88R4257 EAS-D
By: Schatzline H.B. No. 1532
A BILL TO BE ENTITLED
AN ACT
relating to professional liability insurance coverage for and
prohibitions on the provision to certain children of procedures and
treatments for gender transitioning, gender reassignment, or
gender dysphoria and to the abuse of a child.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Section 261.001(1), Family Code, is amended to
read as follows:
(1) "Abuse" includes the following acts or omissions
by a person:
(A) mental or emotional injury to a child that
results in an observable and material impairment in the child's
growth, development, or psychological functioning;
(B) causing or permitting the child to be in a
situation in which the child sustains a mental or emotional injury
that results in an observable and material impairment in the
child's growth, development, or psychological functioning;
(C) physical injury that results in substantial
harm to the child, or the genuine threat of substantial harm from
physical injury to the child, including an injury that is at
variance with the history or explanation given and excluding an
accident or reasonable discipline by a parent, guardian, or
managing or possessory conservator that does not expose the child
to a substantial risk of harm;
(D) failure to make a reasonable effort to
prevent an action by another person that results in physical injury
that results in substantial harm to the child;
(E) sexual conduct harmful to a child's mental,
emotional, or physical welfare, including conduct that constitutes
the offense of continuous sexual abuse of young child or disabled
individual under Section 21.02, Penal Code, indecency with a child
under Section 21.11, Penal Code, sexual assault under Section
22.011, Penal Code, or aggravated sexual assault under Section
22.021, Penal Code;
(F) failure to make a reasonable effort to
prevent sexual conduct harmful to a child;
(G) compelling or encouraging the child to engage
in sexual conduct as defined by Section 43.01, Penal Code,
including compelling or encouraging the child in a manner that
constitutes an offense of trafficking of persons under Section
20A.02(a)(7) or (8), Penal Code, solicitation of prostitution under
Section 43.021, Penal Code, or compelling prostitution under
Section 43.05(a)(2), Penal Code;
(H) causing, permitting, encouraging, engaging
in, or allowing the photographing, filming, or depicting of the
child if the person knew or should have known that the resulting
photograph, film, or depiction of the child is obscene as defined by
Section 43.21, Penal Code, or pornographic;
(I) the current use by a person of a controlled
substance as defined by Chapter 481, Health and Safety Code, in a
manner or to the extent that the use results in physical, mental, or
emotional injury to a child;
(J) causing, expressly permitting, or
encouraging a child to use a controlled substance as defined by
Chapter 481, Health and Safety Code;
(K) causing, permitting, encouraging, engaging
in, or allowing a sexual performance by a child as defined by
Section 43.25, Penal Code;
(L) knowingly causing, permitting, encouraging,
engaging in, or allowing a child to be trafficked in a manner
punishable as an offense under Section 20A.02(a)(5), (6), (7), or
(8), Penal Code, or the failure to make a reasonable effort to
prevent a child from being trafficked in a manner punishable as an
offense under any of those sections; [or]
(M) forcing or coercing a child to enter into a
marriage; or
(N) providing to a child a gender transitioning
or gender reassignment treatment or performing on a child a gender
transitioning or gender reassignment procedure that is prohibited
by Subchapter X, Chapter 161, Health and Safety Code.
SECTION 2. Chapter 161, Health and Safety Code, is amended
by adding Subchapter X to read as follows:
SUBCHAPTER X. GENDER TRANSITIONING AND GENDER REASSIGNMENT
PROCEDURES AND TREATMENTS FOR CERTAIN CHILDREN
Sec. 161.701. DEFINITIONS. In this subchapter:
(1) "Child" means an individual who is younger than 18
years of age.
(2) "Health care provider" means a person other than a
physician who is licensed, certified, or otherwise authorized by
the laws of this state to provide or render health care or to
dispense or prescribe a prescription drug in the ordinary course of
business or practice of a profession.
(3) "Physician" means a person licensed to practice
medicine in this state.
Sec. 161.702. PROHIBITED PROVISION OF GENDER TRANSITIONING
OR GENDER REASSIGNMENT PROCEDURES AND TREATMENTS TO CERTAIN
CHILDREN. For the purpose of transitioning a child's biological
sex as determined by the sex organs, chromosomes, and endogenous
profiles of the child or affirming the child's perception of the
child's sex if that perception is inconsistent with the child's
biological sex, a physician or health care provider may not:
(1) perform a surgery to sterilize the child,
including:
(A) castration;
(B) vasectomy;
(C) hysterectomy;
(D) oophorectomy;
(E) metoidioplasty;
(F) orchiectomy;
(G) penectomy;
(H) phalloplasty; and
(I) vaginoplasty;
(2) perform a mastectomy;
(3) provide, administer, prescribe, or dispense any of
the following prescription drugs that induce transient or permanent
infertility:
(A) puberty suppression or blocking prescription
drugs to stop or delay normal puberty;
(B) supraphysiologic doses of testosterone to
females; or
(C) supraphysiologic doses of estrogen to males;
or
(4) remove any otherwise healthy or non-diseased body
part or tissue.
Sec. 161.703. EXCEPTIONS. The prohibitions under Section
161.702 do not apply to the provision by a physician or health care
provider, with the consent of the child's parent or legal guardian,
of appropriate and medically necessary gender transitioning or
gender reassignment procedures or treatments to a child who:
(1) is born with a medically verifiable genetic
disorder of sex development, including:
(A) 46, XX chromosomes with virilization;
(B) 46, XY chromosomes with undervirilization;
or
(C) both ovarian and testicular tissue; or
(2) does not have the normal sex chromosome structure
for male or female as determined by a physician through genetic
testing.
