ENROLLED ACT No. 466 2023 Regular Session HOUSE BILL NO. 648 (Substitute for House Bill No. 463 by Representative Firment) BY REPRESENTATIVES FIRMENT, AMEDEE, CREWS, GAROFALO, AND HORTON 1 AN ACT 2 To enact Part IX of Chapter 5-A of Title 40 of the Louisiana Revised Statutes of 1950, to be 3 comprised of R.S. 40:1098.1 through 1098.6, relative to certain procedures for minor 4 children; to provide for definitions; to exclude certain services, treatments, and 5 procedures that alter the sex characteristics of a minor; to provide certain restrictions 6 for healthcare professionals; to establish disciplinary procedures; to provide with 7 respect to consent; to provide for legal remedies; and to provide for related matters. 8 Be it enacted by the Legislature of Louisiana: 9 Section 1. Part IX of Chapter 5-A of Title 40 of the Louisiana Revised Statutes of 10 1950, comprised of R.S. 40:1098.1 through 1098.6, is hereby enacted to read as follows: 11 PART IX. THE STOP HARMING OUR KIDS ACT 12 §1098.1. Definitions 13 For the purposes of this Part, the following terms have the meaning ascribed 14 to them unless the context clearly indicates otherwise: 15 (1) "Healthcare professional" shall have the same meaning as the term is 16 defined in R.S. 14:34.8. 17 (2) "Minor" means any natural person who has not reached the age of 18 majority as provided in Civil Code Article 29 and who has not been emancipated 19 pursuant to Title V of Book VII of the Code of Civil Procedure. 20 (3) "Sex" means the biological indication of male or female as evidenced by 21 a medical examination of all of the following: 22 (a) Sex chromosomes. Page 1 of 5 CODING: Words in struck through type are deletions from existing law; words underscored are additions. HB NO. 648 ENROLLED 1 (b) Naturally occurring sex hormones. 2 (c) Gonads. 3 (d) As well as nonambiguous internal and external genitalia present at birth. 4 §1098.2. Healthcare professionals; restrictions 5 A. A healthcare professional shall not knowingly engage in any of the 6 following acts that attempt to alter a minor's appearance in an attempt to validate a 7 minor's perception of the minor's sex, if the minor's perception is inconsistent with 8 the minor's sex: 9 (1) The prescription or administration of gonadotropin-releasing hormone 10 analogues or other synthetic drugs used to stop luteinizing hormone and follicle 11 stimulating hormone secretion, synthetic antiandrogen drugs used to block the 12 androgen receptor, or any drug to suppress or delay normal puberty. 13 (2) The prescription or administration of testosterone, estrogen, or 14 progesterone, in amounts greater than would normally be produced endogenously in 15 a healthy individual of the same age and sex. 16 (3) The performance of any sterilizing surgery, including but not limited to 17 castration, hysterectomy, oophorectomy, orchiectomy, penectomy, and vasectomy. 18 (4) The performance of any surgery that artificially constructs tissue having 19 the appearance of genitalia differing from the minor's sex, including metoidioplasty, 20 phalloplasty, and vaginoplasty. 21 (5) The removal of any healthy or non-diseased body part or tissue. 22 (6) The performance of augmentation mammoplasty, facial feminization 23 surgery, liposuction, lipofilling, pectoral implants, voice surgery, thyroid cartilage 24 reduction, gluteal augmentation, hair reconstruction, or any aesthetic surgical 25 procedure. 26 B. The prohibited acts listed in Subsection A of this Section shall not be 27 considered healthcare services. 28 C. The prohibitions listed in Subsection A of this Section shall not limit or 29 restrict the provision of healthcare: Page 2 of 5 CODING: Words in struck through type are deletions from existing law; words underscored are additions. HB NO. 648 ENROLLED 1 (1) A minor born with a medically verifiable disorder of sex development, 2 including but not limited to external sex characteristics that are irresolvably 3 ambiguous. 4 (2) A minor diagnosed with a disorder of sexual development, if a healthcare 5 professional has determined, through genetic or biochemical testing, that the minor 6 does not have a sex chromosome structure, sex steroid hormone production, or sex 7 steroid hormone action, that is normal for a biological male or biological female. 8 (3) A minor needing treatment for an infection, injury, disease, or disorder 9 that has been caused or exacerbated by any action or procedure prohibited by this 10 Part. 11 (4) A minor suffering from a physical disorder, physical injury, or physical 12 illness that is certified by a healthcare provider and that would place the individual 13 in imminent danger of death or impairment of major bodily function unless surgery 14 is performed. 