Text of MO SB 1185 (2024)

EXPLANATION-Matter enclosed in bold-faced brackets [thus] in this bill is not enacted and is intended to be omitted in the law. SECOND REGULAR SESSION SENATE BILL NO. 1185 102ND GENERAL ASSEMBLY INTRODUCED BY SENATOR BRATTIN. 3261S.01I KRISTINA MARTIN, Secretary AN ACT To repeal section 191.1720, RSMo, and to enact in lieu thereof one new section relating to gender transition. Be it enacted by the General Assembly of the State of Missouri, as follows: Section A. Section 191.1720, RSMo, is repealed and one 1 new section enacted in lieu thereof, to be known as section 2 191.1720, to read as follows: 3 191.1720. 1. This section shall be known and may be 1 cited as the "Missouri Save Adolescents from Experimentation 2 (SAFE) Act". 3 2. For purposes of this section, the following terms 4 mean: 5 (1) "Biological sex", the biological indication of 6 male or female in the context of reproductive potential or 7 capacity, such as sex chromosomes, naturally occurring sex 8 hormones, gonads, and nonambiguous internal and external 9 genitalia present at birth, without regard to an 10 individual's psychological, chosen, or subjective experience 11 of gender; 12 (2) "Cross-sex hormones", testosterone, estrogen, or 13 other androgens given to an individual in amounts that are 14 greater or more potent than would normally occur naturally 15 in a healthy individual of the same age and sex; 16 (3) "Gender", the psychological, behavioral, social, 17 and cultural aspects of being male or female; 18 SB 1185 2 (4) "Gender transition", the process in which an 19 individual transitions from identifying with and living as a 20 gender that corresponds to his or her biological sex to 21 identifying with and living as a gender different from his 22 or her biological sex, and may involve social, legal, or 23 physical changes; 24 (5) "Gender transition surgery", a surgical procedure 25 performed for the purpose of assisting an individual with a 26 gender transition, including, but not limited to: 27 (a) Surgical procedures that sterilize, including, but 28 not limited to, castration, vasectomy, hysterectomy, 29 oophorectomy, orchiectomy, or penectomy; 30 (b) Surgical procedures that artificially construct 31 tissue with the appearance of genitalia that differs from 32 the individual's biological sex, including, but not limited 33 to, metoidioplasty, phalloplasty, or vaginoplasty; or 34 (c) Augmentation mammoplasty or subcutaneous 35 mastectomy; 36 (6) "Health care provider", an individual who is 37 licensed, certified, or otherwise authorized by the laws of 38 this state to administer health care in the ordinary course 39 of the practice of his or her profession; 40 (7) "Puberty-blocking drugs", gonadotropin-releasing 41 hormone analogues or other synthetic drugs used to stop 42 luteinizing hormone secretion and follicle stimulating 43 hormone secretion, synthetic antiandrogen drugs to block the 44 androgen receptor, or any other drug used to delay or 45 suppress pubertal development in children for the purpose of 46 assisting an individual with a gender transition. 47 3. A health care provider shall not knowingly perform 48 a gender transition surgery on any individual under eighteen 49 years of age. 50 SB 1185 3 4. (1) A health care provider shall not knowingly 51 prescribe or administer cross-sex hormones or puberty- 52 blocking drugs for the purpose of a gender transition for 53 any individual under eighteen years of age. 54 (2) The provisions of this subsection shall not apply 55 to the prescription or administration of cross-sex hormones 56 or puberty-blocking drugs for any individual under eighteen 57 years of age who was prescribed or administered such 58 hormones or drugs prior to August 28, 2023, for the purpose 59 of assisting the individual with a gender transition. 60 [(3) The provisions of this subsection shall expire on 61 August 28, 2027.] 62 5. The performance of a gender transition surgery or 63 the prescription or administration of cross-sex hormones or 64 puberty-blocking drugs to an individual under eighteen years 65 of age in violation of this section shall be considered 66 unprofessional conduct and any health care provider doing so 67 shall have his or her license to practice revoked by the 68 appropriate licensing entity or disciplinary review board 69 with competent jurisdiction in this state. 70 6. (1) The prescription or administration of cross- 71 sex hormones or puberty-blocking drugs to an individual 72 under eighteen years of age for the purpose of a gender 73 transition shall be considered grounds for a cause of action 74 against the health care provider. The provisions of chapter 75 538 shall not apply to any action brought under this 76 subsection. 