Text of RI S 2598 (2026)

2026 -- S 2598 ======== LC003338 ======== S T A T E O F R H O D E I S L A N D IN GENERAL ASSEMBLY JANUARY SESSION, A.D. 2026 ____________ A N A C T RELATING TO HEALTH AND SAFETY -- RHODE ISLAND'S CHILDREN DESERVE HELP NOT HARM ACT -- MINOR'S GENDER TRANSITION Introduced By: Senator E Morgan Date Introduced: February 13, 2026 Referred To: Senate Judiciary It is enacted by the General Assembly as follows: SECTION 1. Legislative findings and purpose. 1 The general assembly finds that: 2 (1) Rhode Island has a compelling government interest protecting the health and safety of 3 its citizens, especially vulnerable children; 4 (2) Only a small percentage of the American population experiences distress identifying 5 with their biological sex; 6 (3) For the small percentage of children who are gender nonconforming or experience 7 distress identifying with their biological sex, studies consistently demonstrate that the majority 8 come to embrace their biological sex in adolescence or adulthood, thereby rendering most medical 9 physiological interventions unnecessary; 10 (4) Scientific studies show that individuals experiencing distress identifying with their 11 biological sex have often experienced severe psychopathology preceding their gender dysphoria, 12 which indicates these individuals could benefit greatly from access to mental healthcare services; 13 (5) Even among individuals who have undergone inpatient gender reassignment 14 procedures, suicide rates, psychiatric morbidities, and mortality rates remain markedly elevated 15 above the background population; 16 (6) Some healthcare professionals are prescribing puberty-blocking drugs such as 17 gonadotropin-releasing hormone analogues, in order to delay the natural onset or progression of 18 LC003338 - Page 2 of 11 puberty in children, who experience distress identifying with their biological sex: 1 (i) Puberty-blocking drugs are being prescribed, despite the lack of any long-term 2 longitudinal studies evaluating the risks and benefits of using these drugs for the treatment of such 3 distress or gender dysphoria; and 4 (ii) Puberty-blocking drugs are being prescribed in an off-label and experimental manner 5 on children; 6 (7) Some healthcare professionals are also prescribing cross-sex hormones for children 7 who are experiencing distress identifying with their biological sex, despite the fact no randomized 8 clinical trials have been conducted on the efficacy or safety of the use of cross-sex hormones in 9 adults or children for the purpose of gender transition; 10 (8) The use of cross-sex hormones comes with serious known risks: 11 (i) For biological females, some risks may include; 12 (A) Irreversible infertility; 13 (B) Severe liver dysfunction; 14 (C) Coronary artery disease, including heart attacks; 15 (D) Increased risk of breast, cervical, and uterine cancers; 16 (E) Cerebrovascular disease, including strokes; 17 (F) Hypertension; 18 (G) Erythrocytosis, which is an increase in red blood cells; 19 (H) Sleep apnea; 20 (I) Type 2 diabetes; 21 (J) Loss of bone density; and 22 (K) Destabilization of psychiatric disorders; 23 (ii) For biological males, some risks may include: 24 (A) Irreversible infertility; 25 (B) Thromboembolic disease, including blood clots; 26 (C) Cholelithiasis, including gallstones; 27 (D) Coronary artery disease, including heart attacks; 28 (E) Type 2 diabetes; 29 (F) Breast cancer; 30 (G) Macroprolactinoma, which is a tumor of the pituitary gland; 31 (H) Cerebrovascular disease, including strokes; and 32 (I) Hypertriglyceridemia, which is an elevated level of triglycerides in the blood; 33 (9) Genital and non-genital gender reassignment surgeries are generally not recommended 34 LC003338 - Page 3 of 11 for children, although evidence indicates referrals for children to have such surgeries are becoming 1 more frequent; 2 (10) Genital gender reassignment surgery includes several irreversible invasive procedures 3 for males and females and involves the alteration of biologically healthy and functional body parts. 