6.27 time, a court shall not deny or limit a parent's rights, responsibilities, or parenting time based​ 6.28 on a parent's decision to:​ 6.29 (1) refer to and raise the child in a manner consistent with the child's biological sex;​ 6​ Sec. 8.​ 24-06300 as introduced​ 02/06/24 REVISOR XX/NS​ 7.1 (2) decline to consent to the child receiving gender transition services as defined in​ 7.2 section 145.99;​ 7.3 (3) decline to consent to the child receiving counseling or other mental health services​ 7.4 for the purpose of affirming the child's perception of the child's gender or sex, if the child's​ 7.5 perception is inconsistent with the child's biological sex.​ 7.6 Sec. 9. SAVE WOMEN'S SPORTS ACT.​ 7.7 Subdivision 1. Definition. "Postsecondary institution" means:​ 7.8 (1) an institution governed by the Board of Trustees of the Minnesota State Colleges​ 7.9 and Universities; and​ 7.10 (2) a private postsecondary institution with a campus located in Minnesota and is an​ 7.11 eligible institution as defined in Minnesota Statutes, section 136A.103.​ 7.12 Postsecondary institutions governed by the Board of Regents of the University of Minnesota​ 7.13 are requested to comply with this section.​ 7.14 Subd. 2. Requirements; causes of action. (a) Each postsecondary institution that is a​ 7.15 member of the National Collegiate Athletics Association, the National Association of​ 7.16 Intercollegiate Athletics, or the National Junior College Association shall designate​ 7.17 intercollegiate athletic teams and sports based on the sex of the participants as follows:​ 7.18 (1) separate teams for participants of the female sex within female sports divisions;​ 7.19 (2) separate teams for participants of the male sex within male sports divisions; and​ 7.20 (3) if applicable, coed teams for participants of the female and male sexes within coed​ 7.21 sports divisions.​ 7.22 (b) No postsecondary institution to which paragraph (a) applies shall knowingly allow​ 7.23 individuals of the male sex to participate on athletic teams or in athletic competitions​ 7.24 designated for only participants of the female sex.​ 7.25 (c) Nothing in this section shall be construed to restrict the eligibility of any student to​ 7.26 participate on any athletic teams or in athletic competitions that are designated as male or​ 7.27 coed.​ 7.28 (d) No agency or political subdivision of the state and no accrediting organization or​ 7.29 athletic association that operates or has business activities in this state shall process a​ 7.30 complaint, begin an investigation, or take any other adverse action against a postsecondary​ 7​ Sec. 9.​ 24-06300 as introduced​ 02/06/24 REVISOR XX/NS​ 8.1 institution for maintaining separate single-sex intercollegiate athletic teams or sports for​ 8.2 participants of the female sex.​ 8.3 (e) Any participant who is deprived of an athletic opportunity or suffers direct or indirect​ 8.4 harm as a result of a violation of this section has a private cause of action for injunctive​ 8.5 relief, damages, and any other relief available against the postsecondary institution.​ 8.6 (f) Any participant who is subject to retaliation or other adverse action by a postsecondary​ 8.7 institution or athletic association as a result of reporting a violation of this section has a​ 8.8 private cause of action for injunctive relief, damages, and any other relief available against​ 8.9 the entity that takes the retaliatory or other adverse action.​ 8.10 (g) Any postsecondary institution that suffers any direct or indirect harm as a result of​ 8.11 a violation of this section has a private cause of action for injunctive relief, damages, and​ 8.12 any other relief available against the agency, political subdivision, accrediting organization,​ 8.13 or athletic association that violates this section.​ 8.14 (h) Any civil action brought as a result of a violation of this section shall be initiated​ 8.15 within two years after the date on which the violation occurred. Persons or organizations​ 8.16 who prevail on a claim brought pursuant to this section shall be entitled to monetary damages,​ 8.17 including for any psychological, emotional, or physical harm suffered, reasonable attorney​ 8.18 fees and costs, and any other appropriate relief.​ 8​ Sec. 9.​ 24-06300 as introduced​ 02/06/24 REVISOR XX/NS​