UNOFFICIAL COPY 22 RS BR 1408
Page 1 of 7
XXXX Jacketed
AN ACT relating to children's health. 1
Be it enacted by the General Assembly of the Commonwealth of Kentucky: 2
SECTION 1. A NEW SECTION OF KRS CHAPTER 311 IS CREATED TO 3
READ AS FOLLOWS: 4
As used in Sections 1 to 5 of this Act: 5
(1) "Biological sex" means the biological indication of male and female in the 6
context of reproductive potential or capacity, such as sex chromosomes, naturally 7
occurring sex hormones, gonads, and nonambiguous internal and external 8
genitalia present at birth, without regard to a person’s psychological, chosen, or 9
subjective experience of gender; 10
(2) "Cross-sex hormones" means: 11
(a) Testosterone or other androgens given to biological females in amounts that 12
are larger or more potent than would normally occur naturally in healthy 13
biological females; and 14
(b) Estrogen given to biological males in amounts that are larger or more 15
potent than would normally occur naturally in healthy biological males; 16
(3) "Gender" means the psychological, behavioral, social, and cultural aspects of 17
being male or female; 18
(4) "Gender reassignment surgery" means any medical or surgical service that seeks 19
to surgically alter or remove healthy physical or anatomical characteristics or 20
features that are typical for the person’s biological sex in order to instill or create 21
physiological or anatomical characteristics that resemble a sex different from the 22
person’s biological sex, including but not limited to genital or nongenital gender 23
reassignment surgery performed for the purpose of assisting a person with a 24
gender transition; 25
(5) "Gender transition" means the process in which a person goes from identifying 26
with and living as a gender that corresponds to his or her biological sex to 27 UNOFFICIAL COPY 22 RS BR 1408
Page 2 of 7
XXXX Jacketed
identifying with and living as a gender different from his or her biological sex, 1
and may involve social, legal, or physical changes; 2
(6) (a) "Gender transition procedures" means any medical or surgical service 3
provided or performed for the purpose of assisting a person with a physical 4
gender transition. Gender transition procedures include but are not limited 5
to physician’s services, inpatient and outpatient hospital services, puberty-6
blocking drugs, cross-sex hormones, or genital or nongenital gender 7
reassignment surgery. 8
(b) Gender transition procedures do not include: 9
1. Services to persons born with a medically verifiable disorder of sex 10
development, including a person with unresolvable, ambiguous 11
external biological sex characteristics, such as those born with forty-12
six (46) XX chromosomes with virilization, forty-six (46) XY 13
chromosomes with undervirilization, or having both ovarian and 14
testicular tissue; 15
2. Services provided when a physician has otherwise diagnosed a 16
disorder of sexual development that the physician has determined 17
through genetic or biochemical testing indicates that a person does not 18
have normal sex chromosome structure, sex steroid production, or sex 19
steroid hormone action; 20
3. The acute and chronic treatment of any infection, injury, disease, or 21
disorder that has been caused by or exacerbated by the performance of 22
gender transition procedures, whether or not the gender transition 23
procedure was performed in accordance with state and federal law or 24
whether or not funding for the gender transition procedure is 25
permissible under Sections 1 to 5 of this Act; or 26
4. Any procedure undertaken because a person suffers from a physical 27 UNOFFICIAL COPY 22 RS BR 1408
Page 3 of 7
XXXX Jacketed
disorder, physical injury, or physical illness that would, as certified by 1
a physician, place the person in imminent danger of death or 2
impairment of major bodily function unless surgery is performed; 3
(7) "Health care provider" has the same meaning as in KRS 304.17A-005; 4
(8) "Nongenital gender reassignment surgery" means medical procedures performed 5
for the purpose of assisting a person with a physical gender transition, including 6
but not limited to: 7
(a) Surgical procedures for biologically male patients, such as augmentation 8
mammoplasty, facial feminization surgery, liposuction, lipofilling, voice 9
feminization surgery, thyroid cartilage reduction, gluteal augmentation, 10
hair reconstruction, or various aesthetic procedures; or 11
(b) Surgical procedures for biologically female patients, such as subcutaneous 12
mastectomy, voice masculinization surgery, liposuction, lipofilling, pectoral 13
implants, or various aesthetic procedures; 14
(9) "Physician" has the same meaning as in KRS 311.550; 15
(10) "Puberty-blocking drugs" means gonadotropin-releasing hormone analogues or 16
other synthetic drugs used in biological males to stop luteinizing hormone 17
secretion and therefore testosterone secretion, or synthetic drugs used in 18
biological females which stop the production of estrogen and progesterone, when 19
used to delay or suppress pubertal development in children for the purpose of 20
assisting a child with a gender transition; and 21
(11) "Public funds" means the same as in KRS 446.010. 22
SECTION 2. A NEW SECTION OF KRS CHAPTER 311 IS CREATED TO 23
READ AS FOLLOWS: 24
(1) A physician or other health care provider shall not provide gender transition 25
procedures to any child under the age of eighteen (18) years. 26
(2) A physician or other health care provider shall not refer any child under the age 27 UNOFFICIAL COPY 22 RS BR 1408
Page 4 of 7
XXXX Jacketed
of eighteen (18) years to any health care provider for gender transition 1
procedures. 2
(3) Any referral for or provision of gender transition procedures to a child under the 3
