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STATE OF OKLAHOMA
1st Session of the 59th L egislature (2023)
HOUSE BILL 1011 By: Olsen
AS INTRODUCED
An Act relating to public health and safety ; defining
terms; prohibiting certain health care professionals
from performing or attemp ting to perform gender
transition procedures to certa in individuals;
prohibiting certain health care professionals from
making certain referrals; providing exceptions ;
prohibiting use of public funds for gender transitio n
procedures; prohibiting gender tra nsition procedures
under certain circumstances; prohibiting state
Medicaid program reimbursements ; providing for felony
penalties; authorizing fine or confinement or both;
prescribing statute of limitations; defining certain
conduct as unprofessional ; requiring revocation of
license or certificate ; prescribing statute of
limitations for disciplinary proce edings; authorizing
certain claims or defenses ; prescribing statute of
limitations; authorizing civil actions by minors;
authorizing civil actions after ma jority; authorizing
certain actions without exhaustion of administrative
remedies; authorizing attorney fees; authorizing
Attorney General to bring enforcement actions;
providing for constr uction of act; providing for
codification; and providing an effecti ve date.
BE IT ENACTED BY THE PEOPLE OF THE STATE OF OKLAHOMA:
SECTION 1. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 2607.1 of Title 63, unless there
is created a duplication in numbe ring, reads as follows:
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As used in this act:
1. "Biological sex" means the biological indication of male and
female in the context of reproductive potential or capacity, such as
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;
2. "Cross-sex hormones" means:
a. testosterone or other androgens given to biological
females in amounts that are larger or more potent than
would normally occur naturally in healthy biological
sex females, and
b. estrogen given to biological males in amounts that are
larger or more potent than would normally occur
naturally in healthy biological sex males;
3. "Gender" means the psychological, behavioral, social, and
cultural aspects of being male or female;
4. "Gender reassignment surgery " means any medical or surgical
service that seeks to surgically alter or remove healthy physical or
anatomical characteristics o r features that are typical for the
individual's biological sex, in order to instill or create
physiological or anatomical characteristics that resemble a sex
different from the individual 's biological sex, including but not
limited to genital or nongenita l gender reassignment surgery
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performed for the purpose of assisting an individual with a gender
transition;
5. "Gender transition" means the process in which a person goes
from identifying with and living as a gender that corresponds to his
or her biological sex to identifying with and living as a gender
different from his or her biological sex, and may involve social,
legal, or physical changes;
6. a. "Gender transition procedures " means any medical or
surgical service, including but not limited to
physician's services, inpatient and outpatient
hospital services, or prescribed drugs related to
gender transition, that seeks to:
(1) alter or remove physica l or anatomical
characteristics or features that are typical for
the individual's biological sex, or
(2) instill or create physiological or anatomical
characteristics that resemble a sex different
from the individual's biological sex, including
but not limited to medical services that provide
puberty-blocking drugs, cross -sex hormones, or
other mechanisms to promote the development of
feminizing or masculinizing features in the
opposite biological sex, or genital or nongenital
gender reassignment surgery pe rformed for the
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purpose of assisting an individual with a gender
transition.
b. Gender transition proced ures do not include:
(1) services to persons born with a medically
verifiable disorder of sex development, including
a person with external biological s ex
characteristics that are irresolvably ambiguous,
such as those born with 46 XX chromosomes with
virilization, 46 XY chromosomes with
undervirilization, or having both ovarian and
testicular tissue,
(2) services provided when a physician has otherwise
diagnosed a disorder of sexual development that
the physician has determined through genetic or
biochemical testing that the person does not have
normal sex chromosome structure, sex steroid
hormone production, or sex steroid hormone
action,
(3) the treatment of any infection, injury, disease,
or disorder that has been caused by or
exacerbated by the performan ce of gender
transition procedures, whether or not the gender
transition procedure was performed in accordance
with state and federal law, or
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(4) any procedure undertaken because the individual
suffers from a physical disorder, physical
injury, or physical illness that would, as
certified by a physician, place the individual in
imminent danger of death or impairment of major
bodily function unless surgery is performed;
7. "Genital gender reassignment surgery " means a medical
procedure performed for the pur pose of assisting an individual with
a gender transition, including but not limited to:
a. surgical procedures such as penectomy, orchiectomy,
vaginoplasty, clitoroplasty, or vulvoplasty for
biologically male patients or hysterectomy or
ovariectomy for biologically female patients,
b. reconstruction of the fixed part of the urethra with
or without a metoidioplasty, or
c. phalloplasty, vaginectomy, scroto plasty, or
implantation of erection or testicular prostheses for
biologically female patients;
8. "Health care professional" means a person who is licensed,
certified, or otherwise authorized by the laws of this state to
administer health care in the ordin ary course of the practice of his
or her profession;
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9. "Nongenital gender reassignment surgery " means medical
procedures performed for the purpose of assisting an individual with
a gender transition, including but not limited to:
a. surgical procedures fo r biologically male patients,
such as augmentation mammoplasty, facial feminization
surgery, liposuction , lipofilling, voice surgery,
thyroid cartilage reduction, gluteal augmentation,
hair reconstruction, or various aesthetic procedures,
or
b. surgical procedures for biologically female patients,
such as subcutaneous mastectomy, voice surgery,
liposuction, lipofilling, pectoral implants, or
various aesthetic procedures;
10. "Physician" means a person who is licensed to practice
medicine in this state;
11. "Puberty-blocking drugs" means gonadotropin-releasing
hormone analogues or other synthetic drugs used in biological males
to stop luteinizing hormone secretion and therefore testosterone
secretion, or synthetic drugs used in biological females which stop
the production of estrogens and progesterone, when used to delay or
suppress pubertal development in ch ildren for the purpose of
assisting an individual with a gender transition; and
12. "Public funds" means state, county, or local government
monies, in addition to any department, agency, or instrumentality
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authorized or appropriated under state law or der ived from any fund
in which such monies are deposited.
