Text of OK SB 878 (2023)

Req. No. 1454 Page 1 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 STATE OF OKLAHOMA 1st Session of the 59th Legislature (2023) SENATE BILL 878 By: Jett AS INTRODUCED An Act relating to health care; creating the Oklahoma Save Adolescents from Experimentation (SAFE) Act; providing short title; defining terms; prohibiting provision of or referral for gender transition procedures; providing exceptions; prohibiting certain uses of public funds, public facilities, public employees, and state Medicaid program; providing for administrative and civil enforcement; authorizing certain civil actions and relief; providing certain construction; providing for codification; and declaring an emergency. BE IT ENACTED BY THE PEOPLE OF THE STATE OF OKLAHOMA: SECTION 1. NEW LAW A new section of law to be codified in the Oklahoma Statutes as Section 2607.1 of Title 63, unless there is created a duplication in numbering, reads as follows: This act shall be known and may be cited as the “Oklahoma Save Adolescents from Experimentation (SAFE) Act”. SECTION 2. NEW LAW A new section of law to be codified in the Oklahoma Statutes as Section 2607.2 of Title 63, unless there is created a duplication in numbering, reads as follows: As used in this act: 1. “Biological sex” means the biological indication of male and female in the context of reproductive potential or capacity, such as Req. No. 1454 Page 2 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 sex chromosomes, naturally occurring sex hormones, gonads, and nonambiguous internal and external genitalia present at birth, without regard to an individual’s psychological, chosen, or subjective experience of gender; 2. “Cross-sex hormones” means: a. testosterone or other androgens given to biological females in amounts that are larger or more potent than would normally occur naturally in healthy biological sex females, and b. estrogen given to biological males in amounts that are larger or more potent than would normally occur naturally in healthy biological sex males; 3. “Gender” means the psychological, behavioral, social, and cultural aspects of being male or female; 4. “Gender reassignment surgery” means any medical or surgical service that seeks to surgically alter or remove healthy physical or anatomical characteristics or features that are typical for the individual’s biological sex, in order to instill or create physiological or anatomical characteristics that resemble a sex different from the individual’s biological sex, including but not limited to genital or nongenital gender reassignment surgery performed for the purpose of assisting an individual with a gender transition; Req. No. 1454 Page 3 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 5. “Gender transition” means the process in which a person goes from identifying with and living as a gender that corresponds to his or her biological sex to identifying with and living as a gender different from his or her biological sex, and may involve social, legal, or physical changes; 6. a. “Gender transition procedures” means any medical or surgical service, including but not limited to physician’s services, inpatient and outpatient hospital services, or prescribed drugs related to gender transition that seeks to: (1) alter or remove physical or anatomical characteristics or features that are typical for the individual’s biological sex, or (2) instill or create physiological or anatomical characteristics that resemble a sex different from the individual’s biological sex, including but not limited to medical services that provide puberty-blocking drugs, cross-sex hormones, or other mechanisms to promote the development of feminizing or masculinizing features in the opposite biological sex, or genital or nongenital gender reassignment surgery performed for the purpose of assisting an individual with a gender transition. Req. No. 1454 Page 4 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 b. Gender transition procedures do not include: (1) services to persons born with a medically verifiable disorder of sex development, including a person with external biological sex characteristics that are irresolvably ambiguous, such as those born with 46 XX chromosomes with virilization, 46 XY chromosomes with undervirilization, or having both ovarian and testicular tissue, (2) services provided when a physician has otherwise diagnosed a disorder of sexual development that 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, (3) the treatment of any infection, injury, disease, or disorder that has been caused by or exacerbated by the performance of gender transition procedures, whether or not the gender transition procedure was performed in accordance with state and federal law, or (4) any procedure undertaken because the individual suffers from a physical disorder, physical Req. No. 1454 Page 5 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 injury, or physical illness that would, as certified by a physician, place the individual in imminent danger of death or impairment of major bodily function unless surgery is performed; 7. “Genital gender reassignment surgery” means a medical procedure performed for the purpose of assisting an individual with a gender transition, including but not limited to: a. surgical procedures such as penectomy, orchiectomy, vaginoplasty, clitoroplasty, or vulvoplasty for biologically male patients or hysterectomy or oophorectomy for biologically female patients, b. reconstruction of the fixed part of the urethra with or without a metoidioplasty, or c. phalloplasty, vaginectomy, scrotoplasty, or implantation of erection or testicular prostheses for biologically female patients; 8. “Healthcare 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 his or her profession; 9. “Nongenital gender reassignment surgery” means medical procedures performed for the purpose of assisting an individual with a gender transition including but not limited to: Req. No. 1454 Page 6 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 a. surgical procedures for biologically male patients, such as augmentation mammoplasty, facial feminization surgery, liposuction, lipofilling, voice surgery, thyroid cartilage reduction, gluteal