| 11 | | - | SectionA.Section191.1720,RSMo,isrepealedandtwonewsectionsenactedinlieu |
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| 12 | | - | 2thereof,tobeknownassections191.1705and191.1720,toreadasfollows: |
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| 13 | | - | 191.1705.1.Asusedinthissection,thefollowingtermsmean: |
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| 14 | | - | 2 (1)"Healthcareinstitution",anypublicorprivatehospital,outpatientcenter |
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| 15 | | - | 3forprimarycare,medicalcenter,physicianorganization,healthcareprofessional |
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| 16 | | - | 4association,outpatientcenterforsurgicalservices,privatephysician'soffice,pharmacy, |
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| 17 | | - | 5long-termcarefacility,medicalschool,nursingschool,medicaltrainingfacility,orother |
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| 18 | | - | 6entityorlocationinwhichhealthcareservicesareperformed; |
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| 19 | | - | 7 (2)"Healthcareprofessional",anyphysician;nursepractitionerorothernurse; |
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| 20 | | - | 8physicianassistant;nurse'saide;alliedhealthprofessional;medicalassistant;employee |
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| 21 | | - | 9ofahospital,outpatientcenterforprimarycare,outpatientcenterforsurgicalservices, |
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| 22 | | - | 10long-termcarefacility,orpharmacy;pharmacist;pharmacytechnician;medicalschool |
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| 23 | | - | 11facultymemberorstudent;nursingschoolfacultymemberorstudent;psychologyor |
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| 24 | | - | 12counselingfacultymemberorstudent;medicalresearcher;laboratorytechnician; |
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| 25 | | - | 13counselor;socialworker;orotherpersonwhofacilitatesorparticipatesinahealthcare |
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| 26 | | - | 14service; |
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| 27 | | - | 15 (3)"Sexreassignmentorgenderidentitytransitioning",theprocessinwhicha |
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| 28 | | - | 16persontransitionsfromidentifyingwithandlivingasagenderthatcorrespondstohis |
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| 29 | | - | EXPLANATION—Matterenclosedinbold-facedbrackets[thus] intheabovebillisnotenactedandis |
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| 30 | | - | intendedtobeomittedfromthelaw.Matterinbold-facetypeintheabovebillisproposedlanguage. 17orherbiologicalsextoidentifyingwithandlivingasagenderdifferentfromhisorher |
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| 31 | | - | 18biologicalsexandmayinvolvesocial,legal,orphysicalchanges. |
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| 32 | | - | 19 2.(1)Nohealthcareinstitutionorhealthcareprofessionalshallberequiredto |
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| 33 | | - | 20perform,assist,orparticipateinsexreassignmentorgenderidentitytransitioning |
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| 34 | | - | 21medicalprocedures,treatments,counseling,prescriptions,orsurgeriesifsuch |
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| 35 | | - | 22procedures,treatments,counseling,prescriptions,orsurgeriesarecontrarytothe |
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| 36 | | - | 23establishedpolicyof,orthemoral,ethical,orreligiousbeliefsof,suchhealthcare |
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| 37 | | - | 24institutionorhealthcareprofessional. |
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| 38 | | - | 25 (2)Nocauseofactionshallaccrueagainstanysuchhealthcareinstitutionor |
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| 39 | | - | 26healthcareprofessionalonaccountofsuchrefusaltoperform,assist,orparticipatein |
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| 40 | | - | 27sexreassignmentorgenderidentitytransitioningmedicalprocedures,treatments, |
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| 41 | | - | 28counseling,prescriptions,orsurgeries.Thissectionmaybeusedasadefenseinany |
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| 42 | | - | 29purportedactionrelatedtoorarisingoutoftheexerciseoftherightsprotectedbythis |
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| 43 | | - | 30section. |
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| 44 | | - | 31 3.Nohealthcareinstitutionorhealthcareprofessionalshallbe: |
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| 45 | | - | 32 (1)Deniedordiscriminatedagainstinthereceiptofanypublicbenefit, |
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| 46 | | - | 33assistance,orprivilegewhatsoever;or |
