Text of SC H 4624 (2024)
Gender Reassignment Procedures
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As introduced
10,058 characters
South Carolina General Assembly
125th Session, 2023-2024
Bill 4624
Indicates Matter Stricken
Indicates New Matter
(Text matches printed bills. Document has been reformatted to meet World Wide Web specifications.)
A bill
TO AMEND THE SOUTH CAROLINA CODE OF LAWS BY ADDING CHAPTER
42 to TITLE 44 SO AS TO DEFINE GENDER, SEX, AND OTHER TERMS, TO PROHIBIT THE
PROVISION OF GENDER TRANSITION PROCEDURES TO A PERSON UNDER EIGHTEEN YEARS OF
AGE, TO PROVIDE EXCEPTIONS, TO PROHIBIT THE USE OF PUBLIC FUNDS FOR GENDER
TRANSITION PROCEDURES, AND TO PROVIDE PENALTIES; AND BY ADDING SECTION 59-32-36
SO AS TO PROHIBIT PUBLIC SCHOOL STAFF AND OFFICIALS FROM WITHHOLDING KNOWLEDGE
OF A MINOR'S PERCEPTION OF THEIR GENDER FROM THE MINOR'S PARENTS, AMONG OTHER
THINGS.
Be it enacted by the
General Assembly of the State of South Carolina:
SECTION 1. Title 44 of the S.C. Code is amended by adding:
CHAPTER 42
Gender Reassignment Procedures
Section 44-42-310. For the purposes of this article:
(1)
"Sex" means the biological indication of male and female in the context of
reproductive potential or capacity, such as 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 testosterone, estrogen, or progesterone given to an
individual in an amount greater than would normally be produced endogenously in
a healthy individual of that individual's age and sex.
(3)
"Gender" means the psychological, behavioral, social, and cultural aspects of
being male or female.
(4)
"Gender reassignment surgery" means any surgical service that seeks to
surgically alter or remove healthy physical or anatomical characteristics or
features that are typical for the individual's sex, in order to instill or
create physiological or anatomical characteristics that resemble a sex
different from the individual's sex including, without limitation, genital or
nongenital gender reassignment surgery performed for the purpose of assisting
an individual with a gender transition.
(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 sex to identifying
with and living as a gender different from his or her sex, and may involve
social, legal, or physical changes.
(6)
"Gender transition procedures" means puberty-blocking drugs, cross-sex
hormones, or genital or nongenital gender reassignment surgery, provided or
performed for the purpose of assisting an individual with a physical gender
transition.
(7)
"Genital gender reassignment surgery" means a surgical procedure performed for
the purpose of assisting an individual with a physical gender transition
including, without limitation, penectomy, orchiectomy, vaginoplasty,
clitoroplasty, vulvoplasty, hysterectomy, ophorectomy, reconstruction of the
urethra, metoidioplasty or phalloplasty, vaginectomy, scrotoplasty, or
implantation of erection and/or testicular prostheses.
(8)
"Nongenital gender reassignment surgery" means surgical procedures performed
for the purpose of assisting an individual with a physical gender transition
including, without limitation, augmentation mammoplasty, facial feminization
surgery, liposuction, lipofilling, voice surgery, thyroid cartilage reduction,
gluteal augmentation, hair reconstruction, subcutaneous mastectomy, pectoral
implants, or various aesthetic procedures.
(9)
"Puberty-blocking drugs" means gonadotropin releasing hormone analogues or
other synthetic drugs used to stop luteinizing hormone and follicle stimulating
hormone secretion, synthetic antiandrogen drugs used to block the androgen
receptor, or any drug to suppress or delay normal pubertal development in
children.
Section
44-42-320. (A) A physician, mental health provider,
or other health care professional shall not knowingly provide gender transition
procedures to a person under eighteen years of age.
(B) A
physician, mental health provider, or other health care professional shall not
knowingly engage in conduct that aids or abets in the provision or performance
of gender transition procedures to a person under eighteen years of age. This
section may not be construed to impose liability on any speech protected by
federal or state law.
(C)
If prior to August 1, 2024, a health care professional initiated a course of
treatment that includes the prescription, delivery, or administration of a
puberty-blocking drug or a cross-sex hormone to a person under the age of
eighteen, and if the health care professional determines and documents in the
person's medical record that immediately terminating the person's use of the
drug or hormone would cause harm to the person, the health care professional
may institute a period during which the person's use of the drug or hormone is
systematically reduced. That period may not extend beyond January 31, 2025.