4 These procedures are generally irreversible; 5 (i) For biological males, surgery may involve: 6 (A) Genital reconstruction, including a penectomy, which is the removal of the penis; 7 (B) Orchiectomy, which is the removal of the testicles; 8 (C) Vaginoplasty, which is the construction of a vagina-like structure, typically through a 9 penile inversion procedure; 10 (D) Clitoroplasty which is the construction of a clitoris-like structure; and 11 (E) Vulvoplasty, which is the construction of a vulva-like structure; 12 (ii) For biological females, surgery may involve: 13 (A) Hysterectomy or oophorectomy; 14 (B) Reconstruction of the urethra; 15 (C) Genital reconstruction including metoidioplasty or phalloplasty, which is the 16 construction of a penis-like structure; 17 (D) Vaginectomy, which is the removal of the vagina; 18 (E) Scrotoplasty, which is the construction of a scrotum-like structure; and 19 (F) Implantation of erection and/or testicular prosthesis; 20 (iii) The complications, risks, and long-term care concerns associated with genital sex 21 reassignment surgery, for both males and females, are numerous and complex; 22 (iv) Non-genital sex reassignment surgery includes various invasive procedures for males 23 and females and also involves the alteration or removal of biologically healthy, and functional body 24 parts: 25 (A) For biological males, this surgery may involve: 26 (I) Augmentation mammoplasty; 27 (II) Facial feminization surgery; 28 (III) Liposuction; 29 (IV) Lipofilling; 30 (V) Voice feminization surgery; 31 (VI) Thyroid cartilage reduction; 32 (VII) Gluteal augmentation; 33 (VIII) Hair reconstruction; and 34 LC003338 - Page 4 of 11 (IX) Other aesthetic procedures; 1 (B) For biological females, this surgery may involve: 2 (I) Subcutaneous mastectomy; 3 (II) Voice masculinization surgery; 4 (III) Liposuction; 5 (IV) Lipofilling; 6 (V) Pectoral implants; and 7 (VI) Other aesthetic procedures; 8 (11) It is an accepted principle of economics and public policy that when a service or 9 product is subsidized or reimbursed, demand for that service or product increases; and 10 (12) It is of grave concern to this general assembly that the medical community is allowing 11 individuals, who experience distress identifying with their biological sex, to be subjects of 12 irreversible and drastic non-genital gender reassignment surgery and irreversible, permanently 13 sterilizing genital gender reassignment surgeries, despite the lack of studies showing that such 14 extreme interventions have benefits that outweigh their risks or chances of cure. In fact, they may 15 increase the risk of suicide. 16 SECTION 2. Title 23 of the General Laws entitled "HEALTH AND SAFETY" is hereby 17 amended by adding thereto the following chapter: 18 CHAPTER 106 19 RHODE ISLAND'S CHILDREN DESERVE HELP NOT HARM ACT 20 23-106-1. Short title. 21 This chapter shall be known and may be cited as the "Rhode Island's Children Deserve 22 Help Not Harm Act". 23 23-106-2. Definitions. 24 The following definitions apply in the interpretation of the provisions of this chapter: 25 (1) "Biological sex" means the biological indication of male and female in the context of 26 reproductive potential or capacity, such as sex chromosomes, naturally occurring sex hormones, 27 gonads, and nonambiguous internal and external genitalia, present at birth, including secondary sex 28 characteristics. 29 (2) "Cross-sex hormones" means: 30 (i) Testosterone or other androgens given to biological females in amounts that create 31 serum levels greater than would normally occur naturally in healthy biological females, which may 32 include without limitation, the following risks: 33 (A) Irreversible infertility; 34 LC003338 - Page 5 of 11 (B) Severe liver dysfunction; 1 (C) Coronary artery disease, including heart attacks; 2 (D) Increased risk of breast, cervical, and uterine cancers; 3 (E) Cerebrovascular disease, including strokes; 4 (F) Hypertension; 5 (G) Erythrocytosis, which is an increase in red blood cells; 6 (H) Sleep apnea; 7 (I) Type 2 diabetes; 8 (J) Loss of bone density; and 9 (K) Destabilization of psychiatric disorders; 10 (ii) Estrogen given to biological males, in amounts that create serum levels greater than 11 would normally occur naturally in healthy biological males, which may include without limitation 12 the following risks: 13 (A) Irreversible infertility; 14 (B) Thromboembolic disease, including blood clots; 15 (C) Cholelithiasis, including gallstones; 16 (D) Coronary artery disease, including heart attacks; 17 (E) Type 2 diabetes; 18 (F) Breast cancer; 19 (G) Macroprolactinoma, which is a tumor of the pituitary gland; 20 (H) Cerebrovascular disease, including strokes; and 21 (I) Hypertriglyceridemia, which is an elevated level of triglycerides in the blood. 