Text of PA HB 2421 (2024)

PRINTER'S NO. 3337 THE GENERAL ASSEMBLY OF PENNSYLVANIA HOUSE BILL No. 2421 Session of 2024 INTRODUCED BY ROAE, FEE, GREINER, HAMM, MENTZER, KAUFFMAN, FINK, ROWE, BANTA, COOK AND CUTLER, JUNE 20, 2024 REFERRED TO COMMITTEE ON HEALTH, JUNE 20, 2024 AN ACT Prohibiting gender transition procedures for minors and coverage for gender transition procedures for minors. The General Assembly of the Commonwealth of Pennsylvania hereby enacts as follows: Section 1. Short title. This act shall be known and may be cited as the Save Adolescents from Experimentation Act. Section 2. Declaration of purpose. The General Assembly finds and declares as follows: (1) The Commonwealth has a compelling government interest in protecting the health and safety of vulnerable minors. (2) Gender transition procedures are permanent and often irreversible treatments that carry serious known risks, ranging from increased risks of various types of cancer to infertility. (3) The vast majority of minors who express distress in identifying with their biological sex eventually come to 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 identify with their biological sex in adolescence or adulthood. (4) Studies have refuted the misconception that providing gender transition procedures to vulnerable minors reduces risk of suicide, psychiatric morbidities and mortality. (5) The risks of performing gender transition procedures on minors far outweigh any perceived benefits. (6) The provisions of this act only apply to minors. (7) An individual who has attained 18 years of age may continue to obtain gender transition procedures. Section 3. Definitions. The following words and phrases when used in this act shall have the meanings given to them in this section unless the context clearly indicates otherwise: "Biological sex." The biological indication of male and female in the context of reproductive potential or capacity, including 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. "Cross-sex hormones." Any of the following: (1) Testosterone or other androgens given to a biological female at doses that are profoundly larger or more potent than would normally occur naturally in a healthy biological female. (2) Estrogen given to a biological male at doses that are profoundly larger or more potent than would normally occur naturally in a healthy biological male. "Gender." The psychological, behavioral, social and cultural 20240HB2421PN3337 - 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 25 26 27 28 29 30 aspects of being male or female. "Gender transition." The process in which an individual goes from identifying with and living as a gender that corresponds to the individual's biological sex to identifying with and living as a gender different from the individual's biological sex which may involve social, legal or physical changes. "Gender transition procedure." All forms of treatments related to gender transition, including genital gender reassignment surgery, nongenital gender reassignment surgery, cross-sex hormones and puberty-blocking drugs. "Genital gender reassignment surgery." A genital medical procedure performed for the purpose of assisting an individual with a gender transition, including any of the following: (1) A surgical procedure, including penectomy, orchiectomy, vaginoplasty, clitoroplasty or vulvoplasty, for biologically male patients and hysterectomy or ovariectomy for biologically female patients. (2) Reconstruction of the fixed part of the urethra with or without a metoidioplasty. (3) Phalloplasty, vaginectomy, scrotoplasty or implantation of erection or testicular prostheses for biologically female patients. "Government program." A program of government-sponsored or government-subsidized health care coverage, including any of the following: (1) The children's health insurance program under Article XXIII-A of the act of May 17, 1921 (P.L.682, No.284), known as The Insurance Company Law of 1921. (2) The medical assistance program under Subdivision (f) of Article IV of the act of June 13, 1967 (P.L.31, No.21), 20240HB2421PN3337 - 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 25 26 27 28 29 30 known as the Human Services Code. "Health care practitioner." As defined in section 103 of the act of July 19, 1979 (P.L.130, No.48), known as the Health Care Facilities Act. "Health insurance policy." A policy, subscriber contract, certificate or plan issued by an insurer that provides medical or health care coverage. The term includes a dental only and a vision only policy. The term does not include: (1) An accident only policy. (2) A credit only policy. (3) A long-term care or disability income policy. (4) A specified disease policy. (5) A Medicare supplement policy. (6) A TRICARE policy, including a Civilian Health and Medical Program of the Uniformed Services (CHAMPUS) supplement policy. (7) A fixed indemnity policy. (8) A hospital indemnity policy. (9) A worker's