Section
44-42-330. Notwithstanding the provisions contained
in Section 44-42-320, a physician or other health care professional may provide
to a patient who is under eighteen years of age:
(1)
appropriate medical services to a person who was born with a medically
verifiable disorder of sexual development including, but not limited to, a
person with external biological sexual characteristics that are ambiguous
including, but not limited to, people who were born with forty-six XX
chromosomes with virilization or forty-six XY chromosomes with under
virilization or having both ovarian and testicular tissue;
(2)
appropriate medical services to treat a disorder of sexual development arising
because the person does not have normal sex chromosome structure, sex steroid
hormone production, or sex steroid hormone action that was diagnosed through
genetic or biochemical testing;
(3) 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 or
federal law; and
(4)
any procedure undertaken because the person suffers from a physical disorder,
physical injury, or physical illness that would, as certified by a physician,
place the person in imminent danger of death or impairment of a major bodily
function unless treated by the physician.
Section
44-42-340. Public funds may not be used directly or indirectly for gender
transition procedures.
Section
44-42-350. The South Carolina Medicaid Program shall not reimburse or provide
coverage for practices prohibited under the provisions of this chapter to an
individual under twenty-six (26) years of age.
Section
44-42-360. (A) The provision of services described
in Section 44-42-320 to any person under eighteen years of age shall, upon an
adverse ruling by the appropriate licensing board, be considered unprofessional
conduct and shall be subject to discipline by the licensing entity with
jurisdiction over the physician, mental health provider, or other medical
health care professional.
(B) A
person may assert an actual or threatened violation of Section 44-42-320 as a
claim or defense in a judicial or administrative proceeding and obtain
compensatory damages, injunctive relief, declaratory relief, or any other
appropriate relief.
(C) A
person shall be required to bring a claim for a violation of Section 44-42-320
no later than three years after the day the cause of action accrues. A minor
may bring an action before reaching eighteen years of age through a parent or
guardian and may bring an action in the minor's own name upon reaching eighteen
years of age at any time from that point until twenty-one years after.
(D)
An action or proceeding initiated under this section for an actual or
threatened violation of Section 44-42-320 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.
(E)
In any action or proceeding initiated under this section for an actual or
threatened violation of Section 44-42-320, the prevailing party shall be
entitled to recover reasonable attorneys' fees and court costs.
(F)
The Attorney General may bring an action to enforce compliance with Section
44-42-320 and Section 44-42-340. Nothing herein shall be construed to deny,
impair, or otherwise affect any right or authority of the Attorney General, the
State, or any agency, officer, or employee of the State to institute or
intervene in any proceeding.
SECTION 2. Chapter 32, Title 59 of the S.C. Code is amended by
adding:
Section
59-32-36. (A) A nurse, counselor, teacher,
principal, or other official or staff at a public school shall not knowingly:
(1)
encourage or coerce a minor to withhold from the minor's parent or legal
guardian the fact that the minor's perception of his or her gender is
inconsistent with his or her sex, as defined in Section 44-42-310; or
(2)
withhold from a minor's parent or legal guardian information related to the
minor's perception that his or her gender is inconsistent with his or her sex,
as defined in Section 44-42-310.
(B) A
teacher, school administrator, or other school employee who has reason to
believe or knows that a student suffers from gender dysphoria, gender identity
disorder, or other psychological conditions that can result in a person
identifying with a gender different than that of their sex, as defined in
Section 44-42-310, must notify the student's parent or legal guardian.
SECTION 3. This
act takes effect upon approval by the Governor.
----XX----
This web page was last updated on November 16, 2023 at 02:29 PM
As enrolled or final
11,904 characters
South Carolina General Assembly
125th Session, 2023-2024
Bill 4624
Indicates Matter Stricken
Indicates New Matter
(Text matches printed bills. Document has been reformatted to meet World Wide Web specifications.)