22 (3) "Gender" means the psychological, behavioral, social and cultural aspects of being male 23 and female. 24 (4) "Gender reassignment surgery" means any surgical service that seeks to surgically alter 25 or remove healthy physical or anatomical characteristics or features, that are typical for the 26 individual's biological sex, in order to instill or create physiological or anatomical characteristics, 27 that resemble a sex different from the individual's biological sex, including, without limitation, 28 genital or non-genital gender reassignment surgery performed for the purpose of assisting an 29 individual with a gender transition. 30 (5) "Gender transition" means the process in which a person goes from identifying with 31 and living as a gender that corresponds to their biological sex, and may involve social, legal, or 32 physical changes. 33 (6) "Gender transition procedures" means any medical or surgical service provided or 34 LC003338 - Page 6 of 11 performed for the purpose of assisting an individual with a physical gender transition: 1 (i) Gender transition procedures include, without limitation, physician's services, inpatient 2 and outpatient hospital services, puberty-blocking drugs, cross-sex hormones, or genital or non- 3 genital gender reassignment surgery; 4 (ii) Gender transition procedures do not include: 5 (A) Services to persons born with a medically verifiable disorder of sex development, 6 including a person with external biological sex characteristics that are irresolvably ambiguous, such 7 as those born with 46 XX chromosomes with virilization, 46 XY chromosomes with 8 undervirilization, or having both ovarian and testicular tissue; 9 (B) Services provided when a physician has otherwise diagnosed a disorder of sexual 10 development, that the physician has determined through genetic or biochemical testing that the 11 person does not have normal sex chromosome structure, sex steroid production, or sex steroid 12 hormone action; 13 (C) The acute and chronic treatment of any infection, injury, disease, or disorder that has 14 been caused by or exacerbated by the performance of gender transition procedures, whether or not 15 the gender transition procedure, was performed in violation of state or federal law or whether or 16 not funding for the gender transition procedure is prohibited pursuant to the provisions of this 17 chapter; or 18 (D) Any procedure undertaken because the individual suffers from a physical disorder, 19 physical injury, or physical illness that would, as certified by a physician, place the individual in 20 imminent danger of death or impairment of major bodily function, unless surgery is performed. 21 (7) "Genital gender reassignment surgery" means a surgical procedure performed for the 22 purpose of assisting an individual with a physical gender transition, including, without limitation: 23 (i) Surgical procedures such as a penectomy, orchiectomy, vaginoplasty, clitoroplasty, or 24 vulvoplasty for biologically male patients; or 25 (ii) Surgical procedures such as hysterectomy, oophorectomy, reconstruction of the 26 urethra, metoidioplasty or phalloplasty, vaginectomy, scrotoplasty, or implantation of erection 27 and/or testicular protheses for biologically female patients. 28 (8) "Non-genital gender reassignment surgery" means surgical procedures performed for 29 the purpose of assisting an individual with a physical gender transition, including, without 30 limitation: 31 (i) Surgical procedures for biologically male patients, such as augmentation mammoplasty, 32 facial feminization surgery, liposuction, lipofilling, voice feminization surgery, thyroid cartilage 33 reduction, gluteal augmentation, hair reconstruction, or various aesthetic procedures; or 34 LC003338 - Page 7 of 11 (ii) Surgical procedures for biologically female patients, such as subcutaneous mastectomy, 1 voice masculinization surgery, liposuction, lipofilling, pectoral implants, or various aesthetic 2 procedures. 3 (9) "Physician" means a person who is licensed to practice medicine in this state. 