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| 47 | | - | 34 (2)Deniedordiscriminatedagainstinanypublicorprivateemploymentbyany |
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| 48 | | - | 35meansincluding,butnotlimitedto,anyadverseactionrelatedtohiring,promotion, |
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| 49 | | - | 36advancement,transfer,licensing,education,training,orgrantingofhospitalprivileges |
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| 50 | | - | 37orstaffappointments |
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| 51 | | - | 38 |
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| 52 | | - | 39onthegroundsthatthehealthcareinstitutionorhealthcareprofessionalrefusesto |
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| 53 | | - | 40perform,assist,orparticipateinsexreassignmentorgenderidentitytransitioning |
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| 54 | | - | 41medicalprocedures,treatments,counseling,prescriptions,orsurgeries. |
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| 55 | | - | 42 4.Anypersonwhodeniesordiscriminatesagainstahealthcareinstitutionor |
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| 56 | | - | 43healthcareprofessionalforrefusaltoperform,assist,orparticipateinsexreassignment |
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| 57 | | - | 44orgenderidentitytransitioningmedicalprocedures,treatments,counseling, |
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| 58 | | - | 45prescriptions,orsurgeriesshallbeliabletothepartyinjuredinanactionatlaw,suit |
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| 59 | | - | 46inequity,orotherformofredress.Aprevailingpartywhoestablishesaviolationofthe |
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| 60 | | - | 47rightsprotectedbythissectionshallbeawardedreasonableattorney'sfees. |
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| 61 | | - | 48 5.Nothinginthissectionshallbeconstruedtoallowanypersontodeny |
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| 62 | | - | 49visitation,recognitionofadesignatedrepresentativeforhealthcaredecision-making,or |
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| 63 | | - | 50emergencymedicaltreatmentnecessarytocureanillnessorinjuryasrequiredbylawin |
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| 64 | | - | 51accordancewiththeEmergencyMedicalTreatmentandLaborAct,42U.S.C.Section |
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| 65 | | - | 521395dd,ineffectonJanuary1,2024. |
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| 66 | | - | HCSHBs1520,1519,2355&2357 2 191.1720.1.Thissectionshallbeknownandmaybecitedasthe"MissouriSave |
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| 10 | + | SectionA.Section191.1720,RSMo,isrepealedandonenewsectionenactedinlieu |
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| 11 | + | 2thereof,tobeknownassection191.1720,toreadasfollows: |
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| 12 | + | 191.1720.1.Thissectionshallbeknownandmaybecitedasthe"MissouriSave |
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| 67 | 13 | | 2AdolescentsfromExperimentation(SAFE)Act". |
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| 68 | 14 | | 3 2.Forpurposesofthissection,thefollowingtermsmean: |
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| 69 | 15 | | 4 (1)"Biologicalsex",thebiologicalindicationofmaleorfemaleinthecontextof |
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| 70 | 16 | | 5reproductivepotentialorcapacity,suchassexchromosomes,naturallyoccurringsex |
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| 71 | 17 | | 6hormones,gonads,andnonambiguousinternalandexternalgenitaliapresentatbirth,without |
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| 72 | 18 | | 7regardtoanindividual'spsychological,chosen,orsubjectiveexperienceofgender; |
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| 73 | 19 | | 8 (2)"Cross-sexhormones",testosterone,estrogen,orotherandrogensgiventoan |
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| 74 | 20 | | 9individualinamountsthataregreaterormorepotentthanwouldnormallyoccurnaturallyina |
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| 75 | 21 | | 10healthyindividualofthesameageandsex; |
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| 76 | 22 | | 11 (3)"Gender",thepsychological,behavioral,social,andculturalaspectsofbeingmale |
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| 77 | 23 | | 12orfemale; |
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| 78 | 24 | | 13 (4)"Gendertransition",theprocessinwhichanindividualtransitionsfrom |
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| 79 | 25 | | 14identifyingwithandlivingasagenderthatcorrespondstohisorherbiologicalsexto |
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| 80 | 26 | | 15identifyingwithandlivingasagenderdifferentfromhisorherbiologicalsex,andmay |
