Texas 2017 - 85th Regular

Texas Senate Bill SB1342 Compare Versions

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

Old	New	Differences
1	1	85R9724 MCK-D
2	2	By: Garcia S.B. No. 1342
3	3
4	4
5	5	A BILL TO BE ENTITLED
6	6	AN ACT
7	7	relating to prohibited nonconsensual genital surgery on certain
8	8	minors with intersex traits.
9	9	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
10	10	SECTION 1. Sections 266.001 through 266.012, Family Code,
11	11	are designated as Subchapter A, Chapter 266, Family Code, and a
12	12	heading is added to Subchapter A to read as follows:
13	13	SUBCHAPTER A. GENERAL PROVISIONS; EDUCATIONAL SERVICES; MEDICAL
14	14	CARE
15	15	SECTION 2. Chapter 266, Family Code, is amended by adding
16	16	Subchapter B to read as follows:
17	17	SUBCHAPTER B. MEDICAL PROCEDURES AND TREATMENTS RELATED TO
18	18	INTERSEX TRAITS
19	19	Sec. 266.051. DEFINITIONS. In this subchapter:
20	20	(1) "Intersex child" means an individual who is
21	21	younger than 18 years of age and either:
22	22	(A) has inborn chromosomal, gonadal, genital, or
23	23	endocrine characteristics, or a combination of those
24	24	characteristics, that are not suited to the typical definition of
25	25	male or female or are atypical for the sex assigned; or
26	26	(B) is considered by a medical professional to
27	27	have inborn chromosomal, gonadal, genital, or endocrine
28	28	characteristics that are ambiguous or atypical for the sex
29	29	assigned.
30	30	(2) "Medical procedure or treatment related to an
31	31	intersex trait" includes genital surgery, gonadal surgery, or
32	32	hormonal treatment to treat or modify an intersex trait.
33	33	(3) "Medically necessary" means a medical procedure or
34	34	treatment immediately necessary to treat an injury, illness,
35	35	disease, or condition affecting the intersex child's health that if
36	36	delayed would adversely affect the intersex child's physical
37	37	health.
38	38	Sec. 266.052. REQUIREMENTS FOR CERTAIN MEDICAL PROCEDURES
39	39	OR TREATMENTS. A physician may not perform a medical procedure or
40	40	treatment related to an intersex trait on a foster child younger
41	41	than 12 years of age unless:
42	42	(1) the procedure or treatment is medically necessary
43	43	for the physical health of the child and the department consents to
44	44	the procedure or treatment; or
45	45	(2) the procedure or treatment is not medically
46	46	necessary for the physical health of the child and a court
47	47	authorizes the procedure or treatment as provided under this
48	48	subchapter.
49	49	Sec. 266.053. COURT APPROVAL OF CERTAIN MEDICAL PROCEDURES
50	50	OR TREATMENTS. (a) If the department or an intersex child's
51	51	physician wants the child to undergo a medical procedure or
52	52	treatment related to an intersex trait that is not medically
53	53	necessary for the physical health of the child, the department or
54	54	physician may file a petition with the court having continuing
55	55	jurisdiction over the intersex child seeking court approval of the
56	56	procedure or treatment.
57	57	(b) The court shall hold a hearing to determine whether the
58	58	proposed medical procedure or treatment related to an intersex
59	59	trait is in the child's best interest.
60	60	(c) The child must be represented by an attorney at the
61	61	hearing. The attorney for the child must:
62	62	(1) possess adequate knowledge of intersex traits, the
63	63	intersex population, and the range of medical procedures or
64	64	treatments that may be pursued in connection with the child's
65	65	intersex trait, including the option to delay any procedure or
66	66	treatment;
67	67	(2) communicate with the child, to the extent possible
68	68	given the child's age, regarding:
69	69	(A) the nature of the proposed medical procedure
70	70	or treatment;
71	71	(B) the extent to which the proposed medical
72	72	procedure or treatment is irreversible; and
73	73	(C) the projected outcome of, the possible risks
74	74	associated with, and the alternatives, including delay, to the
75	75	proposed medical procedure or treatment;
76	76	(3) interview the child, to the extent possible given
77	77	the child's age, to determine the child's wishes regarding the
78	78	pursuit or delay of any proposed medical procedure or treatment;
79	79	(4) assist the child, to the extent possible given the
80	80	child's age, in assessing the child's desires related to the child's
81	81	medical care and in communicating the child's desires to the court;
82	82	and
83	83	(5) for a child younger than 12 years of age, argue
84	84	against a proposed medical procedure or treatment that is not
85	85	medically necessary for the physical health of the child.
86	86	(d) Any party to the suit may submit to the court a report or
87	87	introduce evidence from a qualified expert on:
88	88	(1) intersex traits and the intersex population in