SECTION 2. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 2607.2 of Title 63, unless there
is created a duplication in numbering, reads as follo ws:
A. A physician or other health care professional shall not
perform or attempt to perform gender transition procedures to any
individual under twenty-one (21) years of age.
B. A physician or other health care professional shall not
refer any individual under twenty-one (21) years of age to any
health care professional for gender transition procedures.
C. A physician or other health care professional is not
prohibited from providing any of the following procedures which are
not gender transition proced ures to an individual under twenty-one
(21) years of age:
1. Services to persons born with a medically verifiable
disorder of sex development, including a person with exter nal
biological sex characteristics that are irresolvably ambiguous, such
as those born with 46 XX chromosomes with virilization, 46 XY
chromosomes with undervirilization, or having both ovarian and
testicular tissue;
2. Services provided when a physician has otherwise diagnosed a
disorder of sexual development that the physician has det ermined
through genetic or biochemical testing that the person does not have
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normal sex chromosome structure, sex steroid hormone production, or
sex steroid hormone action;
3. The treatment of any infection, injury, disease, or disorder
that has been caused by or exacerbated by the performance of gender
transition procedures, whether or not the gender transition
procedure was performed in accordance with state and federal la w or
whether funding for the gender transition procedure is permissible
under Section 3 of this act; or
4. Any procedure undertaken because the individual suffers from
a physical disorder, physical injury, or physical illness that
would, as certified by a physician, place the individual in imminent
danger of death or impairment of m ajor bodily function unless
surgery is performed.
SECTION 3. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 2607.3 of Title 63, unless there
is created a duplication in numbering, reads as follows:
A. Public funds shall not be directly or indirectly used,
granted, paid, or distributed to any entity, organization, or
individual that provides gender transition pr ocedures to an
individual under twenty-one (21) years of age. Any violation shall
result in the loss of such funding.
B. Health care services furnished in the following situations
shall not include gender transition procedures to an individual
under twenty-one (21) years of age:
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1. By or in a health care facility owned by the state or a
county or local government; or
2. By a physician or other hea lth care professional employed by
the state or a county or local government.
C. The state Medicaid program shall not reimburse or provide
coverage for gender transition pr ocedures to an individual under
twenty-one (21) years of age.
SECTION 4. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 2607.4 of Title 63, unless there
is created a duplication in numbering, reads as follows:
A. 1. As provided in subsection A of Section 2 of this act, a
physician or other health care professional performing or attempting
to perform gender transition proce dures to any individual under
twenty-one (21) years of age shall, upon conviction, be guilty of a
felony punishable by fine not to exceed One Hundred Thousand D ollars
($100,000.00), or by confinement in the custody of the Department of
Corrections for a term not to exceed ten (10) years, or by both such
fine and imprisonment .
2. Prosecution for a criminal violation of this subsection
shall be commenced not later than the date as of whi ch the
individual receiving gender transition procedures attains the age of
forty-five (45) years.
B. 1. As provided in subsection B of Section 2 of this act, a
physician or other hea lth care professional found to have knowingly
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referred any individual under twenty-one (21) years of age to any
health care professional for gender transition procedures shall,
upon conviction, be guilty of a felony.
2. Prosecution for a criminal violation of this subsection
shall be commenced not later than the date as of w hich the
individual receiving gender transition procedures attains the age of
forty-five (45) years.
C. 1. Any referral for or provision of gender transition
procedures to an individu al under twenty-one (21) years of age is
unprofessional conduct and sha ll, upon an adverse ruling by the
appropriate licensing board, result in immediate revocation of the
license or certificate of the physician or other health care
professional.
2. Disciplinary proceedings against the physician or other
health care professional must be commenced not later than the date
as of which the individual receiving gen der transition procedures
attains the age of forty-five (45) years.
D. 1. A person may assert a n actual or threatened violation of
this act as an independent civil act ion or defense in a judicial or
administrative proceeding and obtain compensatory damages ,
injunctive relief, declaratory relief, or any other appropriate
relief.
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2. A person shall bring a claim for a violation of this act no
later than the date as of which the individual receiving gen der
transition procedures attai ns the age of forty-five (45) years.
3. An individual under eighteen (18) years of age may bring an
action throughout thei r minority through a parent or next friend,
and may bring an action in their own name upon reaching majority at
any time from that point until twenty -seven (27) years after
reaching the age of majority.
4. Notwithstanding any other provision of law, an ac tion under
this subsection may be commenced, and relief may be granted, in a
judicial proceeding without regard to whether the person commencing
the action has sought or exhausted available administrative
remedies.
5. In any action or proceeding to enforc e a provision of this
act, a prevailing party who establishes a violati on of this act
shall recover reasonable attorney fees.
E. 1. The Attorney General may bring an action to enforce
compliance with this act.
2. This act does not deny, impair, or other wise affect any
right or authority of the Attorney General, the State o f
Oklahoma, or any agency, officer, or employee of the state,
acting under any law other than this act, to institute or
intervene in any proceeding.
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SECTION 5. This act shall become effective November 1, 2023.
59-1-5096 TJ 11/30/22