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131st MAINE LEGISLATURE
FIRST SPECIAL SESSION-2023
Legislative Document No. 1735H.P. 1114House of Representatives, April 20, 2023
An Act to Safeguard Gender-affirming Health Care
Reference to the Committee on Judiciary suggested and ordered printed.
ROBERT B. HUNT
Clerk
Presented by Representative OSHER of Orono.
Cosponsored by Senator CARNEY of Cumberland and
Representatives: MILLIKEN of Blue Hill, MOONEN of Portland, SALISBURY of
Westbrook, SHEEHAN of Biddeford, WORTH of Ellsworth. Page 1 - 131LR0848(01)
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2 is enacted to read:
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4 subpoena pursuant to this section if the foreign subpoena is based on a violation of another
5 state's laws that interfere with a person's right to allow a child to receive gender-affirming
6 health care or gender-affirming mental health care. For the purposes of this subsection,
7 "gender-affirming health care" and "gender-affirming mental health care" have the same
8 meanings as in Title 19-A, section 1732.
9 is enacted to read:
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13 following terms have the following meanings.
14 A. "Gender-affirming health care" means medically necessary health care that respects
15 the gender identity of the patient, as experienced and defined by the patient, including,
16 but not limited to, the following:
17 (1) Interventions to suppress the development of endogenous secondary sex
18 characteristics;
19 (2) Interventions to align the patient's appearance or physical body with the
20 patient's gender identity; and
21 (3) Interventions to alleviate symptoms of clinically significant distress resulting
22 from gender dysphoria, as defined in the Diagnostic and Statistical Manual of
23 Mental Disorders, 5th edition or its successor in function.
24 B. "Gender-affirming mental health care" means mental health care or behavioral
25 health care that respects the gender identity of the patient, as experienced and defined
26 by the patient, including, but not limited to, developmentally appropriate exploration
27 and integration of identity, reduction of distress, adaptive coping and strategies to
28 increase family acceptance.
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30 for an individual based on violating another state's law against providing, receiving or
31 allowing a child to receive gender-affirming health care or gender-affirming mental health
32 care is the lowest law enforcement priority.
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34 in the arrest or participate in any extradition of an individual pursuant to an out-of-state
35 arrest warrant for violation of another state's law against providing, receiving or allowing
36 a child to receive gender-affirming health care or gender-affirming mental health care in
37 this State, if that care is lawful under the laws of this State, to the fullest extent permitted
38 by federal law. A state or local law enforcement agency may not cooperate with or provide
39 information to any individual or out-of-state agency or department regarding the provision
40 of lawful gender-affirming health care or gender-affirming mental health care performed
41 in this State. Page 2 - 131LR0848(01)
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2 investigation of any criminal activity in this State that may involve the performance of
3 gender-affirming health care or gender-affirming mental health care, except that no
4 information relating to any medical procedure performed on a specific individual may be
5 shared with an out-of-state agency or any other individual without the documented consent
6 of the patient.
7 is enacted to read:
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9 medically necessary health care that respects the gender identity of the patient, as
10 experienced and defined by the patient, including, but not limited to, the following:
11 (1) Interventions to suppress the development of endogenous secondary sex
12 characteristics;
13 (2) Interventions to align the patient's appearance or physical body with the
14 patient's gender identity; and
15 (3) Interventions to alleviate symptoms of clinically significant distress resulting
16 from gender dysphoria, as defined in the Diagnostic and Statistical Manual of
17 Mental Disorders, 5th edition or its successor in function.
18 is enacted to read:
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20 means mental health care or behavioral health care that respects the gender identity of the
21 patient, as experienced and defined by the patient, including, but not limited to,
22 developmentally appropriate exploration and integration of identity, reduction of distress,
23 adaptive coping and strategies to increase family acceptance.
24 is enacted to read:
25 B-1. A court of another state does not have jurisdiction under paragraph A, or a court
26 of the home state of the child has declined to exercise jurisdiction on the grounds that
27 this State is the more appropriate forum under section 1751 or 1752, and the child is
28 present in this State for the purpose of obtaining gender-affirming health care or
29 gender-affirming mental health care;
30 as enacted by PL 1999, c. 486, §3 and affected
31 by §6, is amended to read:
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33 jurisdiction if the child is present in this State and the child has been abandoned or it is
34 necessary in an emergency to protect the child because the child or a sibling or parent of
35 the child is subjected to or threatened with mistreatment or abuse or because the child has
36 been unable to obtain gender-affirming health care or gender-affirming mental health care.
37 is enacted to read:
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39 gender-affirming mental health care to the child is at issue, a court of this State may not
40 determine that it is an inconvenient forum if the law or policy of the other state that may
41 take jurisdiction limits the ability of a parent to obtain gender-affirming health care or
42 gender-affirming mental health care for the parent's child. Page 3 - 131LR0848(01)
1 is enacted to read:
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3 as a factor weighing against the petitioner any taking of the child, or retention of the child
4 after a visit or other temporary relinquishment of physical custody, from the person who
5 has legal custody, if there is evidence that the taking or retention of the child was for the
6 purposes of obtaining gender-affirming health care or gender-affirming mental health care
7 for the child and the law or policy of the other state limits the ability of a parent to obtain
8 gender-affirming health care or gender-affirming mental health care for the parent's child.
9 as amended by PL 2011, c. 373, §2, is repealed
10 and the following enacted in its place:
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12 statewide health information exchange may not disclose health care information:
13 A. For the purpose of marketing or sales without written or oral authorization for the
14 disclosure; or
15 B. Related to a person or entity allowing a child to receive gender-affirming health
16 care or gender-affirming mental health care in response to any civil action, including a
17 foreign subpoena, based on another state's law that authorizes a person to bring a civil
18 action against a person or entity that allows a child to receive gender-affirming health
19 care or gender-affirming mental health care.
20 For the purposes of this paragraph, "gender-affirming health care" and
21 "gender-affirming mental health care" have the same meanings as in Title 19-A, section
22 1732.
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24 This bill prohibits the enforcement of an order based on another state's law authorizing
25 a child to be removed from the child's parent or guardian based on that parent or guardian
26 allowing the child to receive gender-affirming health care or gender-affirming mental
27 health care. The bill prohibits a court from finding that it is an inconvenient forum if the
28 law or policy of another state that may take jurisdiction limits the ability of a parent to
29 obtain gender-affirming health care or gender-affirming mental health care for a child and
30 the provision of that care is at issue in the case before the court. The bill authorizes a court
31 to take temporary jurisdiction because a child has been unable to obtain gender-affirming
32 health care or gender-affirming mental health care. The bill prohibits a court from
33 considering the taking or retention of a child from a person who has legal custody of the
34 child if the taking or retention was for obtaining gender-affirming health care or
35 gender-affirming mental health care for the child. The bill prohibits a health care
36 practitioner, health care facility or state-designated statewide health information exchange
37 from releasing medical information related to a person or entity allowing a child to receive
38 gender-affirming health care or gender-affirming mental health care in response to a
39 criminal or civil action, including a foreign subpoena, based on another state's law that
40 authorizes a person to bring a civil or criminal action against a person or entity that allows
41 a child to receive gender-affirming health care or gender-affirming mental health care. The
42 bill prohibits law enforcement agencies from knowingly making or participating in the
43 arrest or extradition of an individual pursuant to an out-of-state arrest warrant based on
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44 another state's law against providing, receiving or allowing a child to receive gender-
45 affirming health care or gender-affirming mental health care in this State.
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