15 D. If, prior to January 1, 2024, a healthcare professional has initiated a 16 course of treatment, for a minor, which includes the prescription or administration 17 of any drug or hormone prohibited by this Part, and if the healthcare professional 18 determines and documents in the minor's medical record that immediately 19 terminating the minor's use of the drug or hormone would cause harm to the minor, 20 the healthcare professional may institute a period during which the minor's use of the 21 drug or hormone is systematically reduced and discontinued. The period may not 22 extend beyond December 31, 2024. 23 §1098.3. Healthcare professionals; disciplinary actions 24 If a professional or occupational licensing board finds, by a preponderance 25 of the evidence, that a healthcare professional licensed or certified by the board has 26 violated the provisions of this Part, the board shall revoke any professional or 27 occupational license or certificate held by the healthcare professional for a minimum 28 of two years. Page 3 of 5 CODING: Words in struck through type are deletions from existing law; words underscored are additions. HB NO. 648 ENROLLED 1 §1098.4. Minors' lack of consent 2 A. Notwithstanding the provisions of R.S. 40:1079.1 and notwithstanding any 3 other provision of law to the contrary, a minor may not consent to any procedures or 4 services that are prohibited in R.S. 40:1098.2(A). 5 B. The provisions of this Section shall not apply to a minor who is subject to the provisions of R.S. 40:1098.2(D).6 7 §1098.5. Civil actions; remedies 8 A. Notwithstanding any other provision of law to the contrary, a person who 9 has been harmed as a result of acts which are prohibited by this Part or who has been 10 subjected to acts which are prohibited by this Part with or without consent, shall have 11 a cause of action for damages in a court of competent jurisdiction. 12 B. The cause of action for damages shall be commenced before the later of 13 either of the following: 14 (1) The lapse of a twelve-year liberative prescription once the minor reaches 15 the age of majority. 16 (2) Within three years from the time the person discovered or reasonably 17 should have discovered that the injury or damages were caused by the violation. 18 C. Venue pursuant to this Section may be brought pursuant to Code of Civil 19 Procedure Article 42 or in the parish of domicile of the petitioner. 20 D.(1) If a court finds that a person is entitled judgment pursuant to this 21 Section, the court shall award damages, attorney fees, and all costs of the proceeding 22 against the defendant for violation of this Part. 23 (2) Damages awarded by the court pursuant to this Section may include but 24 is not to be limited to damages for infertility or sterility that is suffered by the minor 25 as a result of the acts prohibited by this Part. 26 E. Consent shall not operate as defense to a petitioner's claim that is filed 27 pursuant to this Section. 28 §1098.6. Attorney general; injunctive or declaratory relief 29 A. The attorney general may bring a civil action to enforce compliance with 30 this Part in a court of competent jurisdiction. Page 4 of 5 CODING: Words in struck through type are deletions from existing law; words underscored are additions. HB NO. 648 ENROLLED 1 B. The attorney general may seek injunctive or declaratory relief and any 2 other appropriate remedy from in order to protect a minor from those harms resulting 3 from conduct that is prohibited pursuant to this Part. 4 C. Venue pursuant to this Section shall be that same venue which is provided 5 in R.S. 40:1098.5. 6 D. If the court grants relief pursuant to this Section, the court shall award 7 attorney fees and all costs of the proceeding against the defendant for violation of 8 this Part. 9 E. Nothing in this Part shall be construed to deny, impair, or otherwise affect 10 any right or authority of the attorney general, the state, or any agency, officer, or 11 employee of the state to institute or intervene in any proceeding. 12 Section 2. If any provision or item of this Act, or the application thereof, is held 13 invalid, such invalidity shall not affect other provisions, items, or applications of the Act 14 which can be given effect without the invalid provision, item, or application and to this end 15 the provisions of this Act are hereby declared severable. 16 Section 3. This Act shall become effective on January 1, 2024; if vetoed by the 17 governor and subsequently approved by the legislature, this Act shall become effective on 18 the day following such approval by the legislature or January 1, 2024, whichever is later. SPEAKER OF THE HOUSE OF REPRESENTATIVES PRESIDENT OF THE SENATE GOVERNOR OF THE STATE OF LOUISIANA APPROVED: Page 5 of 5 CODING: Words in struck through type are deletions from existing law; words underscored are additions.