89	89	general;
90	90	(2) the child's specific intersex traits;
91	91	(3) the range of medical procedures and treatments
92	92	that may be pursued in connection with the child's intersex traits,
93	93	including delay;
94	94	(4) the specific medical procedure or treatment
95	95	proposed for the child, including the risks and anticipated
96	96	benefits associated with the procedure or treatment and the
97	97	possibility that the child's ultimate gender identity may differ
98	98	from the sex assigned;
99	99	(5) the extent to which the medical procedure or
100	100	treatment:
101	101	(A) is irreversible; and
102	102	(B) may safely be delayed until the child is of an
103	103	age to participate in the decision-making process;
104	104	(6) the physician's responsibilities to obtain
105	105	informed consent from the child and the child's parent or guardian
106	106	and whether those responsibilities have been adequately
107	107	discharged; and
108	108	(7) the public statements of intersex individuals or
109	109	patient advocates regarding Subdivisions (1)-(6).
110	110	(e) Following the hearing, the court shall determine
111	111	whether the proposed medical procedure or treatment related to an
112	112	intersex trait is in the child's best interest and render an order
113	113	with specific findings on:
114	114	(1) whether clear and convincing evidence establishes
115	115	that the short-term or long-term physical benefits of the proposed
116	116	medical procedure or treatment outweigh the short-term or long-term
117	117	physical risks;
118	118	(2) whether clear and convincing evidence establishes
119	119	that the short-term and long-term psychological benefits of the
120	120	proposed medical procedure or treatment outweigh the short-term or
121	121	long-term psychological risks;
122	122	(3) the extent to which the proposed medical procedure
123	123	or treatment would limit the child's future options for:
124	124	(A) fertility;
125	125	(B) development or construction of
126	126	female-typical characteristics;
127	127	(C) development or construction of male-typical
128	128	characteristics; and
129	129	(D) preservation of body characteristics
130	130	unaltered by decisions the child did not initiate; and
131	131	(4) whether clear and convincing evidence establishes
132	132	that any limitation identified under Subdivision (3) is justified
133	133	by an urgent need for the proposed medical procedure or treatment.
134	134	(f) If the requirements of Sections 266.054(1) and (2) are
135	135	satisfied, the court may consider the child's consent to the
136	136	proposed medical procedure or treatment related to an intersex
137	137	trait as clear and convincing evidence for purposes of the court's
138	138	best-interest determination under Subsection (e).
139	139	Sec. 266.054. FOSTER CHILD'S CONSENT TO MEDICAL PROCEDURE
140	140	OR TREATMENT. Notwithstanding Section 32.003 or 266.004 or other
141	141	law, a foster child 12 years of age or older may consent to a medical
142	142	procedure or treatment related to an intersex trait if the child:
143	143	(1) has been evaluated by a physician and a
144	144	psychologist, both of whom have had previous experience treating
145	145	patients with intersex traits, and the physician and psychologist
146	146	determine the child has the maturity necessary to make decisions
147	147	regarding the child's medical care; and
148	148	(2) has been provided with the information necessary
149	149	to enable the child to provide voluntary and informed consent to the
150	150	proposed medical procedure or treatment, including:
151	151	(A) the nature of the proposed medical procedure
152	152	or treatment, including whether and to what extent the proposed
153	153	procedure or treatment is irreversible;
154	154	(B) the projected outcome of the proposed medical
155	155	procedure or treatment, including whether the benefits of the
156	156	procedure or treatment are medical, psychological, or social, and
157	157	the strength of the evidence supporting the claims that the
158	158	procedure or treatment provides each of those benefits;
159	159	(C) the possible risks associated with the
160	160	proposed medical procedure or treatment, including, as applicable,
161	161	loss of reproductive capacity, loss of sexual function or
162	162	sensation, and the child's ultimate gender identity differing from
163	163	the sex assigned; and
164	164	(D) the alternatives to the proposed medical
165	165	procedure or treatment, including delaying the procedure or
166	166	treatment.
167	167	SECTION 3. This Act takes effect immediately if it receives
168	168	a vote of two-thirds of all the members elected to each house, as
169	169	provided by Section 39, Article III, Texas Constitution. If this
170	170	Act does not receive the vote necessary for immediate effect, this
171	171	Act takes effect September 1, 2017.