HOUSE BILL NO. 4190 A bill to amend 1978 PA 368, entitled "Public health code," (MCL 333.1101 to 333.25211) by adding sections 17019 and 17519. the people of the state of michigan enact: Sec. 17019. (1) Except as otherwise provided in subsection (2), a physician shall not knowingly do any of the following: (a) Perform gender reassignment surgery on a minor. (b) Prescribe a cross-sex hormone or puberty-blocking drug for a minor with the intent to assist the minor with gender transition. (2) A physician may continue to prescribe a cross-sex hormone or puberty-blocking drug for a minor if the minor has been a resident of this state since the effective date of the amendatory act that added this section and the physician has done both of the following: (a) Initiated a course of treatment for the minor before the effective date of the amendatory act that added this section that includes the prescription of a cross-sex hormone or puberty-blocking drug prohibited under subsection (1). (b) Determined and documented in the minor's medical record that terminating the minor's prescription for the cross-sex hormone or puberty-blocking drug would cause harm to the minor. (3) As used in this section: (a) "Biological sex" means the biological indication of male and female, including sex chromosomes, naturally occurring sex hormones, gonads, and nonambiguous internal and external genitalia present at birth, without regard to an individual's psychological, chosen, or subjective experience of gender. (b) "Cross-sex hormone" means testosterone, estrogen, or progesterone given to a minor in an amount greater than would normally be produced endogenously in a healthy individual of the minor's age and biological sex. (c) "Gender reassignment surgery" means a surgery performed for the purpose of assisting an individual with gender transition that seeks to surgically alter or remove a healthy physical or anatomical characteristic or feature that is typical for the individual's biological sex, in order to instill or create a physiological or anatomical characteristic that resembles a sex different from the individual's biological sex. Gender reassignment surgery includes genital gender reassignment surgery and nongenital gender reassignment surgery. (d) "Gender transition" means the process in which an individual goes from identifying with and living as a gender that corresponds to the individual's biological sex to identifying with and living as a gender different from the individual's biological sex, including a social, legal, or physical change. (e) "Genital gender reassignment surgery" means surgery performed for the purpose of assisting an individual with gender transition and includes both of the following: (i) Surgery that sterilizes, including, but not limited to, a castration, vasectomy, hysterectomy, oophorectomy, orchiectomy, and penectomy. (ii) Surgery that artificially constructs tissue with the appearance of genitalia that differs from the individual's biological sex, including, but not limited to, metoidiplasty, phalloplasty, and vaginoplasty. (f) "Nongenital gender reassignment surgery" means surgery performed for the purpose of assisting an individual with gender transition such as augmentation mammoplasty, facial feminization surgery, liposuction, lipofilling, voice surgery, thyroid cartilage reduction, gluteal augmentation, pectoral implants, or any other aesthetic procedure. (g) "Puberty-blocking drug" means a gonadotropin-releasing hormone analog or other synthetic drug used to stop luteinizing hormone and follicle stimulating hormone secretion, a synthetic antiandrogen drug used to block the androgen receptor, or any other drug used to delay or suppress normal puberty. Sec. 17519. A physician shall comply with section 17019.
HOUSE BILL NO. 4190
A bill to amend 1978 PA 368, entitled
"Public health code,"
(MCL 333.1101 to 333.25211) by adding sections 17019 and 17519.
the people of the state of michigan enact:
Sec. 17019. (1) Except as otherwise provided in subsection (2), a physician shall not knowingly do any of the following:
(a) Perform gender reassignment surgery on a minor.
(b) Prescribe a cross-sex hormone or puberty-blocking drug for a minor with the intent to assist the minor with gender transition.
(2) A physician may continue to prescribe a cross-sex hormone or puberty-blocking drug for a minor if the minor has been a resident of this state since the effective date of the amendatory act that added this section and the physician has done both of the following:
(a) Initiated a course of treatment for the minor before the effective date of the amendatory act that added this section that includes the prescription of a cross-sex hormone or puberty-blocking drug prohibited under subsection (1).
(b) Determined and documented in the minor's medical record that terminating the minor's prescription for the cross-sex hormone or puberty-blocking drug would cause harm to the minor.
(3) As used in this section:
(a) "Biological sex" means the biological indication of male and female, including sex chromosomes, naturally occurring sex hormones, gonads, and nonambiguous internal and external genitalia present at birth, without regard to an individual's psychological, chosen, or subjective experience of gender.
(b) "Cross-sex hormone" means testosterone, estrogen, or progesterone given to a minor in an amount greater than would normally be produced endogenously in a healthy individual of the minor's age and biological sex.
(c) "Gender reassignment surgery" means a surgery performed for the purpose of assisting an individual with gender transition that seeks to surgically alter or remove a healthy physical or anatomical characteristic or feature that is typical for the individual's biological sex, in order to instill or create a physiological or anatomical characteristic that resembles a sex different from the individual's biological sex. Gender reassignment surgery includes genital gender reassignment surgery and nongenital gender reassignment surgery.
(d) "Gender transition" means the process in which an individual goes from identifying with and living as a gender that corresponds to the individual's biological sex to identifying with and living as a gender different from the individual's biological sex, including a social, legal, or physical change.
(e) "Genital gender reassignment surgery" means surgery performed for the purpose of assisting an individual with gender transition and includes both of the following:
(i) Surgery that sterilizes, including, but not limited to, a castration, vasectomy, hysterectomy, oophorectomy, orchiectomy, and penectomy.
(ii) Surgery that artificially constructs tissue with the appearance of genitalia that differs from the individual's biological sex, including, but not limited to, metoidiplasty, phalloplasty, and vaginoplasty.
(f) "Nongenital gender reassignment surgery" means surgery performed for the purpose of assisting an individual with gender transition such as augmentation mammoplasty, facial feminization surgery, liposuction, lipofilling, voice surgery, thyroid cartilage reduction, gluteal augmentation, pectoral implants, or any other aesthetic procedure.
(g) "Puberty-blocking drug" means a gonadotropin-releasing hormone analog or other synthetic drug used to stop luteinizing hormone and follicle stimulating hormone secretion, a synthetic antiandrogen drug used to block the androgen receptor, or any other drug used to delay or suppress normal puberty.
Sec. 17519. A physician shall comply with section 17019.