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North Carolina House Bill H1000

North Carolina 2025-2026 Regular Session

North Carolina House Bill H1000 Compare Versions

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11 GENERAL ASSEMBLY OF NORTH CAROLINA
22 SESSION 2025
3-H 1
4-HOUSE BILL 1000
3+H D
4+HOUSE BILL DRH40506-NB-123
5+
56
67
78 Short Title: Detransitioners Bill of Rights. (Public)
8-Sponsors: Representatives Johnson, N. Jackson, and Almond (Primary Sponsors).
9-For a complete list of sponsors, refer to the North Carolina General Assembly web site.
10-Referred to: Rules, Calendar, and Operations of the House
11-April 14, 2025
12-*H1000 -v-1*
9+Sponsors: Representative Johnson.
10+Referred to:
11+
12+*DRH40506 -NB-123*
1313 A BILL TO BE ENTITLED 1
1414 AN ACT TO ESTABLISH THE DETRANSITIONER BILL OF RIGHTS. 2
1515 The General Assembly of North Carolina enacts: 3
1616 SECTION 1. Article 1N of Chapter 90 of the General Statutes reads as rewritten: 4
1717 "Article 1N. 5
1818 "Gender Transition Procedures on Minors.Minors and Detransitioner Bill of Rights. 6
1919 "§ 90-21.150. Definitions. 7
2020 The following definitions apply in this Article: 8
2121 … 9
2222 (2a) Department. – The Department of Health and Human Services. 10
2323 (2b) Detransitioner. – An individual who (i) began or completed a gender transition 11
2424 procedure but later sought treatment to reverse the effects of the surgical 12
2525 gender transition procedure or regimen of cross-sex hormones or 13
2626 puberty-blocking drugs due to the resolution of any inconsistency between the 14
2727 individual's sex and individual's perceived sex or perceived gender or (ii) has 15
2828 ceased the surgical gender transition procedure or regimen of cross-sex 16
2929 hormones or puberty-blocking drugs due to the resolution of any 17
3030 inconsistency between the individual's sex and the individual's perceived sex 18
3131 or perceived gender. 19
3232 (2c) Detransition procedure. – Any treatment, including mental health treatment, 20
3333 medical interventions, and surgeries that (i) stop or reverse the effects of a 21
3434 prior surgical gender transition procedure or regimen of cross-sex hormones 22
3535 or puberty-blocking drugs due to the resolution of any inconsistency between 23
3636 the individual's sex and the individual's perceived sex or perceived gender or 24
3737 (ii) help an individual cope with the effects of a prior surgical gender transition 25
3838 procedure or regimen of cross-sex hormones or puberty-blocking drugs after 26
3939 the resolution of any inconsistency between the individual's sex and the 27
4040 individual's perceived sex or perceived gender. 28
4141 (2d) Female. – An individual who has, had, will have, or would have but for a 29
4242 developmental or genetic anomaly or historical accident, the reproductive 30
4343 system that at some point produces, transports, and utilizes eggs for 31
4444 fertilization. 32
4545 (3) Gender. – The psychological, behavioral, social, and cultural aspects of being 33
46-male or female. 34 General Assembly Of North Carolina Session 2025
47-Page 2 House Bill 1000-First Edition
48-(3a) Gender clinic. – A health care entity that provides or prescribes gender 1
49-transition procedures or refers individuals for surgical gender transition 2
50-procedures or the dispensing of puberty-blocking drugs or cross-sex 3
51-hormones. 4
52-… 5
53-(6a) Male. – An individual who has, had, will have, or would have but for a 6
54-developmental or genetic anomaly or historical accident, the reproductive 7
55-system that at some point produces, transports, and utilizes sperm for 8
56-fertilization. 9
57-… 10
58-"§ 90-21.151. Limitations on detransition procedures and gender transition procedures. 11
59-It shall be unlawful for a medical professional to perform a detransition procedure, surgical 12
60-gender transition procedure on a minor or to prescribe, provide, or dispense puberty-blocking 13
61-drugs or cross-sex hormones to a minor. 14
62-"§ 90-21.152. When certain procedures are permitted. 15
63-(a) Notwithstanding G.S. 90-21.151, and provided the minor's parents or guardians give 16
64-informed consent, a medical professional shall not be prohibited from providing any of the 17
65-following procedures to a minor: 18
