SESSION OF 2023
SUPPLEMENTAL NOTE ON SENATE BILL NO. 233
As Recommended by Senate Committee on
Public Health and Welfare
Brief*
SB 233 would create the Kansas Child Mutilation
Prevention Act (Act). The bill would allow an individual who
had gender reassignment service performed as a child to
bring a civil cause of action under the Act against the
physician who performed such service. The bill would
establish the statute of limitations for such cause of action,
the medically verifiable disorders of sex development to
which the Act would not apply, the relief that could be sought,
and the time frame to which the Act would apply. The
provisions of the Act would not apply if the child was born with
a medically verifiable disorder of sex development, as defined
in the bill.
The bill also would require the Kansas State Board of
Healing Arts (Board) to revoke the license of a physician who
performed a childhood gender reassignment service.
Definitions
The bill would define the following terms:
●“Childhood gender reassignment service” would
mean performing, or causing to be performed, acts
including, but not limited to, any of the following
performed on a child under 18 years of age for the
purpose of attempting to affirm the child’s
____________________
*Supplemental notes are prepared by the Legislative Research
Department and do not express legislative intent. The supplemental
note and fiscal note for this bill may be accessed on the Internet at
http://www.kslegislature.org perception of the child’s sex or gender, if that
perception is inconsistent with the child’s sex:
○A surgery that sterilizes or is intended to result
in sterilization, including, but not limited to,
castration, vasectomy, hysterectomy,
oophorectomy, orchiectomy and penectomy;
○A surgery that artificially constructs tissue with
the appearance of genitalia, including, but not
limited to, metoidioplasty, phalloplasty, and
vaginoplasty;
○A mastectomy;
○Prescribing, dispensing, administering or
otherwise supplying the following
medications:
- Puberty-blocking medication to delay, hinder,
stop, or reverse normal puberty;
- Supraphysiologic doses of testosterone to
females; or
- Supraphysiologic doses of estrogen to
males; or
○Removing any body part or tissue;
●“Physician” would mean a person licensed by the
Board to practice medicine and surgery;
●“Sex” would mean the biological state of being
female or male based on the individual’s sex
organs, chromosomes and endogenous hormone
profiles; and
●“Supraphysiologic doses” would mean a
pharmacologic dosage regimen that produces
blood concentrations greater than the accepted
range for a child’s age and sex.
2- 233 Medically Verifiable Disorder of Sex Development
The Act would not apply if a child was born with a
medically verifiable disorder of sex development, including,
but not limited to:
●A child with external biological sex characteristics
that are irresolvably ambiguous, such as a child
born having 46,XX chromosomes with virilization,
46,XY chromosomes with undervirilization, or both
ovarian and testicular tissue; or
●When a physician has otherwise diagnosed a
disorder of sexual development, determined
through genetic or biochemical testing, that the
child does not have the normal sex chromosome
structure, sex steroid hormone production, or sex
steroid hormone action for a male or female of the
child’s age.
Civil Cause of Action
Statute of Limitations
The bill would allow a civil cause of action under the Act
to be commenced no more than three years after the date the
individual attains 18 years of age.
Time Frame for Application of Act
The Act would apply to:
●Any action commenced on or after July 1, 2023,
including any action that would be barred by the
period of limitation applicable prior to such date;
and
3- 233 ●Any action commenced prior to July 1, 2023, and
pending on such date.
Available Relief
The bill would provide that an individual who brings a
civil cause of action under the Act could seek actual
damages, exemplary or punitive damages, injunctive relief,
and other appropriate relief. The bill would require the court to
award the prevailing plaintiff the cost of the suit including
reasonable attorney fees.
Physician License Revocation
The bill would require the Board to revoke a physician’s
license upon a finding that the physician had performed a
childhood gender reassignment service, as defined by the
Act.
Background
The bill was introduced by the Senate Committee on
Federal and State Affairs at the request of Senator
Thompson.
Senate Committee on Public Health and Welfare
In the Senate Committee hearing, proponent testimony
was provided by Senator Thompson, two private citizens, two
physicians, a member of the clergy, and a representative of
MassResistance. The proponents generally stated the bill
would protect minors from medical and chemical procedures
used to change a child’s gender. The proponents stated the
decision to accede to gender reassignment services should
be made only by the individuals on whom the services would
be performed and who are at an age when they can take
responsibility for and fully understand the risks and impact of
4- 233 such choices. Two proponents testified as to their negative
experiences with gender reassignment services.
Written-only proponent testimony was provided by an
endocrinologist, a representative of American Family Action of
Kansas and Missouri, two attorneys, and 28 additional
proponents.
Opponent testimony was provided by an advanced
practice registered nurse, a physician, and representatives of
the American Civil Liberties Union of Kansas, Kansas
Chapter of the American Academy of Pediatrics, and Kansas
Interfaith Action. The opponents generally stated the bill
would negatively affect the lives of transgender youth and
young adults, including directly causing an increase in
suicide-related deaths; would prevent parents from protecting
and caring for the health of their minor children and making
decisions in partnership with medical providers without
government infringement; and would cause physicians
practicing within their scope of practice with informed consent
from a patient, guardian, or both, to be fearful of losing their
license. One proponent spoke about a positive experience
with gender reassignment services.
Written-only opponent testimony was provided by
Representative Woodard, a licensed clinical professional
counselor, a representative of the University of Kansas
School of Social Welfare, and more than 130 additional
opponents.
Fiscal Information
According to the fiscal note prepared by the Division of
the Budget on the bill, the Board states the enactment of the
bill could result in actionable complaints, which would
increase the staff workload of the Board. The total fiscal effect
cannot be estimated.
5- 233 The Office of Judicial Administration (Office) states
enactment of the bill could increase the number of cases filed
in district court because it allows for a civil suit to be filed
against a physician who performed a childhood gender
reassignment service, which could result in more time spent
by district court judicial and nonjudicial personnel in
processing, researching, and hearing these cases. The Office
estimates enactment of the bill could result in the collection of
docket fees assessed in those cases filed under the bill’s
provisions. According to the Office, a fiscal effect cannot be
estimated.
Any fiscal effect associated with enactment of the bill is
not reflected in The FY 2024 Governor’s Budget Report.
Kansas Child Mutilation Prevention Act; gender reassignment services; civil cause of
action; statute of limitations; State Board of Healing Arts; physician licensure
revocation
6- 233