4 (10) "Puberty-blocking drugs" means gonadotropin-releasing hormone analogues or other 5 synthetic drugs used in biological males to stop luteinizing hormone secretion and therefore 6 testosterone production, or synthetic drugs used in biological females, which stop the production 7 of estrogen and progesterone, when used to delay or suppress pubertal development in children, for 8 the purpose of assisting an individual with a gender transition. 9 (11) "Public funds" means state or local government monies, in addition to any department, 10 agency, or instrumentality authorized or appropriated under state law or derived from any fund in 11 which monies are deposited. 12 23-106-3. Gender transition procedures for minors prohibited. 13 (a) A physician or other healthcare professional shall not provide gender transition 14 procedures to any individual under eighteen (18) years of age. 15 (b) A healthcare institution or entity shall not facilitate the provision of gender transition 16 procedures to any individual under eighteen (18) years of age. 17 23-106-4. Insurance coverage for gender transition procedures for minors prohibited. 18 (a) A health benefit plan under an insurance policy or other plan providing healthcare 19 coverage in this state shall not include reimbursement for gender transition procedures for a person 20 under eighteen (18) years of age. 21 (b) A health benefit plan under an insurance policy or other plan providing healthcare 22 coverage in this state is not required to provide coverage for gender transition procedures. 23 (c) A federal health benefit plan under an insurance policy or other plan providing 24 healthcare coverage, such as TRICare or Veterans Administration Healthcare, shall not include 25 reimbursement for gender transition procedures for a person under eighteen (18) years of age in 26 this state. 27 23-106-5. Prohibition on aiding or abetting. 28 (a) A person or entity shall not knowingly engage in conduct that aids or abets the 29 performance or inducement of gender transition procedures, to any individual under eighteen (18) 30 years of age, including employees of other state governments, the federal government, or foreign 31 governments. 32 (b) This provision shall not apply to any first amendment-protected speech. 33 (c) No parent of a child victim shall be held liable under this section. 34 LC003338 - Page 8 of 11 23-106-6. Prohibition on use of public funds for gender transition. 1 (a) Public funds shall not be directly or indirectly used, granted, paid, or distributed to any 2 entity, organization, or individual that provides gender transition procedures to an individual under 3 eighteen (18) years of age. 4 (b) Healthcare services furnished in the following situations shall not include gender 5 transition procedures to an individual under eighteen (18) years of age: 6 (1) By or in a facility owned by the state or a local government; or 7 (2) By a physician or other healthcare professional employed by the state or local 8 government. 9 (c) An amount paid by an individual or an entity, during a taxable year, for provision of 10 gender transition procedures or as premiums for healthcare coverage, that includes coverage for 11 gender transition procedures, is not tax-deductible. 12 (d) The state Medicaid program shall not reimburse or provide coverage for gender 13 transition procedures to an individual under eighteen (18) years of age. 14 23-106-7. Gender transition procedures on minors constitute unprofessional and 15 reckless conduct. 16 Any referral for or provision of gender transition procedures to an individual, under 17 eighteen (18) years of age, is unprofessional conduct and is subject to discipline by the appropriate 18 licensing entity or disciplinary review board, with competent jurisdiction in this state. 19 23-106-8. Private cause of action. 20 Every person who subjects or causes to be subjected any citizen of this state or other person 21 within the jurisdiction to suffer injury by violating the provisions of this chapter shall be liable to 22 the party injured in an action at law, suit in equity, or other appropriate proceedings for redress in 23 the superior court of this state. The court may award attorney fees and costs to a prevailing plaintiff. 24 23-106-9. Enforcement actions for recovery of damages suffered as a result of gender 25 transition procedures on minors. 