46+male or female. 34
47+(3a) Gender clinic. – A health care entity that provides or prescribes gender 35
48+transition procedures or refers individuals for surgical gender transition 36
49+H.B. 1000
50+Apr 10, 2025
51+HOUSE PRINCIPAL CLERK General Assembly Of North Carolina Session 2025
52+Page 2 DRH40506-NB-123
53+procedures or the dispensing of puberty-blocking drugs or cross-sex 1
54+hormones. 2
55+… 3
56+(6a) Male. – An individual who has, had, will have, or would have but for a 4
57+developmental or genetic anomaly or historical accident, the reproductive 5
58+system that at some point produces, transports, and utilizes sperm for 6
59+fertilization. 7
60+… 8
61+"§ 90-21.151. Limitations on detransition procedures and gender transition procedures. 9
62+It shall be unlawful for a medical professional to perform a detransition procedure, surgical 10
63+gender transition procedure on a minor or to prescribe, provide, or dispense puberty-blocking 11
64+drugs or cross-sex hormones to a minor. 12
65+"§ 90-21.152. When certain procedures are permitted. 13
66+(a) Notwithstanding G.S. 90-21.151, and provided the minor's parents or guardians give 14
67+informed consent, a medical professional shall not be prohibited from providing any of the 15
68+following procedures to a minor: 16
69+… 17
70+(7) A detransition procedure. 18
6671 … 19
67-(7) A detransition procedure. 20
68-… 21
69-"§ 90-21.153. Penalties. 22
70-(a) A violation of any of the provisions of this Article by a medical professional shall be 23
71-considered unprofessional conduct and shall result in the revocation of the medical professional's 24
72-license to practice.practice for a minimum of one year. 25
73-(b) An entity that employs or contracts with a medical professional who violates any of 26
74-the provisions of this Article shall be liable for a civil penalty not to exceed two hundred fifty 27
75-thousand dollars ($250,000). 28
76-"§ 90-21.154. Civil remedies. 29
77-(a) Any (i) medical professional who performs a surgical gender transition procedure on 30
78-a minor or who prescribes, provides, or dispenses puberty-blocking drugs or cross-sex hormones 31
79-to a minor and (ii) entity that employs or contracts with a medical professional who performs a 32
80-surgical gender transition procedure on a minor or who prescribes, provides, or dispenses 33
81-puberty-blocking drugs or cross-sex hormones to a minor shall be strictly liable to the minor for 34
82-any physical, psychological, emotional, or physiological harms the minor suffers as a result of 35
83-the surgical gender transition procedure, puberty-blocking drugs, or cross-sex hormones. 36
84-(a1) Any individual who undergoes a detransition procedure may bring a civil action either 37
85-within 10 years from the day the person reaches 18 years of age or within four years from the 38
86-time the cost of a detransition procedure is incurred, whichever date is later, against a medical 39
87-professional in a court of competent jurisdiction. 40
88-(b) A minor who suffers an injury described in subsection (a) subsections (a) and (a1) of 41
89-this section, or a parent or guardian of a minor who suffers an injury described in subsection (a) 42
90-subsections (a) and (a1) of this section, may bring a civil action within the latter of 25 10 years 43
91-from the day the minor reaches 18 years of age or four years from the time of discovery by the 44
92-injured party of both the injury and the causal relationship between the treatment and the injury 45
93-against the offending medical professional or entity. If the minor who suffered any injury 46
94-described in subsection (a) subsections (a) and (a1) of this section is under a legal disability upon 47
95-attaining 18 years of age, the time limitation in this subsection does not begin to run until that 48
96-legal disability is removed. An individual commencing an action under this section may seek the 49
97-following relief: 50
98-(1) Declaratory or injunctive relief. 51 General Assembly Of North Carolina Session 2025
99-House Bill 1000-First Edition Page 3
72+"§ 90-21.153. Penalties. 20
73+(a) A violation of any of the provisions of this Article by a medical professional shall be 21
74+considered unprofessional conduct and shall result in the revocation of the medical professional's 22
