Missouri 2025 Regular Session

Missouri Senate Bill SB26 Compare Versions

Only one version of the bill is available at this time.

Old	New	Differences
1	1
2	2	EXPLANATION-Matter enclosed in bold-faced brackets [thus] in this bill is not enacted
3	3	and is intended to be omitted in the law.
4	4	FIRST REGULAR SESSION
5	5	SENATE BILL NO. 26
6	6	103RD GENERAL ASSEMBLY
7	7	INTRODUCED BY SENATOR MOON.
8	8	1080S.01I KRISTINA MARTIN, Secretary
9	9	AN ACT
10	10	To repeal section 191.1720, RSMo, and to enact in lieu thereof two new sections relating to gender
11	11	transition.
12	12
13	13	Be it enacted by the General Assembly of the State of Missouri, as follows:
14	14	Section A. Section 191.1720, RSMo, is repealed and two 1
15	15	new sections enacted in lieu thereof, to be known as sections 2
16	16	1.208 and 191.1720, to read as follows:3
17	17	1.208. As used in the laws and regulations of this 1
18	18	state, unless clearly and specifically stated otherwise, the 2
19	19	term "reproductive health care" shall not be construed to 3
20	20	include gender transition surgeries or the use of cross -sex 4
21	21	hormones or puberty-blocking drugs for the pu rpose of gender 5
22	22	transition, as such terms are defined in section 191.1720, 6
23	23	for minor children or adults. 7
24	24	191.1720. 1. This section shall be known and may be 1
25	25	cited as the "Missouri Save Adolescents from Experimentation 2
26	26	(SAFE) Act". 3
27	27	2. For purposes of this section, the following terms 4
28	28	mean: 5
29	29	(1) "Biological sex", the biological indication of 6
30	30	male or female in the context of reproductive potential or 7
31	31	capacity, such as sex chromosomes, naturally occurring sex 8
32	32	hormones, gonads, and nonambiguous internal and external 9
33	33	genitalia present at birth, without regard to an 10 SB 26 2
34	34	individual's psychological, chosen, or subjective experience 11
35	35	of gender; 12
36	36	(2) "Cross-sex hormones", testosterone, estrogen, or 13
37	37	other androgens given to an individual in amounts that are 14
38	38	greater or more potent than would normally occur naturally 15
39	39	in a healthy individual of the same age and sex; 16
40	40	(3) "Gender", the psychological, behavioral, social, 17
41	41	and cultural aspects of being male or female; 18
42	42	(4) "Gender transition", the process in which an 19
43	43	individual transitions from identifying with and living as a 20
44	44	gender that corresponds to his or her biological sex to 21
45	45	identifying with and living as a gender different from his 22
46	46	or her biological sex, and ma y involve social, legal, or 23
47	47	physical changes; 24
48	48	(5) "Gender transition surgery", a surgical procedure 25
49	49	performed for the purpose of assisting an individual with a 26
50	50	gender transition, including, but not limited to: 27
51	51	(a) Surgical procedures that st erilize, including, but 28
52	52	not limited to, castration, vasectomy, hysterectomy, 29
53	53	oophorectomy, orchiectomy, or penectomy; 30
54	54	(b) Surgical procedures that artificially construct 31
55	55	tissue with the appearance of genitalia that differs from 32
56	56	the individual's biological sex, including, but not limited 33
57	57	to, metoidioplasty, phalloplasty, or vaginoplasty; or 34
58	58	(c) Augmentation mammoplasty or subcutaneous 35
59	59	mastectomy; 36
60	60	(6) "Health care provider", an individual who is 37
61	61	licensed, certified, or otherwise autho rized by the laws of 38
62	62	this state to administer health care in the ordinary course 39
63	63	of the practice of his or her profession; 40
64	64	(7) "Puberty-blocking drugs", gonadotropin -releasing 41
65	65	hormone analogues or other synthetic drugs used to stop 42 SB 26 3
66	66	luteinizing hormone secretion and follicle stimulating 43
67	67	hormone secretion, synthetic antiandrogen drugs to block the 44
68	68	androgen receptor, or any other drug used to delay or 45
69	69	suppress pubertal development in children for the purpose of 46
70	70	assisting an individual with a gend er transition. 47
71	71	3. A health care provider shall not knowingly perform 48
72	72	a gender transition surgery on any individual under eighteen 49
73	73	years of age. 50
74	74	4. (1) A health care provider shall not knowingly 51
75	75	prescribe or administer cross -sex hormones or puberty- 52
76	76	blocking drugs for the purpose of a gender transition for 53
77	77	any individual under eighteen years of age. 54
78	78	(2) The provisions of this subsection shall not apply 55
79	79	to the prescription or administration of cross -sex hormones 56
80	80	or puberty-blocking drugs for any individual under eighteen 57
81	81	years of age who was prescribed or administered such 58
82	82	hormones or drugs prior to August 28, 2023, for the purpose 59
83	83	of assisting the individual with a gender transition. 60
84	84	[(3) The provisions of this subsection sha ll expire on 61
85	85	August 28, 2027.] 62
86	86	5. The performance of a gender transition surgery or 63
87	87	the prescription or administration of cross -sex hormones or 64
88	88	puberty-blocking drugs to an individual under eighteen years 65
89	89	of age in violation of this section shall be considered 66
90	90	unprofessional conduct and any health care provider doing so 67
91	91	shall have his or her license to practice revoked by the 68
92	92	appropriate licensing entity or disciplinary review board 69
93	93	with competent jurisdiction in this state. 70