age of eighteen (18) years by a health care provider shall be considered 4
unprofessional conduct and be subject to disciplinary action by the appropriate 5
licensing or certifying entity. 6
SECTION 3. A NEW SECTION OF KRS CHAPTER 311 IS CREATED TO 7
READ AS FOLLOWS: 8
(1) Any violation of Section 2 of this Act shall be deemed as acting recklessly as 9
defined in KRS 501.020 for purposes of tort claims. 10
(2) Notwithstanding any other provision of the law to the contrary, for any violation 11
of Section 2 of this Act, the action may be brought by the child's parent or 12
guardian before the child attains age eighteen (18) years and may be brought by 13
the child within thirty (30) years after the child attains the age of eighteen (18) 14
years except: 15
(a) If at the time the child attains the age of eighteen (18) years he or she is 16
under other legal disability, the limitation period shall not begin to run until 17
the removal of the disability; or 18
(b) If during any period of time the person is subject to threats, intimidation, 19
manipulation, fraudulent concealment, or fraud perpetrated by the 20
physician or health care provider who prescribed or otherwise provided 21
gender transition procedures or by any person acting in the interest of the 22
physician or other health care provider, the limitation period shall not run 23
during this time period. 24
(3) A person may assert an actual or threatened violation of Section 2 of this Act as a 25
claim or defense in a judicial or administrative proceeding. 26
(4) In an action brought under this section: 27 UNOFFICIAL COPY 22 RS BR 1408
Page 5 of 7
XXXX Jacketed
(a) If the plaintiff prevails, he or she shall be entitled to reasonable costs and 1
attorney's fees; 2
(b) Punitive damages as well as compensatory damages shall be awardable, 3
including but not limited to: 4
1. Pain and suffering; 5
2. Loss of reputation; 6
3. Loss of income; and 7
4. Loss of consortium, including the loss of expectation of sharing 8
parenthood; and 9
(c) Injunctive, declaratory, and any other appropriate relief may be awarded. 10
(5) Notwithstanding any other provision of law to the contrary, an action under this 11
section may be commenced, and relief may be granted, in a judicial proceeding 12
without regard to whether the person commencing the action has sought or 13
exhausted available administrative remedies. 14
SECTION 4. A NEW SECTION OF KRS CHAPTER 311 IS CREATED TO 15
READ AS FOLLOWS: 16
(1) Public funds shall not be directly or indirectly used, granted, paid, or distributed 17
to any entity, organization, or person that provides gender transition procedures 18
to a child under the age of eighteen (18) years. 19
(2) Any amount paid by a person or an entity for the provision of gender transition 20
procedures or as premiums for health care coverage that includes coverage for 21
gender transition procedures shall not be exempt from taxation. 22
(3) Health care services provided to a child under the age of eighteen (18) years shall 23
not include gender transition procedures if provided: 24
(a) In a facility owned by the state or a county or local government; or 25
(b) By a physician or other health care provider employed by the state or a 26
county or local government. 27 UNOFFICIAL COPY 22 RS BR 1408
Page 6 of 7
XXXX Jacketed
SECTION 5. A NEW SECTION OF KRS CHAPTER 311 IS CREATED TO 1
READ AS FOLLOWS: 2
(1) The Attorney General may bring an action to enforce compliance with Sections 1 3
to 5 of this Act. 4
(2) Nothing in Sections 1 to 5 of this Act shall deny, impair, or otherwise affect any 5
right or authority of the Attorney General, the Commonwealth of Kentucky, or 6
any agency, officer, or employee of the state, acting under any other law other, to 7
institute or intervene in any proceeding. 8
(3) The General Assembly of the Commonwealth of Kentucky, by resolution, may 9
appoint one (1) or more of its members who sponsored or cosponsored Sections 1 10
to 5 of this Act in his or her official capacity to intervene as a matter of right in 11
any case to which the constitutionality or enforceability of Sections 1 to 5 of this 12
Act is challenged. 13
SECTION 6. A NEW SECTION OF KRS CHAPTER 205 IS CREATED TO 14
READ AS FOLLOWS: 15
The Department for Medicaid Services and any managed care organization contracted 16
to provide Medicaid benefits pursuant to this chapter shall not reimburse or provide 17
coverage for gender transition procedures as defined in Section 1 of this Act to a child 18
under the age of eighteen (18) years. 19
SECTION 7. A NEW SECTION OF SUBTITLE 17A OF KRS CHAPTER 304 20
IS CREATED TO READ AS FOLLOWS: 21
(1) As used in this section, "gender transition procedures" has the same meaning as 22
in Section 1 of this Act. 23
(2) Health benefit plans shall not be required to provide coverage for gender 24
transition procedures. 25
(3) If a health benefit plan elects to provide coverage for gender transition 26
procedures, the plan shall not include coverage for gender transition procedures 27 UNOFFICIAL COPY 22 RS BR 1408
Page 7 of 7
XXXX Jacketed
for a child under the age of eighteen (18) years. 1
Section 8. If any provision of this Act or the application thereof to any person or 2
circumstance is held invalid, the invalidity shall not affect the other provisions or 3
applications of the Act that can be given effect without the invalid provision or 4
application, and to this end the provisions of this Act are severable. 5
Section 9. This Act may be cited as the Kentucky's Children Deserve Help Not 6
Harm Act. 7
Section 10. This Act shall take effect January 1, 2023, so that children in this 8
state currently using puberty-blocking drugs or cross-sex hormones have time for 9
appropriate medication tapering and discontinuation under the care of their physician or 10
other health care provider. 11