75+license to practice.practice for a minimum of one year. 23
76+(b) An entity that employs or contracts with a medical professional who violates any of 24
77+the provisions of this Article shall be liable for a civil penalty not to exceed two hundred fifty 25
78+thousand dollars ($250,000). 26
79+"§ 90-21.154. Civil remedies. 27
80+(a) Any (i) medical professional who performs a surgical gender transition procedure on 28
81+a minor or who prescribes, provides, or dispenses puberty-blocking drugs or cross-sex hormones 29
82+to a minor and (ii) entity that employs or contracts with a medical professional who performs a 30
83+surgical gender transition procedure on a minor or who prescribes, provides, or dispenses 31
84+puberty-blocking drugs or cross-sex hormones to a minor shall be strictly liable to the minor for 32
85+any physical, psychological, emotional, or physiological harms the minor suffers as a result of 33
86+the surgical gender transition procedure, puberty-blocking drugs, or cross-sex hormones. 34
87+(a1) Any individual who undergoes a detransition procedure may bring a civil action either 35
88+within 10 years from the day the person reaches 18 years of age or within four years from the 36
89+time the cost of a detransition procedure is incurred, whichever date is later, against a medical 37
90+professional in a court of competent jurisdiction. 38
91+(b) A minor who suffers an injury described in subsection (a) subsections (a) and (a1) of 39
92+this section, or a parent or guardian of a minor who suffers an injury described in subsection (a) 40
93+subsections (a) and (a1) of this section, may bring a civil action within the latter of 25 10 years 41
94+from the day the minor reaches 18 years of age or four years from the time of discovery by the 42
95+injured party of both the injury and the causal relationship between the treatment and the injury 43
96+against the offending medical professional or entity. If the minor who suffered any injury 44
97+described in subsection (a) subsections (a) and (a1) of this section is under a legal disability upon 45
98+attaining 18 years of age, the time limitation in this subsection does not begin to run until that 46
99+legal disability is removed. An individual commencing an action under this section may seek the 47
100+following relief: 48
101+(1) Declaratory or injunctive relief. 49 General Assembly Of North Carolina Session 2025
102+DRH40506-NB-123 Page 3
100103 (2) Compensatory damages, including pain and suffering, loss of reputation, loss 1
101104 of income, and loss of consortium, which includes the loss of expectation of 2
102105 sharing parenthood. 3
103106 (3) Punitive damages. 4
104107 (4) Attorneys' fees and court costs. 5
105108 (5) Any other appropriate relief. 6
106109 (6) Costs associated with a subsequent detransition procedure. 7
107110 (c) Minors bringing an action under this section may do so through a parent or guardian 8
108111 prior to attaining majority and may do so in their own name after attaining majority. 9
109112 Notwithstanding G.S. 143-299, any action brought under this section may be commenced within 10
110113 the time frames described in subsection (b) of this section. 11
111114 (d) G.S. 90-21.19(a) shall not apply to damages awarded in an action brought under this 12
112115 section. 13
113116 (e) Medical professionals and entities employing or contracting with medical 14
114117 professionals may not seek a contractual waiver of the liability imposed under this section. Any 15
115118 attempted waiver is null and void. 16
116119 "§ 90-21.155. Right to public transparency. 17
117120 (a) Any gender clinic operating in the State must provide a report of statistics regarding 18
118121 all surgical gender transition procedures and prescribed regimens of cross-sex hormones or 19
119122 puberty-blocking drugs to patients to the Department. 20
120123 (b) The Department shall develop a form for this purpose and determine the statistics to 21
121124 be reported, which must include the following: 22
122125 (1) The date on which the surgical gender transition procedure or prescribed 23
123126 regimen of cross-sex hormones or puberty-blocking drugs was prescribed or 24
124127 the referral was made for either. 25
