Text of MT SB 218 (2025)

**** 69th Legislature 2025 SB 218.1 - 1 - Authorized Print Version – SB 218 1 SENATE BILL NO. 218 2 INTRODUCED BY J. FULLER, G. HERTZ 3 4 A BILL FOR AN ACT ENTITLED: “AN ACT PROVIDING FOR A PRIVATE CAUSE OF ACTION FOR 5 INJURIES CAUSED BY CERTAIN MEDICAL INTERVENTIONS AS TREATMENT OF GENDER DYSPHORIA; 6 PROVIDING A STATUTE OF LIMITATIONS; REPEALING SECTION 50-4-1005, MCA; AND PROVIDING AN 7 EFFECTIVE DATE.” 8 9 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MONTANA: 10 11 NEW SECTION. Section 1. Private cause of action for injuries caused by treatment of gender 12 dysphoria -- statute of limitations -- definitions. (1) Any health care professional or physician who provides 13 the medical treatments listed in subsection (4) is strictly liable if the medical treatment or the after-effects of the 14 medical treatment result in any injury, including physical, psychological, emotional, or physiological harms, 15 within 25 years from the date of the last treatment. 16 (2) Except as provided in subsection (3), a person who suffers an injury described in subsection 17 (1) or the person's legal guardian or estate may bring a civil action with respect to the injury within 25 years 18 from the time of discovery by the injured party of both the injury and the causal relationship between the 19 medical treatment and the injury against the offending health care professional or physician in a court of 20 competent jurisdiction for: 21 (a) declaratory or injunctive relief; 22 (b) compensatory damages, including but not limited to pain and suffering, loss of reputation, loss 23 of income, and loss of consortium, including the loss of expectation of sharing parenthood; 24 (c) punitive damages; 25 (d) any other appropriate relief; and 26 (e) attorney fees and costs. 27 (3) (a) If the person subjected to medical treatment is under legal disability at the time the person 28 discovers the injury and the causal relationship between the medical treatment and the injury, the limitation **** 69th Legislature 2025 SB 218.1 - 2 - Authorized Print Version – SB 218 1 period in subsection (2) does not begin to run until the removal of the disability. 2 (b) The limitation period in subsection (2) does not run during a time period when the individual is 3 subject to threats, intimidation, manipulation, fraudulent concealment, or fraud perpetrated by the health care 4 professional or physician who provided the medical treatment described in subsection (1) or by any person 5 acting in the interest of the health care professional or physician. 6 (4) (a) Except as provided in subsection (5), a health care professional or physician may be found 7 liable under subsection (1) for an injury caused by the following treatments or the after-effects of the following 8 treatments provided to a female patient to address the patient's perception that the patient's gender or sex is 9 not female: 10 (i) surgical procedures, including a vaginectomy, hysterectomy, oophorectomy, ovariectomy, 11 reconstruction of the urethra, metoidioplasty, phalloplasty, scrotoplasty, implantation of erection or testicular 12 protheses, subcutaneous mastectomy, voice surgery, or pectoral implants; 13 (ii) supraphysiologic doses of testosterone or other androgens; or 14 (iii) puberty blockers such as GnRH agonists or other synthetic drugs that suppress the production 15 of estrogen and progesterone to delay or suppress pubertal development in female minors. 16 (b) Except as provided in subsection (5), a health care professional or physician may be found 17 liable under subsection (1) for an injury caused by the following treatments or the after-effects of the following 18 treatments provided to a male patient to address the patient's perception that the patient's gender or sex is not 19 male: 20 (i) surgical procedures, including a penectomy, orchiectomy, vaginoplasty, clitoroplasty, 21 vulvoplasty, augmentation mammoplasty, facial feminization surgery, voice surgery, thyroid cartilage reduction, 22 or gluteal augmentation; 23 (ii) supraphysiologic doses of estrogen; or 24 (iii) puberty blockers such as GnRH agonists or other synthetic drugs that suppress the production 25 of testosterone or delay or suppress pubertal development in male minors. 26 (5) The medical treatments listed in subsections (4)(a) and (4)(b) may be the basis of a claim 27 under subsection (1) only when knowingly provided to address a female patient's perception that the patient's 28 gender or sex is not female or a male patient's perception that the patient's gender or sex is not male. **** 69th Legislature 2025 SB 218.1 - 3 - Authorized Print Version – SB 218 1 Subsections (4)(a) and (4)(b) do not apply for other purposes, including: 2 (a) treatment for a person born with a medically verifiable disorder of sex development, including: 3 (i) a person born with external biological sex characteristics that are irresolvably ambiguous, 4 including an individual born with 46 XX chromosomes with virilization, an individual born with 46 XY 5 chromosomes with undervirilization, or an individual having both ovarian and testicular tissue; and 6 (ii) a person whom a physician has otherwise diagnosed with a disorder of sexual