26 (a) Statute of limitations: 27 (1) Notwithstanding any other provision of law, an individual under eighteen (18) years of 28 age may bring an action, throughout their minority, through a parent or next friend, and may bring 29 an action in their own name, upon reaching the age of majority at any time from that point until 30 thirty (30) years after reaching the age of majority. 31 (2) Exceptions: 32 (i) If at the time the person abused or suffering damages as a result of acts violating the 33 provisions of this chapter, attains the age of eighteen (18) years and is under disability by reason 34 LC003338 - Page 9 of 11 of mental incompetence or under other legal disability, the limitation period under subsection (a)(1) 1 of this section does not begin to run until the removal of the disability; and 2 (ii) The limitation period in subsection (a)(1) of this section does not run during a time 3 period when the individual is subject to threats, intimidation, manipulation, fraudulent 4 concealment, or fraud perpetrated by the physician or other healthcare professional, who prescribed 5 or otherwise provided gender transition procedures or by any person, acting in the interest of the 6 physician or other healthcare professional. 7 (b) A person may assert an actual or threatened violation of this chapter, as a claim or 8 defense in a judicial or administrative proceeding. 9 (1) The following damages may be awarded to the claimant: 10 (i) Compensatory damages, including, but not limited to: 11 (A) Pain and suffering; 12 (B) Loss of reputation; 13 (C) Loss of income; and 14 (D) Loss of consortium, including, but not limited to, the loss of expectation of sharing 15 parenthood; 16 (ii) Injunctive relief; 17 (iii) Declaratory relief; 18 (iv) Punitive damages; 19 (v) Any other appropriate relief; and 20 (vi) A prevailing party, who establishes a violation of this chapter shall recover reasonable 21 attorneys' fees and cost. 22 (c) Notwithstanding any other provision of law, an action under this chapter, may be 23 commenced, and relief may be granted, in a judicial proceeding, without regard to whether the 24 person commencing the action has sought or exhausted available administrative remedies. 25 (d) The attorney general may bring an action to enforce compliance with this chapter. 26 (e) This chapter does not deny, impair, or otherwise affect any right or authority of the 27 attorney general, the State of Rhode Island, or any agency, officer, or employee of the state, acting 28 under any law, other than this chapter, to institute or intervene in any proceeding. 29 23-106-10. Right of intervention. 30 The general assembly, by joint resolution, may appoint one or more of its members who 31 sponsored or cosponsored this chapter in their official capacity, to intervene or defend the chapter 32 as a matter of right, in any case in which the constitutionality or enforceability of this chapter, any 33 portion thereof, or any rule or regulation adopted pursuant hereto, is challenged. 34 LC003338 - Page 10 of 11 23-106-11. Severability. 1 Any provision of this chapter held to be invalid or unenforceable by its terms, or as applied 2 to any person or circumstance, shall be construed so as to give it the maximum effect, permitted by 3 law, unless such holding, shall be one of utter invalidity or unenforceability, in which event such 4 provision shall be deemed severable herefrom and shall not affect the remainder hereof or the 5 application of such provision to other persons not similarly situated to or to other, dissimilar 6 circumstances. 7 23-106-12. Effective date. 8 This act shall take effect on January 1, 2027, in order that minors in this state currently 9 using puberty-blocking drugs or cross-sex hormones, shall have the time for appropriate medication 10 tapering and discontinuation, under the care of their physician or other healthcare professional. 11 SECTION 3. This act shall take effect on January 1, 2027. 12 ======== LC003338 ======== LC003338 - Page 11 of 11 EXPLANATION BY THE LEGISLATIVE COUNCIL OF A N A C T RELATING TO HEALTH AND SAFETY -- RHODE ISLAND'S CHILDREN DESERVE HELP NOT HARM ACT -- MINOR'S GENDER TRANSITION *** This act would prohibit gender transition procedures for all minors, use of public funds for 1 that purpose, discipline for health care providers for providing same, a thirty (30) year statute of 2 limitation, after reaching the age of majority, and right to a civil action for damages. 3 This act would take effect on January 1, 2027. 4 ======== LC003338 ========