125128 (2) The age and sex of the person to whom the surgical gender transition 26
126129 procedure or prescribed regimen of cross-sex hormones or puberty-blocking 27
127130 drugs was prescribed or for whom the referral was made for either. 28
128131 (3) For any cross-sex hormone or puberty-blocking drug prescribed as part of a 29
129132 gender transition, (i) the name of the drug or hormone, (ii) the dosage, (iii) the 30
130133 dosage frequency and duration, and (iv) the method by which the drug will be 31
131134 administered. 32
132135 (4) For any surgical gender transition procedure, the type of surgical procedure, 33
133136 identified by current procedural terminology code. 34
134137 (5) The state and county of residence of the person receiving the surgical gender 35
135138 transition procedure or regimen of cross-sex hormones or puberty-blocking 36
136139 drugs. 37
137140 (6) The name, contact information, and medical specialty of the medical 38
138141 professional who prescribed the (i) surgical gender transition procedure or (ii) 39
139142 regimen of cross-sex hormones or puberty-blocking drugs or made the referral 40
140143 for either. 41
141144 (7) If applicable, a description of any other neurological, behavioral, or mental 42
142145 health conditions that the person has been diagnosed with or exhibits 43
143146 symptoms of, including autism spectrum disorder, depressions, anxiety, or 44
144147 bipolar disorder. 45
145148 (c) A form shall be completed by each gender clinic that prescribes or performs a surgical 46
146149 gender transition procedure or regimen of cross-sex hormones or puberty-blocking drugs that is 47
147150 signed by the medical professional who prescribes the surgical gender transition procedure or 48
148151 regimen of cross-sex hormones or puberty-blocking drugs or makes a referral for either. 49
149152 (d) Each form shall be transmitted by the gender clinic to the Department within 15 days 50
150153 after the end of the calendar month during which the surgical gender transition procedure or 51 General Assembly Of North Carolina Session 2025
151-Page 4 House Bill 1000-First Edition
154+Page 4 DRH40506-NB-123
152155 regimen of cross-sex hormones or puberty-blocking drugs was prescribed or the referral was 1
153156 made for either. 2
154157 "§ 90-21.156. Local limitations. 3
155158 (a) No city or county may prohibit the provision of mental health services or therapy to 4
156159 help a minor address an inconsistency between the minor's biological sex and the minor's 5
157160 perceived gender or perceived biological sex. 6
158161 (b) No city or county may prohibit a parent or legal guardian from consenting to, or 7
159162 withholding consent from, the provision of mental health services or therapy to help a minor 8
160163 address an inconsistency between the minor's biological sex and the minor's perceived gender or 9
161164 perceived biological sex. 10
162165 "§ 90-21.157. Enforcement. 11
163166 The Attorney General may investigate any complaints received alleging violation of this 12
164167 Article. If the Attorney General finds that there has been a violation of this Article, the Attorney 13
165168 General may bring an action to impose civil penalties and to seek any other appropriate relief 14
166169 under this Article. Any clear proceeds of civil penalties imposed in actions instituted by the 15
167170 Attorney General shall be remitted to the Civil Penalty and Forfeiture Fund in accordance with 16
168171 G.S. 115C-457.2. 17
169172 "§ 90-21.158. Reporting. 18
170173 On November 1 of each year, the Department shall submit an annual report to the Joint 19
171174 Legislative Oversight Committee on Health and Human Services that compiles the data required 20
172175 to be collected under this Article into a comprehensive statistical report. Any information in this 21
173176 report shall not disclose the identity of any person or entity that is the subject of any report. The 22
174177 Department shall also publish the report on a publicly available website." 23
175178 SECTION 2.(a) Article 3 of Chapter 58 of the General Statutes is amended by adding 24
176179 a new section to read: 25
177180 "§ 58-3-257. Detransition procedure coverage. 26
178181 (a) The following definitions apply in this section: 27