development in 7 which the physician has determined through genetic or biochemical testing that the person does not have 8 normal sex chromosome structure, sex steroid hormone production, or sex steroid hormone action for a male or 9 female; and 10 (b) treatment of any infection, injury, disease, or disorder that has been caused or exacerbated by 11 a medical treatment listed in subsection (4)(a) or (4)(b), whether or not the medical treatment was performed in 12 accordance with state and federal law and whether or not funding for the medical treatment is permissible 13 under state and federal law. 14 (6) As used in this section, unless the context clearly indicates otherwise, the following definitions 15 apply: 16 (a) "Female" means a member of the human species who, under normal development, has XX 17 chromosomes and produces or would produce relatively large, relatively immobile gametes, or eggs, during her 18 life cycle and has a reproductive and endocrine system oriented around the production of those gametes. An 19 individual who would otherwise fall within this definition, but for a biological or genetic condition, is female for 20 the purposes of this section. 21 (b) "Gender" means the psychological, behavioral, social, and cultural aspects of being male or 22 female. 23 (c) "Health care professional" means a person who is licensed, certified, or otherwise authorized 24 by the laws of this state to administer health care in the ordinary course of the practice of the person's 25 profession. 26 (d) "Male" means a member of the human species who, under normal development, has XY 27 chromosomes and produces or would produce small, mobile gametes, or sperm, during his life cycle and has a 28 reproductive and endocrine system oriented around the production of those gametes. An individual who would **** 69th Legislature 2025 SB 218.1 - 4 - Authorized Print Version – SB 218 1 otherwise fall within this definition, but for a biological or genetic condition, is male for the purposes of this 2 section. 3 (e) "Physician" means a person who is licensed to practice medicine in this state. 4 (f) "Sex" means the organization of body parts and gametes for reproduction in human beings and 5 other organisms. In human beings, there are exactly two sexes, male and female, with two corresponding types 6 of gametes. The sexes are determined by the biological and genetic indication of male or female, including sex 7 chromosomes, naturally occurring sex chromosomes, gonads, and nonambiguous internal and external 8 genitalia present at birth, without regard to an individual's psychological, behavioral, social, cultural, chosen, or 9 subjective experience of gender. 10 11 NEW SECTION. Section 2. Repealer. The following section of the Montana Code Annotated is 12 repealed: 13 50-4-1005. Private cause of action for subsequent harm. 14 15 NEW SECTION. Section 3. Codification instruction. [Section 1] is intended to be codified as a new 16 part in Title 50, chapter 4, and the provisions of Title 50, chapter 4, apply to [section 1]. 17 18 NEW SECTION. Section 4. Severability. If a part of [this act] is invalid, all valid parts that are 19 severable from the invalid part remain in effect. If a part of [this act] is invalid in one or more of its applications, 20 the part remains in effect in all valid applications that are severable from the invalid applications. 21 22 NEW SECTION. Section 5. Effective date. [This act] is effective July 1, 2025. 23 - END -

- 2025 69th Legislature 2025 SB 218 - 1 - Authorized Print Version – SB 218 ENROLLED BILL AN ACT PROVIDING FOR A PRIVATE CAUSE OF ACTION FOR INJURIES CAUSED BY CERTAIN MEDICAL INTERVENTIONS AS TREATMENT OF GENDER DYSPHORIA; PROVIDING A STATUTE OF LIMITATIONS; AMENDING SECTION 27-2-205, MCA; REPEALING SECTION 50-4-1005, MCA; AND PROVIDING AN EFFECTIVE DATE.” BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MONTANA: Section 1. Private cause of action for injuries caused by treatment of gender dysphoria -- statute of limitations -- definitions. (1) Any health care professional or physician who provides the medical treatments listed in subsection (4) is strictly liable to a minor, may be subject to a civil action if the medical treatment or the after-effects of the medical treatment result results in any injury, including physical, psychological, emotional, or physiological harms, within 25 years from the date of the last treatment that is proximately caused by a deviation from the applicable medical standard of care of the health care professional or physician as established by qualified expert testimony. (2) Except as provided in subsection (3), a person who suffers an injury described in subsection (1) or the person's legal guardian or estate may bring a civil action with respect to the injury within 25 years from within 2 years from the time of discovery by the injured party of both the injury and the causal relationship between the medical treatment and the injury against the offending health care professional or physician in a court of competent jurisdiction for: (a) declaratory or injunctive relief; (b) compensatory damages, including but not limited to pain and suffering, loss of reputation, loss of income, and