SECONDREGULARSESSION
HOUSEBILLNO.1520
102NDGENERALASSEMBLY
INTRODUCEDBYREPRESENTATIVEHUDSON.
3009H.01I DANARADEMANMILLER,ChiefClerk
ANACT
Torepealsection191.1720,RSMo,andtoenactinlieuthereofonenewsectionrelatingto
gendertransitionprocedures.
BeitenactedbytheGeneralAssemblyofthestateofMissouri,asfollows:
SectionA.Section191.1720,RSMo,isrepealedandonenewsectionenactedinlieu
2thereof,tobeknownassection191.1720,toreadasfollows:
191.1720.1.Thissectionshallbeknownandmaybecitedasthe"MissouriSave
2AdolescentsfromExperimentation(SAFE)Act".
3 2.Forpurposesofthissection,thefollowingtermsmean:
4 (1)"Biologicalsex",thebiologicalindicationofmaleorfemaleinthecontextof
5reproductivepotentialorcapacity,suchassexchromosomes,naturallyoccurringsex
6hormones,gonads,andnonambiguousinternalandexternalgenitaliapresentatbirth,without
7regardtoanindividual'spsychological,chosen,orsubjectiveexperienceofgender;
8 (2)"Cross-sexhormones",testosterone,estrogen,orotherandrogensgiventoan
9individualinamountsthataregreaterormorepotentthanwouldnormallyoccurnaturallyina
10healthyindividualofthesameageandsex;
11 (3)"Gender",thepsychological,behavioral,social,andculturalaspectsofbeingmale
12orfemale;
13 (4)"Gendertransition",theprocessinwhichanindividualtransitionsfrom
14identifyingwithandlivingasagenderthatcorrespondstohisorherbiologicalsexto
15identifyingwithandlivingasagenderdifferentfromhisorherbiologicalsex,andmay
16involvesocial,legal,orphysicalchanges;
EXPLANATION—Matterenclosedinbold-facedbrackets[thus] intheabovebillisnotenactedandis
intendedtobeomittedfromthelaw.Matterinbold-facetypeintheabovebillisproposedlanguage. 17 (5)"Gendertransitionsurgery",asurgicalprocedureperformedforthepurposeof
18assistinganindividualwithagendertransition,including,butnotlimitedto:
19 (a)Surgicalproceduresthatsterilize,including,butnotlimitedto,castration,
20vasectomy,hysterectomy,oophorectomy,orchiectomy,orpenectomy;
21 (b)Surgicalproceduresthatartificiallyconstructtissuewiththeappearanceof
22genitaliathatdiffersfromtheindividual'sbiologicalsex,including,butnotlimitedto,
23metoidioplasty,phalloplasty,orvaginoplasty;or
24 (c)Augmentationmammoplastyorsubcutaneousmastectomy;
25 (6)"Healthcareprovider",anindividualwhoislicensed,certified,orotherwise
26authorizedbythelawsofthisstatetoadministerhealthcareintheordinarycourseofthe
27practiceofhisorherprofession;
28 (7)"Puberty-blockingdrugs",gonadotropin-releasinghormoneanaloguesorother
29syntheticdrugsusedtostopluteinizinghormonesecretionandfolliclestimulatinghormone
30secretion,syntheticantiandrogendrugstoblocktheandrogenreceptor,oranyotherdrugused
31todelayorsuppresspubertaldevelopmentinchildrenforthepurposeofassistingan
32individualwithagendertransition.
33 3.Ahealthcareprovidershallnotknowinglyperformagendertransitionsurgeryon
34anyindividualundereighteenyearsofage.
35 4.[(1)]Ahealthcareprovidershallnotknowinglyprescribeoradministercross-sex
36hormonesorpuberty-blockingdrugsforthepurposeofagendertransitionforanyindividual
37undereighteenyearsofage.
38 [(2)Theprovisionsofthissubsectionshallnotapplytotheprescriptionor
39administrationofcross-sexhormonesorpuberty-blockingdrugsforanyindividualunder
40eighteenyearsofagewhowasprescribedoradministeredsuchhormonesordrugspriorto
41August28,2023,forthepurposeofassistingtheindividualwithagendertransition.
42 (3)TheprovisionsofthissubsectionshallexpireonAugust28,2027.]
43 5.Theperformanceofagendertransitionsurgeryortheprescriptionor
44administrationofcross-sexhormonesorpuberty-blockingdrugstoanindividualunder
45eighteenyearsofageinviolationofthissectionshallbeconsideredunprofessionalconduct
46andanyhealthcareproviderdoingsoshallhavehisorherlicensetopracticerevokedbythe
47appropriatelicensingentityordisciplinaryreviewboardwithcompetentjurisdictioninthis
48state.