179182 (1) Detransition procedure. – As defined in G.S. 90-21.150. 28
180183 (2) Female. – An individual who has, had, will have, or would have but for a 29
181184 developmental or genetic anomaly or historical accident, the reproductive 30
182185 system that at some point produces, transports, and utilizes eggs for 31
183186 fertilization. 32
184187 (3) Gender. – The psychological, behavioral, social, and cultural aspects of being 33
185188 male or female. 34
186189 (4) Gender transition procedure. – Any pharmaceutical or surgical intervention to 35
187190 alter an individual's body as a treatment to address an inconsistency between 36
188191 the individual's sex and the individual's perceived gender or perceived sex. 37
189192 (5) Male. – An individual who has, had, will have, or would have but for a 38
190193 developmental or genetic anomaly or historical accident, the reproductive 39
191194 system that at some point produces, transports, and utilizes sperm for 40
192195 fertilization. 41
193196 (6) Minor. – An individual who is younger than 18 years of age. 42
194197 (7) Perceived sex. – An individual's internal sense of his or her sex. 43
195198 (8) Perceived gender. – An individual's internal sense of his or her gender. 44
196199 (9) Sex. – The biological indication of male and female in the context of 45
197200 reproductive potential or capacity, including sex chromosomes, naturally 46
198201 occurring sex hormones, gonads, and nonambiguous internal and external 47
199202 genitalia present at birth, including secondary sex characteristics, without 48
200203 regard to an individual's psychological, chosen, or subjective experience of 49
201204 gender. 50 General Assembly Of North Carolina Session 2025
202-House Bill 1000-First Edition Page 5
205+DRH40506-NB-123 Page 5
203206 (b) All health benefit plans that provide coverage for one or more gender transition 1
204207 procedures for insureds who are minors, including coverage for any applicable related diagnostic, 2
205208 billing, or CPT code, shall also provide coverage for all of the following: 3
206209 (1) All possible adverse consequences related to the gender transition procedure, 4
207210 including both short-term and long-term side effects of the procedure. 5
208211 (2) Testing and screening necessary to monitor the mental health and physical 6
209212 health of any insured on no less than an annual basis and without regard to the 7
210213 sex designation on the insured's medical record. 8
211214 (3) Any procedure or treatment, including therapy, necessary to manage, reverse, 9
212215 or recover from the insured's previous gender transition procedure. 10
213216 (c) Coverage required under this section shall be provided to all insureds that underwent 11
214217 a gender transition procedure as a minor regardless of whether that gender transition procedure 12
215218 occurred when the individual was not insured under the current health benefit plan. 13
216219 (d) On at least an annual basis, an insurer offering one or more health benefit plans that 14
217220 provide coverage for gender transition or detransition procedures shall provide the following 15
218221 information, if known, to the Commissioner and the Secretary of the Department of Health and 16
219222 Human Services in a manner determined by the Commissioner or the Secretary and that contains 17
220223 no protected health information nor personally identifiable information: 18
221224 (1) The number of claims made for a gender transition or detransition procedure. 19
222225 (2) The age and sex of the individuals for whom a gender transition or detransition 20
223226 procedure claim is submitted. 21
224227 (3) The date that the individual for whom a detransition procedure claim is 22
225228 submitted initially began a prior gender transition procedure. 23
226229 (4) The county of residence of the person for whom the gender transition or 24
227230 detransition procedure claim is submitted. 25
228231 (e) Nothing in this section shall be construed to require an insurer to provide any coverage 26
229232 for gender transition procedures." 27
230233 SECTION 2.(b) This section becomes effective October 1, 2025, and applies to 28
231234 insurance contracts issued, renewed, or amended on or after that date. 29
232235 SECTION 3.(a) G.S. 130A-118 reads as rewritten: 30