augmentation, hair reconstruction, or various aesthetic procedures, or b. surgical procedures for biologically female patients, such as subcutaneous mastectomy, voice surgery, liposuction, lipofilling, pectoral implants, or various aesthetic procedures; 10. “Physician” means a person who is licensed to practice medicine in this state; 11. “Puberty-blocking drugs” means gonadotropin-releasing hormone analogues or other synthetic drugs used in biological males to stop luteinizing hormone secretion and therefore testosterone secretion, or synthetic drugs used in biological females which stop the production of estrogens and progesterone, when used to delay or suppress pubertal development in children for the purpose of assisting an individual with a gender transition; and 12. “Public funds” means state, county, or local government monies, in addition to any department, agency, or instrumentality authorized or appropriated under state law or derived from any fund in which such moneys are deposited. Req. No. 1454 Page 7 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 SECTION 3. NEW LAW A new section of law to be codified in the Oklahoma Statutes as Section 2607.3 of Title 63, unless there is created a duplication in numbering, reads as follows: A. A physician or other healthcare professional shall not provide gender transition procedures to any individual under eighteen (18) years of age. B. A physician or other healthcare professional shall not refer any individual under eighteen (18) years of age to any healthcare professional for gender transition procedures. C. A physician or other healthcare professional is not prohibited from providing any of the following procedures which are not gender transition procedures to an individual under eighteen (18) years of age: 1. Services to persons born with a medically verifiable disorder of sex development, including a person with external biological sex characteristics that are irresolvably ambiguous, such as those born with 46 XX chromosomes with virilization, 46 XY chromosomes with undervirilization, or having both ovarian and testicular tissue; 2. Services provided when a physician has otherwise diagnosed a disorder of sexual development that 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; Req. No. 1454 Page 8 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 3. The treatment of any infection, injury, disease, or disorder that has been caused by or exacerbated by the performance of gender transition procedures, whether or not the gender transition procedure was performed in accordance with state and federal law or whether or not funding for the gender transition procedure is permissible under Section 4 of this act; or 4. Any procedure undertaken because the individual suffers from a physical disorder, physical injury, or physical illness that would, as certified by a physician, place the individual in imminent danger of death or impairment of major bodily function unless surgery is performed. SECTION 4. NEW LAW A new section of law to be codified in the Oklahoma Statutes as Section 2607.4 of Title 63, unless there is created a duplication in numbering, reads as follows: A. Public funds shall not be directly or indirectly used, granted, paid, or distributed to any entity, organization, or individual that provides gender transition procedures to an individual under eighteen (18) years of age. B. Healthcare services furnished in the following situations shall not include gender transition procedures to an individual under eighteen (18) years of age: 1. By or in a healthcare facility owned by the state or a county or local government; or Req. No. 1454 Page 9 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 2. By a physician or other healthcare professional employed by the state or a county or local government. C. The state Medicaid program shall not reimburse or provide coverage for gender transition procedures to an individual under eighteen (18) years of age. SECTION 5. NEW LAW A new section of law to be codified in the Oklahoma Statutes as Section 2607.5 of Title 63, unless there is created a duplication in numbering, reads as follows: A. Any referral for or provision of gender transition procedures to an individual under eighteen (18) years of age is unprofessional conduct and shall, upon an adverse ruling by the appropriate licensing board, result in immediate revocation of the license or certificate of the physician or other healthcare professional. B. 1. A person may assert an actual or threatened violation of this act as a claim or defense in a judicial or administrative proceeding and obtain compensatory damages, injunctive relief, declaratory relief, or any other appropriate relief. 2. A person shall bring a claim for a violation of this act no later than two (2) years after the day the cause of action accrues. 3. An individual under eighteen (18) years of age may bring an action throughout their minority through a parent or next friend, and may bring an action in their own name upon reaching majority at Req. No. 1454 Page 10 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 any time from that point until twenty (20) years after reaching the age of majority. 4. Notwithstanding any other provision of law, an action under this subsection may be commenced, and relief may be granted, in a judicial proceeding without regard to whether the person commencing the action has sought or exhausted available administrative remedies. 5. In any action or proceeding to enforce a provision of this act, a prevailing party who establishes a violation of this act shall recover reasonable attorney fees. C. 1. The Attorney General may bring an action to enforce compliance with this act. 2. This act does not deny, impair, or otherwise affect any right or authority of the Attorney General, this state, or any agency, officer, or employee of the state, acting under any law other than this act, to institute or intervene in any proceeding. SECTION 6. It being immediately necessary for the preservation of the public peace, health or safety, an emergency is hereby declared to exist, by reason whereof this act shall take effect and be in full force from and after its passage and approval. 59-1-1454 DC 1/19/2023 10:08:29 AM