loss of consortium, including the loss of expectation of sharing parenthood; and (c) punitive damages; (d)(c) any other appropriate relief; and. - 2025 69th Legislature 2025 SB 218 - 2 - Authorized Print Version – SB 218 ENROLLED BILL (e) attorney fees and costs. (3) (a) If the person subjected to medical treatment is under legal disability at the time the person discovers the injury and the causal relationship between the medical treatment and the injury, the limitation period in subsection (2) does not begin to run until the removal of the disability. (b) The limitation period in subsection (2) does not run until the minor reaches the age of 23 or during a time period when the individual is subject to threats, intimidation, manipulation, fraudulent concealment, or fraud perpetrated by the health care professional or physician who provided the medical treatment described in subsection (1) or by any person acting in the interest of the health care professional or physician. (4) (a) Except as provided in subsection (5), a health care professional or physician may be found liable under subsection (1) for an injury proximately caused by a deviation from the applicable medical standard of care of the health care professional or physician, as established by qualified expert testimony, in providing the following treatments or the after-effects of the following treatments provided to a minor female patient to address the patient's perception that the patient's gender or sex is not female: (i) surgical procedures, including a vaginectomy, hysterectomy, oophorectomy, ovariectomy, reconstruction of the urethra, metoidioplasty, phalloplasty, scrotoplasty, implantation of erection or testicular protheses, subcutaneous mastectomy, voice surgery, or pectoral implants; (ii) supraphysiologic doses of testosterone or other androgens; or (iii) puberty blockers such as GnRH agonists or other synthetic drugs that suppress the production of estrogen and progesterone to delay or suppress pubertal development in female minors. (b) Except as provided in subsection (5), a health care professional or physician may be found liable under subsection (1) for an injury proximately caused by a deviation from the applicable medical standard of care of the health care professional or physician, as established by qualified expert testimony, in providing the following treatments or the after-effects of the following treatments provided to a minor male patient to address the patient's perception that the patient's gender or sex is not male: (i) surgical procedures, including a penectomy, orchiectomy, vaginoplasty, clitoroplasty, vulvoplasty, augmentation mammoplasty, facial feminization surgery, voice surgery, thyroid cartilage reduction, or gluteal augmentation; - 2025 69th Legislature 2025 SB 218 - 3 - Authorized Print Version – SB 218 ENROLLED BILL (ii) supraphysiologic doses of estrogen; or (iii) puberty blockers such as GnRH agonists or other synthetic drugs that suppress the production of testosterone or delay or suppress pubertal development in male minors. (5) The medical treatments listed in subsections (4)(a) and (4)(b) may be the basis of a claim under subsection (1) only when knowingly provided to address a minor female patient's perception that the patient's gender or sex is not female or a minor male patient's perception that the patient's gender or sex is not male and only when performed in a manner that deviates from the applicable medical standard of care as established by qualified expert testimony. Subsections (4)(a) and (4)(b) do not apply for other purposes, including: (a) treatment for a person born with a medically verifiable disorder of sex development, including: (i) a person born with external biological sex characteristics that are irresolvably ambiguous, including an individual born with 46 XX chromosomes with virilization, an individual born with 46 XY chromosomes with undervirilization, or an individual having both ovarian and testicular tissue; and (ii) a person whom a physician has otherwise diagnosed with a disorder of sexual development in which the physician has determined through genetic or biochemical testing that the person does not have normal sex chromosome structure, sex steroid hormone production, or sex steroid hormone action for a male or female; and (b) treatment of any infection, injury, disease, or disorder that has been caused or exacerbated by a medical treatment listed in subsection (4)(a) or (4)(b), whether or not the medical treatment was performed in accordance with state and federal law and whether or not funding for the medical treatment is permissible under state and federal law; or (c) any other clinically appropriate or evidence-based basis for the treatment. (6) As used in this section, unless the context clearly indicates otherwise, the following definitions apply: (a) "Female" means a member of the human species who, under normal development, has XX chromosomes and produces or would produce relatively large, relatively immobile gametes, or eggs, during her life cycle and has a reproductive and endocrine system oriented around the production of those gametes. An individual who would otherwise fall within this definition, but