233236 "§ 130A-118. Amendment of birth and death certificates. 31
234237 … 32
235238 (b) A new certificate of birth shall be made by the State Registrar when:if any of the 33
236239 following conditions are met: 34
237240 (1) Proof is submitted to the State Registrar that the previously unwed parents of 35
238241 a person have intermarried subsequent to the birth of the person;person. 36
239242 (2) Notification is received by the State Registrar from the clerk of a court of 37
240243 competent jurisdiction of a judgment, order or decree disclosing different or 38
241244 additional information relating to the parentage of a person;person. 39
242245 (3) Satisfactory proof is submitted to the State Registrar that there has been 40
243246 entered in a court of competent jurisdiction a judgment, order or decree 41
244247 disclosing different or additional information relating to the parentage of a 42
245248 person; orperson. 43
246249 … 44
247250 (5) A written request from an individual is received by the State Registrar to 45
248251 change the sex on that individual's birth record because the person is a 46
249252 destransitioner, if the request is accompanied by a notarized statement from a 47
250253 physician licensed to practice medicine who can certify that the person has 48
251254 undergone a detransition procedure, as defined in Article 1N of Chapter 90 of 49
252255 the General Statutes." 50
253256 SECTION 3.(b) This section becomes effective October 1, 2025. 51 General Assembly Of North Carolina Session 2025
254-Page 6 House Bill 1000-First Edition
257+Page 6 DRH40506-NB-123
255258 SECTION 4.(a) Part 1 of Article 1A of Chapter 90 of the General Statutes is 1
256259 amended by adding a new section to read: 2
257260 "§ 90-21.5A. Limited access to records. 3
258261 (a) Notwithstanding any other provision of law to the contrary, no medical professional 4
259262 shall deny a parent or legal guardian access to the medical records or medical information of the 5
260263 parent's or legal guardian's minor, except in the following circumstances: 6
261264 (1) The medical records or medical information relate to harm resulting from 7
262265 abuse, neglect, or domestic violence. 8
263266 (2) The person denying access reasonably believes (i) the parent or legal guardian 9
264267 is responsible for the abuse, neglect, or other injury resulting from domestic 10
265268 violence or (ii) that informing the parent or legal guardian would not be in the 11
266269 best interest of the minor. 12
267270 (b) For the purposes of this section, the term "abuse, neglect, or domestic violence" does 13
268271 not include any of the following: 14
269272 (1) A parent's or legal guardian's refusal to permit the parent's or legal guardian's 15
270273 minor to seek a surgical gender transition procedure or regimen of cross-sex 16
271274 hormones or puberty-blocking drugs, as those terms are defined in Article 1N 17
272275 of this Chapter, in violation of that Article. 18
273276 (2) A parent's or legal guardian's refusal to address the parent's or legal guardian's 19
274277 minor using pronouns that are inconsistent with the minor's sex. 20
275278 (c) A parent or legal guardian who is denied access to medical records or medical 21
276279 information in violation of this section shall have a private cause of action for damages and 22
277280 equitable relief as the court may determine is justified. The court may also award reasonable 23
278281 attorneys' fees and court costs to a prevailing party. 24
279282 (d) The Attorney General may investigate a potential violation of this section, seek 25
280283 production of documentation or testimony through a civil investigative demand, and bring an 26
281284 action to enforce compliance with this section." 27
282285 SECTION 4.(b) This section is effective when it becomes law. 28
283286 SECTION 5. If any provision of this act or its application is held invalid, the 29
284287 invalidity does not affect other provisions or applications of this act that can be given effect 30
285288 without the invalid provisions or application and, to this end, the provisions of this act are 31
286289 severable. 32
287290 SECTION 6. Except as otherwise provided, this act becomes effective October 1, 33
288291 2025. 34