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| 81 | 27 | | 16involvesocial,legal,orphysicalchanges; |
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| 83 | 30 | | 18assistinganindividualwithagendertransition,including,butnotlimitedto: |
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| 84 | 31 | | 19 (a)Surgicalproceduresthatsterilize,including,butnotlimitedto,castration, |
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| 85 | 32 | | 20vasectomy,hysterectomy,oophorectomy,orchiectomy,orpenectomy; |
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| 86 | 33 | | 21 (b)Surgicalproceduresthatartificiallyconstructtissuewiththeappearanceof |
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| 87 | 34 | | 22genitaliathatdiffersfromtheindividual'sbiologicalsex,including,butnotlimitedto, |
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| 88 | 35 | | 23metoidioplasty,phalloplasty,orvaginoplasty;or |
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| 89 | 36 | | 24 (c)Augmentationmammoplastyorsubcutaneousmastectomy; |
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| 90 | 37 | | 25 (6)"Healthcareprovider",anindividualwhoislicensed,certified,orotherwise |
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| 91 | 38 | | 26authorizedbythelawsofthisstatetoadministerhealthcareintheordinarycourseofthe |
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| 92 | 39 | | 27practiceofhisorherprofession; |
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| 93 | 40 | | 28 (7)"Puberty-blockingdrugs",gonadotropin-releasinghormoneanaloguesorother |
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| 94 | 41 | | 29syntheticdrugsusedtostopluteinizinghormonesecretionandfolliclestimulatinghormone |
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| 95 | 42 | | 30secretion,syntheticantiandrogendrugstoblocktheandrogenreceptor,oranyotherdrugused |
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| 96 | 43 | | 31todelayorsuppresspubertaldevelopmentinchildrenforthepurposeofassistingan |
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| 97 | 44 | | 32individualwithagendertransition. |
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| 98 | 45 | | 33 3.Ahealthcareprovidershallnotknowinglyperformagendertransitionsurgeryon |
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| 99 | 46 | | 34anyindividualundereighteenyearsofage. |
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| 100 | 47 | | 35 4.[(1)]Ahealthcareprovidershallnotknowinglyprescribeoradministercross-sex |
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| 101 | 48 | | 36hormonesorpuberty-blockingdrugsforthepurposeofagendertransitionforanyindividual |
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| 102 | 49 | | 37undereighteenyearsofage. |
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| 119 | 66 | | 54oftheindividualinjuredattainingtheageoftwenty-oneorofthedatethetreatmentofthe |
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| 120 | 67 | | 55injuryatissueintheactionbythedefendanthasceased,whicheverislater. |
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| 121 | 68 | | 56 (3)Anindividualbringinganactionunderthissubsectionshallbeentitledtoa |
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| 122 | 69 | | 57rebuttablepresumptionthattheindividualwasharmediftheindividualisinfertilefollowing |
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| 123 | 70 | | 58theprescriptionoradministrationofcross-sexhormonesorpuberty-blockingdrugsandthat |
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| 124 | 71 | | 59theharmwasadirectresultofthehormonesordrugsprescribedoradministeredbythehealth |
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| 125 | 72 | | 60careprovider.Suchpresumptionmayberebuttedonlybyclearandconvincingevidence. |
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| 126 | 73 | | 61 (4)Inanyactionbroughtpursuanttothissubsection,aplaintiffmayrecover |
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| 127 | 74 | | 62economicandnoneconomicdamagesandpunitivedamages,withoutlimitationtotheamount |
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| 128 | 75 | | 63andnolessthanfivehundredthousanddollarsintheaggregate.Thejudgmentagainsta |
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| 129 | 76 | | 64defendantinanactionbroughtpursuanttothissubsectionshallbeinanamountofthreetimes |
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| 130 | 77 | | 65theamountofanyeconomicandnoneconomicdamagesorpunitivedamagesassessed.Any |
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| 131 | 78 | | 66awardofdamagesinanactionbroughtpursuanttothissubsectiontoaprevailingplaintiff |
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| 132 | 79 | | 67shallincludeattorney'sfeesandcourtcosts. |