94	94	6. (1) The prescription or administration of cross - 71
95	95	sex hormones or puberty -blocking drugs to an individual 72
96	96	under eighteen years of age for the purpose of a gender 73
97	97	transition shall be considered grounds for a cause of action 74 SB 26 4
98	98	against the health care provider. The provisions of chapter 75
99	99	538 shall not apply to any action brought under this 76
100	100	subsection. 77
101	101	(2) An action brought pursuant to this subsection 78
102	102	shall be brought within fifteen years of the individual 79
103	103	injured attaining the age of twenty -one or of the date the 80
104	104	treatment of the injury at issue in the action by the 81
105	105	defendant has ceased, whichever is later. 82
106	106	(3) An individual bringing an action under this 83
107	107	subsection shall be entitled to a rebuttable presumption 84
108	108	that the individual was harmed if the i ndividual is 85
109	109	infertile following the prescription or administration of 86
110	110	cross-sex hormones or puberty -blocking drugs and that the 87
111	111	harm was a direct result of the hormones or drugs prescribed 88
112	112	or administered by the health care provider. Such 89
113	113	presumption may be rebutted only by clear and convincing 90
114	114	evidence. 91
115	115	(4) In any action brought pursuant to this subsection, 92
116	116	a plaintiff may recover economic and noneconomic damages and 93
117	117	punitive damages, without limitation to the amount and no 94
118	118	less than five hundred thousand dollars in the aggregate. 95
119	119	The judgment against a defendant in an action brought 96
120	120	pursuant to this subsection shall be in an amount of three 97
121	121	times the amount of any economic and noneconomic damages or 98
122	122	punitive damages assessed. Any award of damages in an 99
123	123	action brought pursuant to this subsection to a prevailing 100
124	124	plaintiff shall include attorney's fees and court costs. 101
125	125	(5) An action brought pursuant to this subsection may 102
126	126	be brought in any circuit court of this state. 103
127	127	(6) No health care provider shall require a waiver of 104
128	128	the right to bring an action pursuant to this subsection as 105
129	129	a condition of services. The right to bring an action by or 106 SB 26 5
130	130	through an individual under the age of eighteen shall not be 107
131	131	waived by a parent o r legal guardian. 108
132	132	(7) A plaintiff to an action brought under this 109
133	133	subsection may enter into a voluntary agreement of 110
134	134	settlement or compromise of the action, but no agreement 111
135	135	shall be valid until approved by the court. No agreement 112
136	136	allowed by the court shall include a provision regarding the 113
137	137	nondisclosure or confidentiality of the terms of such 114
138	138	agreement unless such provision was specifically requested 115
139	139	and agreed to by the plaintiff. 116
140	140	(8) If requested by the plaintiff, any pleadings, 117
141	141	attachments, or exhibits filed with the court in any action 118
142	142	brought pursuant to this subsection, as well as any 119
143	143	judgments issued by the court in such actions, shall not 120
144	144	include the personal identifying information of the 121
145	145	plaintiff. Such information shall be provided in a 122
146	146	confidential information filing sheet contemporaneously 123
147	147	filed with the court or entered by the court, which shall 124
148	148	not be subject to public inspection or availability. 125
149	149	7. The provisions of this section shall not apply to 126
150	150	any speech protected by the First Amendment of the United 127
151	151	States Constitution. 128
152	152	8. The provisions of this section shall not apply to 129
153	153	the following: 130
154	154	(1) Services to individuals born with a medically - 131
155	155	verifiable disorder of sex development, including, bu t not 132
156	156	limited to, an individual with external biological sex 133
157	157	characteristics that are irresolvably ambiguous, such as 134
158	158	those born with 46,XX chromosomes with virilization, 46,XY 135
159	159	chromosomes with undervirilization, or having both ovarian 136
160	160	and testicular tissue; 137 SB 26 6
161	161	(2) Services provided when a physician has otherwise 138
162	162	diagnosed an individual with a disorder of sex development 139
163	163	and determined through genetic or biochemical testing that 140
164	164	the individual does not have normal sex chromosome 141
165	165	structure, sex steroid hormone production, or sex steroid 142
166	166	hormone action; 143
167	167	(3) The treatment of any infection, injury, disease, 144
168	168	or disorder that has been caused by or exacerbated by the 145
169	169	performance of gender transition surgery or the prescription 146
170	170	or administration of cross-sex hormones or puberty -blocking 147
171	171	drugs regardless of whether the surgery was performed or the 148
172	172	hormones or drugs were prescribed or administered in 149
173	173	accordance with state and federal law; or 150
174	174	(4) Any procedure undertaken because the indivi dual 151
175	175	suffers from a physical disorder, physical injury, or 152
176	176	physical illness that would, as certified by a physician, 153
177	177	place the individual in imminent danger of death or 154
178	178	impairment of a major bodily function unless surgery is 155
179	179	performed. 156
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