Sec. 161.704. DISCIPLINARY ACTION. The Texas Medical Board
or another state regulatory agency with jurisdiction over a
physician or health care provider subject to Section 161.702 shall
revoke the license, certification, or authorization of a physician
or health care provider who the board or agency determines has
violated that section.
SECTION 3. Subchapter F, Chapter 1901, Insurance Code, is
amended by adding Section 1901.256 to read as follows:
Sec. 1901.256. PROHIBITED COVERAGE FOR PROVISION OF CERTAIN
GENDER-RELATED PROCEDURES AND TREATMENTS TO CERTAIN CHILDREN. A
professional liability insurance policy issued to a physician or
health care provider may not include coverage for damages assessed
against the physician or health care provider who provides to a
child gender transitioning or gender reassignment procedures or
treatments that are prohibited by Section 161.702, Health and
Safety Code.
SECTION 4. Section 164.052, Occupations Code, is amended by
amending Subsection (a) and adding Subsection (d) to read as
follows:
(a) A physician or an applicant for a license to practice
medicine commits a prohibited practice if that person:
(1) submits to the board a false or misleading
statement, document, or certificate in an application for a
license;
(2) presents to the board a license, certificate, or
diploma that was illegally or fraudulently obtained;
(3) commits fraud or deception in taking or passing an
examination;
(4) uses alcohol or drugs in an intemperate manner
that, in the board's opinion, could endanger a patient's life;
(5) commits unprofessional or dishonorable conduct
that is likely to deceive or defraud the public, as provided by
Section 164.053, or injure the public;
(6) uses an advertising statement that is false,
misleading, or deceptive;
(7) advertises professional superiority or the
performance of professional service in a superior manner if that
advertising is not readily subject to verification;
(8) purchases, sells, barters, or uses, or offers to
purchase, sell, barter, or use, a medical degree, license,
certificate, or diploma, or a transcript of a license, certificate,
or diploma in or incident to an application to the board for a
license to practice medicine;
(9) alters, with fraudulent intent, a medical license,
certificate, or diploma, or a transcript of a medical license,
certificate, or diploma;
(10) uses a medical license, certificate, or diploma,
or a transcript of a medical license, certificate, or diploma that
has been:
(A) fraudulently purchased or issued;
(B) counterfeited; or
(C) materially altered;
(11) impersonates or acts as proxy for another person
in an examination required by this subtitle for a medical license;
(12) engages in conduct that subverts or attempts to
subvert an examination process required by this subtitle for a
medical license;
(13) impersonates a physician or permits another to
use the person's license or certificate to practice medicine in
this state;
(14) directly or indirectly employs a person whose
license to practice medicine has been suspended, canceled, or
revoked;
(15) associates in the practice of medicine with a
person:
(A) whose license to practice medicine has been
suspended, canceled, or revoked; or
(B) who has been convicted of the unlawful
practice of medicine in this state or elsewhere;
(16) performs or procures a criminal abortion, aids or
abets in the procuring of a criminal abortion, attempts to perform
or procure a criminal abortion, or attempts to aid or abet the
performance or procurement of a criminal abortion;
(17) directly or indirectly aids or abets the practice
of medicine by a person, partnership, association, or corporation
that is not licensed to practice medicine by the board;
(18) performs an abortion on a woman who is pregnant
with a viable unborn child during the third trimester of the
pregnancy unless:
(A) the abortion is necessary to prevent the
death of the woman;
(B) the viable unborn child has a severe,
irreversible brain impairment; or
(C) the woman is diagnosed with a significant
likelihood of suffering imminent severe, irreversible brain damage
or imminent severe, irreversible paralysis;
(19) performs an abortion on an unemancipated minor
without the written consent of the child's parent, managing
conservator, or legal guardian or without a court order, as
provided by Section 33.003 or 33.004, Family Code, unless the
abortion is necessary due to a medical emergency, as defined by
Section 171.002, Health and Safety Code;
(20) otherwise performs an abortion on an
unemancipated minor in violation of Chapter 33, Family Code;
(21) performs or induces or attempts to perform or
induce an abortion in violation of Subchapter C, F, or G, Chapter
171, Health and Safety Code;
(22) in complying with the procedures outlined in
Sections 166.045 and 166.046, Health and Safety Code, wilfully
fails to make a reasonable effort to transfer a patient to a
physician who is willing to comply with a directive; [or]
(23) performs or delegates to another individual the
performance of a pelvic examination on an anesthetized or
unconscious patient in violation of Section 167A.002, Health and
Safety Code; or
(24) for the purpose of facilitating the gender
transition or treating the gender dysphoria of an unemancipated
minor:
(A) provides, administers, prescribes, or
dispenses a puberty suppression or blocking prescription drug or
cross-sex hormone to the minor, including by writing a false or
fictitious prescription; or
(B) performs or attempts to perform a surgical
intervention on the minor.
(d) Notwithstanding Subsection (a)(24), a physician or
applicant for a license to practice medicine does not commit a
prohibited practice if the physician or applicant provides a
puberty suppression or blocking prescription drug to an
unemancipated minor for the purpose of normalizing puberty for a
minor experiencing precocious puberty.
SECTION 5. Section 1901.256, Insurance Code, as added by
this Act, applies only to a medical professional liability
insurance policy that is delivered, issued for delivery, or renewed
on or after January 1, 2024. An insurance policy that is delivered,
issued for delivery, or renewed before January 1, 2024, is governed
by the law in effect immediately before the effective date of this
Act, and that law is continued in effect for that purpose.
SECTION 6. Section 164.052, Occupations Code, as amended by
this Act, applies only to conduct that occurs on or after the
effective date of this Act. Conduct that occurs before the
effective date of this Act is governed by the law in effect on the
date the conduct occurred, and the former law is continued in effect
for that purpose.
SECTION 7. This Act takes effect September 1, 2023.