Indicates Matter
Stricken
Indicates New Matter
As Passed By The Senate
May 02, 2024
H. 4624
Introduced by Reps. Hiott, G. M. Smith, McCravy,
Davis, Vaughan, Trantham, Pope, Chapman, Taylor, Oremus, Hartnett, Leber, Long,
Nutt, Haddon, Burns, Chumley, Murphy, Mitchell, Brewer, Robbins, Gatch, West,
Gilliam, Cromer, Kilmartin, O'Neal, Yow, S. Jones, Landing, Ballentine,
Sandifer, Crawford, Guest, Willis, Ligon, Forrest, Pace, W. Newton, Bradley,
Erickson, Gibson, Blackwell and M. M. Smith
S. Printed 05/02/24--S. [SEC
5/7/2024 11:48 AM]
Read the first time January 18, 2024
________
A bill
TO AMEND THE SOUTH CAROLINA CODE OF LAWS BY ADDING CHAPTER
42 to TITLE 44 SO AS TO DEFINE GENDER, SEX, AND OTHER TERMS, TO PROHIBIT THE
PROVISION OF GENDER TRANSITION PROCEDURES TO A PERSON UNDER EIGHTEEN YEARS OF
AGE, TO PROVIDE EXCEPTIONS, TO PROHIBIT THE USE OF PUBLIC FUNDS FOR GENDER
TRANSITION PROCEDURES, AND TO PROVIDE PENALTIES; AND BY ADDING SECTION 59-32-36
SO AS TO PROHIBIT PUBLIC SCHOOL STAFF AND OFFICIALS FROM WITHHOLDING KNOWLEDGE
OF A MINOR'S PERCEPTION OF THEIR GENDER FROM THE MINOR'S PARENTS, AMONG OTHER
THINGS.
Amend Title To Conform
Be it enacted by the
General Assembly of the State of South Carolina:
SECTION 1. Title 44 of the S.C. Code is amended by adding:
CHAPTER 42
Gender Reassignment Procedures
Section 44-42-310. For the purposes of this article:
(1)
"Sex" means the biological indication of male and female in the context of
reproductive potential or capacity, such as 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 testosterone, estrogen, or progesterone given to an
individual in an amount greater than would normally be produced endogenously in
a healthy individual of that individual's age and sex.
(3)
"Gender" means the psychological, behavioral, social, and cultural aspects of
being male or female.
(4)
"Gender reassignment surgery" means any surgical service that seeks to
surgically alter or remove healthy physical or anatomical characteristics or
features that are typical for the individual's sex, in order to instill or
create physiological or anatomical characteristics that resemble a sex
different from the individual's sex including, without limitation, genital or
nongenital gender reassignment surgery performed for the purpose of assisting
an individual with a gender transition.
(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 sex to identifying
with and living as a gender different from his or her sex, and may involve
social, legal, or physical changes.
(6)
"Gender transition procedures" means puberty-blocking drugs, cross-sex
hormones, or genital or nongenital gender reassignment surgery, provided or
performed for the purpose of assisting an individual with a physical gender
transition.
(7)
"Genital gender reassignment surgery" means a surgical procedure performed for
the purpose of assisting an individual with a physical gender transition
including, without limitation, penectomy, orchiectomy, vaginoplasty,
clitoroplasty, vulvoplasty, hysterectomy, ophorectomy, reconstruction of the
urethra, metoidioplasty or phalloplasty, vaginectomy, scrotoplasty, or
implantation of erection and/or testicular prostheses.
(8)
"Nongenital gender reassignment surgery" means surgical procedures performed
for the purpose of assisting an individual with a physical gender transition
including, without limitation, augmentation mammoplasty, facial feminization
surgery, liposuction, lipofilling, voice surgery, thyroid cartilage reduction,
gluteal augmentation, hair reconstruction, subcutaneous mastectomy, pectoral
implants, or various aesthetic procedures.
(9)
"Puberty-blocking drugs" means gonadotropin releasing hormone analogues or
other synthetic drugs used to stop luteinizing hormone and follicle stimulating
hormone secretion, synthetic antiandrogen drugs used to block the androgen
receptor, or any drug to suppress or delay normal pubertal development in
children.
Section
44-42-320. (A)
A physician, mental health provider, or other health care professional shall
not knowingly provide gender transition procedures to a person under eighteen
years of age.
(B) A
physician, mental health provider, or other health care professional shall not
engage in the provision or performance of gender transition procedures to a
person under eighteen years of age. This section may not be construed to impose
liability on any speech protected by federal or state law.
(C)
If prior to August 1, 2024, a health care professional initiated a course of
treatment that includes the prescription, delivery, or administration of a
puberty-blocking drug or a cross-sex hormone to a person under the age of
eighteen, and if the health care professional determines and documents in the
person's medical record that immediately terminating the person's use of the
drug or hormone would cause harm to the person, the health care professional
may institute a period during which the person's use of the drug or hormone is
systematically reduced. That period may not extend beyond January 31, 2025.
(D) Subject
to the provisions in subsections (A) and (B), nothing in this section prohibits
a licensed health provider from offering mental health services within the
scope of his practice.