compensation policy. (10) An automobile medical payment policy under 75 Pa.C.S. (relating to vehicles). (11) A homeowner's insurance policy. (12) Any other similar policies providing for limited benefits. "Insurer." An entity licensed by the Insurance Department that offers, issues or renews a health insurance policy and is governed under any of the following: (1) The act of December 29, 1972 (P.L.1701, No.364), known as the Health Maintenance Organization Act. (2) 40 Pa.C.S. Ch. 61 (relating to hospital plan 20240HB2421PN3337 - 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 25 26 27 28 29 30 corporations). (3) 40 Pa.C.S. Ch. 63 (relating to professional health services plan corporations). "Licensing board." Each licensing board within the Bureau of Professional and Occupational Affairs of the Department of State with jurisdiction over a health care practitioner. "Minor." An individual who is younger than 18 years of age. "Nongenital gender reassignment surgery." A nongenital medical procedure performed for the purpose of assisting an individual with a gender transition, including any of the following: (1) A surgical procedure for a biologically male patient, including augmentation mammoplasty, facial feminization surgery, liposuction, lipofilling, voice surgery, thyroid cartilage reduction, gluteal augmentation, hair reconstruction or various aesthetic procedures. (2) A surgical procedure for a biologically female patient, including subcutaneous mastectomy, voice surgery, liposuction, lipofilling, pectoral implants or various aesthetic procedures. "Pharmacist." An individual duly licensed by the State Board of Pharmacy to engage in the practice of pharmacy. "Physician." A medical doctor or doctor of osteopathy. "Puberty-blocking drugs." Any of the following: (1) Gonadotropin-releasing hormone analogs or other synthetic drugs used in a biological male patient to stop luteinizing hormone secretion and, therefore, testosterone secretion. (2) Synthetic drugs used in biological females that stop the production of estrogens and progesterone when used to 20240HB2421PN3337 - 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 25 26 27 28 29 30 delay or suppress pubertal development in children for the purpose of assisting an individual with a gender transition. Section 4. Prohibition on gender transition procedures for minors. (a) Prohibition on health care practitioners.-- (1) A health care practitioner may not perform gender transition procedures on a minor or refer a minor to receive gender transition procedures. (2) A health care practitioner with prescriptive authority may not prescribe cross-sex hormones or puberty- blocking drugs to a minor or refer a minor to be prescribed cross-sex hormones or puberty-blocking drugs. (b) Prohibition on pharmacists.--A pharmacist may not dispense cross-sex hormones or puberty-blocking drugs to a minor. (c) Construction.--Nothing in this section shall be construed to restrict any of the following: (1) Services provided to an individual born with a medically verifiable disorder of sex development, sex chromosome structure, sex steroid hormone production or sex steroid hormone action. (2) The treatment of an infection, injury, disease or disorder that has been caused or exacerbated by the performance of gender transition procedures. (3) Medically necessary procedures, as determined by a physician, undertaken to prevent death or impairment of a major bodily function. (4) Mental health treatment that is not prohibited under subsection (a). (d) Penalties.--A health care practitioner who violates 20240HB2421PN3337 - 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 25 26 27 28 29 30 subsection (a) shall be subject to discipline by the applicable licensing board with jurisdiction over the health care practitioner. A licensing board with jurisdiction over a health care practitioner who violates subsection (a) shall consider the violation to be a violation of the health care practitioner's scope of practice as specified under State law and grounds for sanctions as specified under State law. Section 5. Prohibition on coverage for gender transition procedures for minors. (a) Prohibition on insurers.--Except as authorized under section 4(c), an insurer may not provide a health insurance policy to provide coverage for gender transition procedures. (b) Prohibition on government programs.--Except as authorized under section 4(c), a government program may not provide coverage for gender transition procedures. Section 6. Severability. The provisions of this act are severable. If any provision of this act or its application to any person or circumstance is held invalid, the invalidity shall not affect other provisions or applications of this act which can be given effect without the invalid provision or application. Section 7. Effective date. This act shall take effect in 60 days. 20240HB2421PN3337 - 7 - 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23