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| 133 | 80 | | 68 (5)Anactionbroughtpursuanttothissubsectionmaybebroughtinanycircuitcourt |
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| 134 | 81 | | 69ofthisstate. |
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| 135 | 82 | | 70 (6)Nohealthcareprovidershallrequireawaiveroftherighttobringanaction |
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| 136 | 83 | | 71pursuanttothissubsectionasaconditionofservices.Therighttobringanactionbyor |
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| 137 | 84 | | 72throughanindividualundertheageofeighteenshallnotbewaivedbyaparentorlegal |
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| 138 | 85 | | 73guardian. |
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| 140 | 87 | | 75agreementofsettlementorcompromiseoftheaction,butnoagreementshallbevaliduntil |
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| 141 | 88 | | 76approvedbythecourt.Noagreementallowedbythecourtshallincludeaprovisionregarding |
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| 142 | 89 | | 77thenondisclosureorconfidentialityofthetermsofsuchagreementunlesssuchprovisionwas |
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| 143 | 90 | | 78specificallyrequestedandagreedtobytheplaintiff. |
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| 144 | 91 | | 79 (8)Ifrequestedbytheplaintiff,anypleadings,attachments,orexhibitsfiledwiththe |
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| 145 | 92 | | 80courtinanyactionbroughtpursuanttothissubsection,aswellasanyjudgmentsissuedbythe |
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| 146 | 93 | | 81courtinsuchactions,shallnotincludethepersonalidentifyinginformationoftheplaintiff. |
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| 147 | 94 | | 82Suchinformationshallbeprovidedinaconfidentialinformationfilingsheet |
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| 148 | 95 | | 83contemporaneouslyfiledwiththecourtorenteredbythecourt,whichshallnotbesubject |
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| 149 | 96 | | 84topublicinspectionoravailability. |
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| 150 | 97 | | 85 7.TheprovisionsofthissectionshallnotapplytoanyspeechprotectedbytheFirst |
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| 151 | 98 | | 86AmendmentoftheUnitedStatesConstitution. |
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| 152 | 99 | | 87 8.Theprovisionsofthissectionshallnotapplytothefollowing: |
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| 153 | 100 | | 88 (1)Servicestoindividualsbornwithamedically-verifiabledisorderofsex |
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| 154 | 101 | | 89development,including,butnotlimitedto,anindividualwithexternalbiologicalsex |
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| 156 | 103 | | 91withvirilization,46,XYchromosomeswithundervirilization,orhavingbothovarianand |
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| 157 | 104 | | 92testiculartissue; |
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| 158 | 105 | | 93 (2)Servicesprovidedwhenaphysicianhasotherwisediagnosedanindividualwitha |
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| 159 | 106 | | 94disorderofsexdevelopmentanddeterminedthroughgeneticorbiochemicaltestingthatthe |
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| 160 | 107 | | 95individualdoesnothavenormalsexchromosomestructure,sexsteroidhormoneproduction, |
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| 161 | 108 | | 96orsexsteroidhormoneaction; |
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| 162 | 109 | | 97 (3)Thetreatmentofanyinfection,injury,disease,ordisorderthathasbeencausedby |
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| 163 | 110 | | 98orexacerbatedbytheperformanceofgendertransitionsurgeryortheprescriptionor |
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| 164 | 111 | | 99administrationofcross-sexhormonesorpuberty-blockingdrugsregardlessofwhetherthe |
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| 165 | 112 | | 100surgerywasperformedorthehormonesordrugswereprescribedoradministeredin |
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| 166 | 113 | | 101accordancewithstateandfederallaw;or |
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| 167 | 114 | | 102 (4)Anyprocedureundertakenbecausetheindividualsuffersfromaphysicaldisorder, |
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| 168 | 115 | | 103physicalinjury,orphysicalillnessthatwould,ascertifiedbyaphysician,placetheindividual |
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| 169 | 116 | | 104inimminentdangerofdeathorimpairmentofamajorbodilyfunctionunlesssurgeryis |
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| 170 | 117 | | 105performed. |
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