Printed on recycled paper 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) 1 2 is enacted to read: 3 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: 10 11 12 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. 29 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. 33 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) 1 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: 8 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: 19 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: 32 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: 38 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: 2 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: 11 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. 23 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 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 Page 4 - 131LR0848(01) 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. 1 2