49 6.(1)Theprescriptionoradministrationofcross-sexhormonesorpuberty-blocking
50drugstoanindividualundereighteenyearsofageforthepurposeofagendertransitionshall
51beconsideredgroundsforacauseofactionagainstthehealthcareprovider.Theprovisions
52ofchapter538shallnotapplytoanyactionbroughtunderthissubsection.
HB1520 2 53 (2)Anactionbroughtpursuanttothissubsectionshallbebroughtwithinfifteenyears
54oftheindividualinjuredattainingtheageoftwenty-oneorofthedatethetreatmentofthe
55injuryatissueintheactionbythedefendanthasceased,whicheverislater.
56 (3)Anindividualbringinganactionunderthissubsectionshallbeentitledtoa
57rebuttablepresumptionthattheindividualwasharmediftheindividualisinfertilefollowing
58theprescriptionoradministrationofcross-sexhormonesorpuberty-blockingdrugsandthat
59theharmwasadirectresultofthehormonesordrugsprescribedoradministeredbythehealth
60careprovider.Suchpresumptionmayberebuttedonlybyclearandconvincingevidence.
61 (4)Inanyactionbroughtpursuanttothissubsection,aplaintiffmayrecover
62economicandnoneconomicdamagesandpunitivedamages,withoutlimitationtotheamount
63andnolessthanfivehundredthousanddollarsintheaggregate.Thejudgmentagainsta
64defendantinanactionbroughtpursuanttothissubsectionshallbeinanamountofthreetimes
65theamountofanyeconomicandnoneconomicdamagesorpunitivedamagesassessed.Any
66awardofdamagesinanactionbroughtpursuanttothissubsectiontoaprevailingplaintiff
67shallincludeattorney'sfeesandcourtcosts.
68 (5)Anactionbroughtpursuanttothissubsectionmaybebroughtinanycircuitcourt
69ofthisstate.
70 (6)Nohealthcareprovidershallrequireawaiveroftherighttobringanaction
71pursuanttothissubsectionasaconditionofservices.Therighttobringanactionbyor
72throughanindividualundertheageofeighteenshallnotbewaivedbyaparentorlegal
73guardian.
74 (7)Aplaintifftoanactionbroughtunderthissubsectionmayenterintoavoluntary
75agreementofsettlementorcompromiseoftheaction,butnoagreementshallbevaliduntil
76approvedbythecourt.Noagreementallowedbythecourtshallincludeaprovisionregarding
77thenondisclosureorconfidentialityofthetermsofsuchagreementunlesssuchprovisionwas
78specificallyrequestedandagreedtobytheplaintiff.
79 (8)Ifrequestedbytheplaintiff,anypleadings,attachments,orexhibitsfiledwiththe
80courtinanyactionbroughtpursuanttothissubsection,aswellasanyjudgmentsissuedbythe
81courtinsuchactions,shallnotincludethepersonalidentifyinginformationoftheplaintiff.
82Suchinformationshallbeprovidedinaconfidentialinformationfilingsheet
83contemporaneouslyfiledwiththecourtorenteredbythecourt,whichshallnotbesubject
84topublicinspectionoravailability.
85 7.TheprovisionsofthissectionshallnotapplytoanyspeechprotectedbytheFirst
86AmendmentoftheUnitedStatesConstitution.
87 8.Theprovisionsofthissectionshallnotapplytothefollowing:
88 (1)Servicestoindividualsbornwithamedically-verifiabledisorderofsex
89development,including,butnotlimitedto,anindividualwithexternalbiologicalsex
HB1520 3 90characteristicsthatareirresolvablyambiguous,suchasthosebornwith46,XXchromosomes
91withvirilization,46,XYchromosomeswithundervirilization,orhavingbothovarianand
92testiculartissue;
93 (2)Servicesprovidedwhenaphysicianhasotherwisediagnosedanindividualwitha
94disorderofsexdevelopmentanddeterminedthroughgeneticorbiochemicaltestingthatthe
95individualdoesnothavenormalsexchromosomestructure,sexsteroidhormoneproduction,
96orsexsteroidhormoneaction;
97 (3)Thetreatmentofanyinfection,injury,disease,ordisorderthathasbeencausedby
98orexacerbatedbytheperformanceofgendertransitionsurgeryortheprescriptionor
99administrationofcross-sexhormonesorpuberty-blockingdrugsregardlessofwhetherthe
100surgerywasperformedorthehormonesordrugswereprescribedoradministeredin
101accordancewithstateandfederallaw;or
102 (4)Anyprocedureundertakenbecausetheindividualsuffersfromaphysicaldisorder,
103physicalinjury,orphysicalillnessthatwould,ascertifiedbyaphysician,placetheindividual
104inimminentdangerofdeathorimpairmentofamajorbodilyfunctionunlesssurgeryis
105performed.
âś”
HB1520 4