77 (2) An action brought pursuant to this subsection 78 shall be brought within fifteen years of the individual 79 injured attaining the age of twenty-one or of the date the 80 treatment of the injury at issue in the action by the 81 defendant has ceased, whichever is later. 82 SB 1185 4 (3) An individual bringing an action under this 83 subsection shall be entitled to a rebuttable presumption 84 that the individual was harmed if the individual is 85 infertile following the prescription or administration of 86 cross-sex hormones or puberty-blocking drugs and that the 87 harm was a direct result of the hormones or drugs prescribed 88 or administered by the health care provider. Such 89 presumption may be rebutted only by clear and convincing 90 evidence. 91 (4) In any action brought pursuant to this subsection, 92 a plaintiff may recover economic and noneconomic damages and 93 punitive damages, without limitation to the amount and no 94 less than five hundred thousand dollars in the aggregate. 95 The judgment against a defendant in an action brought 96 pursuant to this subsection shall be in an amount of three 97 times the amount of any economic and noneconomic damages or 98 punitive damages assessed. Any award of damages in an 99 action brought pursuant to this subsection to a prevailing 100 plaintiff shall include attorney's fees and court costs. 101 (5) An action brought pursuant to this subsection may 102 be brought in any circuit court of this state. 103 (6) No health care provider shall require a waiver of 104 the right to bring an action pursuant to this subsection as 105 a condition of services. The right to bring an action by or 106 through an individual under the age of eighteen shall not be 107 waived by a parent or legal guardian. 108 (7) A plaintiff to an action brought under this 109 subsection may enter into a voluntary agreement of 110 settlement or compromise of the action, but no agreement 111 shall be valid until approved by the court. No agreement 112 allowed by the court shall include a provision regarding the 113 nondisclosure or confidentiality of the terms of such 114 SB 1185 5 agreement unless such provision was specifically requested 115 and agreed to by the plaintiff. 116 (8) If requested by the plaintiff, any pleadings, 117 attachments, or exhibits filed with the court in any action 118 brought pursuant to this subsection, as well as any 119 judgments issued by the court in such actions, shall not 120 include the personal identifying information of the 121 plaintiff. Such information shall be provided in a 122 confidential information filing sheet contemporaneously 123 filed with the court or entered by the court, which shall 124 not be subject to public inspection or availability. 125 7. The provisions of this section shall not apply to 126 any speech protected by the First Amendment of the United 127 States Constitution. 128 8. The provisions of this section shall not apply to 129 the following: 130 (1) Services to individuals born with a medically- 131 verifiable disorder of sex development, including, but not 132 limited to, an individual with external biological sex 133 characteristics that are irresolvably ambiguous, such as 134 those born with 46,XX chromosomes with virilization, 46,XY 135 chromosomes with undervirilization, or having both ovarian 136 and testicular tissue; 137 (2) Services provided when a physician has otherwise 138 diagnosed an individual with a disorder of sex development 139 and determined through genetic or biochemical testing that 140 the individual does not have normal sex chromosome 141 structure, sex steroid hormone production, or sex steroid 142 hormone action; 143 (3) The treatment of any infection, injury, disease, 144 or disorder that has been caused by or exacerbated by the 145 performance of gender transition surgery or the prescription 146 SB 1185 6 or administration of cross-sex hormones or puberty-blocking 147 drugs regardless of whether the surgery was performed or the 148 hormones or drugs were prescribed or administered in 149 accordance with state and federal law; or 150 (4) Any procedure undertaken because the individual 151 suffers from a physical disorder, physical injury, or 152 physical illness that would, as certified by a physician, 153 place the individual in imminent danger of death or 154 impairment of a major bodily function unless surgery is 155 performed. 156 