for a biological or genetic condition, is female for - 2025 69th Legislature 2025 SB 218 - 4 - Authorized Print Version – SB 218 ENROLLED BILL the purposes of this section. (b) "Gender" means the psychological, behavioral, social, and cultural aspects of being male or female. (c) "Health care professional" means a person who is licensed, certified, or otherwise authorized by the laws of this state to administer health care in the ordinary course of the practice of the person's profession. (d) "Male" means a member of the human species who, under normal development, has XY chromosomes and produces or would produce small, mobile gametes, or sperm, during his life cycle and has a reproductive and endocrine system oriented around the production of those gametes. An individual who would otherwise fall within this definition, but for a biological or genetic condition, is male for the purposes of this section. (e) "Physician" means a person who is licensed to practice medicine in this state. (f) "Sex" means the organization of body parts and gametes for reproduction in human beings and other organisms. In human beings, there are exactly two sexes, male and female, with two corresponding types of gametes. The sexes are determined by the biological and genetic indication of male or female, including sex chromosomes, naturally occurring sex chromosomes, gonads, and nonambiguous internal and external genitalia present at birth, without regard to an individual's psychological, behavioral, social, cultural, chosen, or subjective experience of gender. Section 2. Section 27-2-205, MCA, is amended to read: "27-2-205. Actions for medical malpractice. (1) Action in tort or contract for injury or death against a physician or surgeon, physician assistant, dentist, dental hygienist, registered nurse, advanced practice registered nurse, nursing home or hospital administrator, dispensing optician, optometrist, licensed physical therapist, podiatrist, psychologist, osteopath, chiropractor, clinical laboratory bioanalyst, clinical laboratory technologist, pharmacist, veterinarian, a licensed hospital or long-term care facility, or licensed medical professional corporation, based upon alleged professional negligence or for rendering professional services without consent or for an act, error, or omission, must, except as provided in subsection subsections (2) and (3), be commenced within 2 years after the date of injury or within 2 years after the plaintiff discovers or through - 2025 69th Legislature 2025 SB 218 - 5 - Authorized Print Version – SB 218 ENROLLED BILL the use of reasonable diligence should have discovered the injury, whichever occurs last, but in no case may an action be commenced after 5 years from the date of injury. However, this time limitation is tolled for any period during which there has been a failure to disclose any act, error, or omission upon which an action is based and that is known to the defendant or through the use of reasonable diligence subsequent to the act, error, or omission would have been known to the defendant. (2) Notwithstanding the provisions of 27-2-401, in an action for death or injury of a minor who was under the age of 4 on the date of the minor's injury, the period of limitations in subsection (1) begins to run when the minor reaches the minor's eighth birthday or dies, whichever occurs first, and the time for commencement of the action is tolled during any period during which the minor does not reside with a parent or guardian. (3) In an action brought for an injury described in [section 1], the time limitation in subsection (1) is tolled until the plaintiff discovers both the injury and the causal relationship between the medical treatment and the injury.." Section 3. Repealer. The following section of the Montana Code Annotated is repealed: 50-4-1005. Private cause of action for subsequent harm. Section 4. Codification instruction. [Section 1] is intended to be codified as a new part in Title 50, chapter 4, and the provisions of Title 50, chapter 4, apply to [section 1]. Section 5. Severability. If a part of [this act] is invalid, all valid parts that are severable from the invalid part remain in effect. If a part of [this act] is invalid in one or more of its applications, the part remains in effect in all valid applications that are severable from the invalid applications. Section 6. Effective date. [This act] is effective July 1, 2025. - END - I hereby certify that the within bill, SB 218, originated in the Senate. ___________________________________________ Secretary of the Senate ___________________________________________ President of the Senate Signed this _______________________________day of____________________________________, 2025. ___________________________________________ Speaker of the House Signed this _______________________________day of____________________________________, 2025. SENATE BILL NO. 218 INTRODUCED BY J. FULLER, G. HERTZ AN ACT PROVIDING FOR A PRIVATE CAUSE OF ACTION FOR INJURIES CAUSED BY CERTAIN MEDICAL INTERVENTIONS AS TREATMENT OF GENDER DYSPHORIA; PROVIDING A STATUTE OF LIMITATIONS; AMENDING SECTION 27-2-205, MCA; REPEALING SECTION 50-4-1005, MCA; AND PROVIDING AN EFFECTIVE DATE.”