(E) A
physician who knowingly performs genital gender reassignment surgery in
violation of this chapter is guilty of inflicting great bodily injury upon a
child as provided for in Section 16-3-95(A).
Section
44-42-330. Notwithstanding the provisions contained
in Section 44-42-320, a physician or other health care professional may provide
to a patient who is under eighteen years of age:
(1)
appropriate medical services to a person for precocious puberty, prostate
cancer, breast cancer, endometriosis, or other procedure unrelated to gender
transition, or to a person who was born with a medically verifiable disorder of
sexual development including, but not limited to, a person with external
biological sexual characteristics that are ambiguous including, but not limited
to, people who were born with forty-six XX chromosomes with virilization or
forty-six XY chromosomes with under virilization or having both ovarian and
testicular tissue;
(2)
appropriate medical services to treat a disorder of sexual development arising
because the person does not have normal sex chromosome structure, sex steroid
hormone production, or sex steroid hormone action that was diagnosed through
genetic or biochemical testing;
(3) 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 or
federal law; and
(4)
any procedure undertaken because the person suffers from a physical disorder,
physical injury, or physical illness that would, as certified by a physician,
place the person in imminent danger of death or impairment of a major bodily
function unless treated by the physician.
Section
44-42-340. Public funds may not be used directly or indirectly for gender
transition procedures.
Section
44-42-350. The South Carolina Medicaid Program shall not reimburse or provide
coverage for practices prohibited under the provisions of this chapter.
Section
44-42-360. (A)
The provision of services described in Section 44-42-320 to any person under
eighteen years of age shall, upon an adverse ruling by the appropriate
licensing board, be considered unprofessional conduct and shall be subject to
discipline by the licensing entity with jurisdiction over the physician, mental
health provider, or other medical health care professional.
(B) A
person may assert an actual or threatened violation of Section 44-42-320 as a
claim or defense in a judicial or administrative proceeding and obtain
compensatory damages, injunctive relief, declaratory relief, or any other
appropriate relief.
(C) A
person shall be required to bring a claim for a violation of Section 44-42-320
no later than three years after the day the cause of action accrues. A minor
may bring an action before reaching eighteen years of age through a parent or
guardian and may bring an action in the minor's own name upon reaching eighteen
years of age at any time from that point until twenty-one years after.
(D)
An action or proceeding initiated under this section for an actual or
threatened violation of Section 44-42-320 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.
(E)
In any action or proceeding initiated under this section for an actual or
threatened violation of Section 44-42-320, the prevailing party shall be
entitled to recover reasonable attorneys' fees and court costs.
(F)
The Attorney General may bring an action to enforce compliance with Section
44-42-320 and Section 44-42-340. Nothing herein shall be construed to deny,
impair, or otherwise affect any right or authority of the Attorney General, the
State, or any agency, officer, or employee of the State to institute or
intervene in any proceeding.
SECTION 2. Chapter 32, Title 59 of the S.C. Code is amended by
adding:
Section
59-32-36. (A)
A nurse, counselor, teacher, principal, or other official or staff at a public
school shall not knowingly:
(1)
encourage or coerce a minor to withhold from the minor's parent or legal
guardian the fact that the minor's perception of his or her gender is
inconsistent with his or her sex, as defined in Section 44-42-310; or
(2)
withhold from a minor's parent or legal guardian information related to the
minor's perception that his or her gender is inconsistent with his or her sex,
as defined in Section 44-42-310.
(B)
The principal, vice principal, or counselor at a public school shall
immediately notify in writing a minor's parent or legal guardian if the minor:
(1)
asserts to any school employee that the minor's gender is inconsistent with his
or her sex, as defined in Section 44-42-310; or
(2)
requests a school employee to address a minor using a pronoun or title that
does not align with the minor's sex.
SECTION 3. If any section, subsection,
paragraph, subparagraph, sentence, clause, phrase, or word of this act is for
any reason held to be unconstitutional or invalid, such holding shall not
affect the constitutionality or validity of the remaining portions of this act,
the General Assembly hereby declaring that it would have passed this act, and
each and every section, subsection, paragraph, subparagraph, sentence, clause,
phrase, and word thereof, irrespective of the fact that any one or more other
sections, subsections, paragraphs, subparagraphs, sentences, clauses, phrases,
or words hereof may be declared to be unconstitutional, invalid, or otherwise
ineffective.
SECTION 4. This act takes effect upon approval
by the Governor.
----XX----
This web page was last updated on May 07, 2024 at 11:49 AM