,,ii #aah? ,,congress #b;d ,session ,s4 #edbd ,,9 ,,! ,,s5ate ,,( ,,! ,,unit$ ,,/ates ,decemb] #d1 #bjbd,mr4 ,m>%all introduc$ ! foll[+ bill2 :i* 0 read twice & ref]r$ to ! ,committee on ,heal?1 ,education1 ,labor1 & ,p5sions ,a ,,bill ,to prohibit g5d] transition proc$ures on m9ors1 to au?orize ! ,secret>y ( ,heal? & ,human ,s]vices to impose civil p5alties on p]sons :o p]=m g5d] transition proc$ures on m9ors1 & = o!r purposes4 #a4 ,%ort title ,?is ,act may be cit$ z ! ,safegu>d+ ,! ,ov]all ,protection ( ,m9ors ,act or ! ,,/op ,act4 #b4 ,def9itions ,9 ?is ,act3 7#a7 ,cross-sex hormones ,! t]m cross-sex hormones means-- 7,a7 te/o/]one or o!r &rog5s giv5 to females at doses t are pr(\ndly l>g] or m pot5t ?an w\ld normally occur naturally 9 heal?y females2 & 7,b7 e/rog5 giv5 to males at doses t are pr(\ndly l>g] or m pot5t ?an w\ld normally occur naturally 9 heal?y males4 7#b7 ,detransition ,! t]m detransition means to halt or rev]se g5d] transition proc$ures1 includ+ exploration & seek+ m$ical advice ab\t rev]s+ g5d] transition proc$ures4 7#c7 ,employ] ,! t]m employ] includes an individual or entity t engages a p]son 9 ! p]=mance ( "w z an indep5d5t contractor4 7#d7 ,employm5t ,! t]m employm5t includes "w z an indep5d5t contractor4 7#e7 ,female ,! t]m female1 :5 us$ to ref] to a natural p]son1 means an individual :o naturally has1 _h1 w h1 or w\ld h1 b = a cong5ital anomaly or int5tional or un9t5tional disruption1 ! reproductive sy/em t at "s po9t produces1 transports1 & utilizes eggs = f]tilization4 7#f7 ,g5d] 7,a7 ,9 g5]al ,subject to subp>agraph 7,b71 ! t]m g5d]1 :5 us$ alone to ref] to males1 females1 or ! natural diff]5ces betwe5 males & females-- 7i7 is a synonym = sex2 & 7ii7 %all n be consid]$ a synonym or %ort-h& expression = g5d] id5tity1 exp]i5c$ g5d]1 g5d] expression1 or g5d] role4 7,b7 ,exception ,subp>agraph 7,a7 %all n apply :5 ! t]m g5d] is us$ 9 conjunction ) o!r words or z an adjective to modify o!r words1 or :5 context or explicit def9ition 9 law indicates o!rwise4 7#g7 ,g5d] id5tity ,! t]m g5d] id5tity does n mean sex or g5d]4 7#h7 ,g5d] transition ,! t]m g5d] transition means ! process 9 :i* an individual goes f id5tify+ ) or pres5t+ z 8 or h] sex to id5tify+ ) or pres5t+ a self-proclaim$ id5tity t does n correspond ) or is diff]5t f 8 or h] sex1 & may be accompani$ ) social1 legal1 or physical *anges4 7#i7 ,g5d] transition proc$ure 7,a7 ,9 g5]al ,! t]m g5d] transition proc$ure means any hormonal or surgical s]vice t seeks-- 7i7 to alt] or remove physical or anatomical *>act]i/ics or features t are typical = ! individual's sex1 z det]m9$ by ! sex organs1 *romosomes1 & endog5\s pr(iles ( ! individual2 or 7ii7 to *ange ! body ( su* individual to no long] correspond to _! sex4 7,b7 ,inclusions ,! t]m g5d] transition proc$ure includes ! foll[+3 7i7 ,provid+1 prescrib+1 adm9i/]+1 disp5s+1 or o!rwise convey+ any ( ! foll[+ prescription drugs t induce transi5t or p]man5t inf]tility3 7,i7 ,pub]ty suppression drugs or pub]ty-block+ drugs to /op or delay normal pub]ty4 7,,ii7 ,cross-sex hormones1 includ+ supraphysiologic doses ( te/o/]one to females or supraphysiologic doses ( e/rog5 to males4 7ii7 ,g5ital g5d] transition surg]y4 7iii7 ,non-g5ital g5d] transition surg]y4 7iv7 ,! removal ( any o!rwise heal?y or non-diseas$ body "p or tissue4 7,c7 ,exclusions ,! t]m g5d] transition proc$ure does n include-- 7i7 s]vices to individuals born ) a m$ically v]ifiable disord] ( sex developm5t1 includ+ an individual ) ext]nal sex *>act]i/ics t are irresolvably ambigu\s1 su* z an individual born ) #df ,,xx *romosomes ) virilization1 an individual born ) #df ,,xy *romosomes ) und]virilization1 or an individual born hav+ bo? ov>ian & te/icul> tissue2 7ii7 s]vices provid$ :5 a physician has o!rwise diagnos$ a disord] ( sexual developm5t 9 :i* ! physician has det]m9$ ?r\gh g5etic or bio*emical te/+ t ! individual does n h normal sex *romosome /ructure1 sex /]oid hormone production1 or sex /]oid hormone action = a male or female2 7iii7 ! treatm5t ( any infection1 injury1 disease1 or disord] t has be5 caus$ by or exac]bat$ by ! p]=mance ( g5d] transition proc$ures1 :e!r or n ! g5d] transition proc$ure 0 p]=m$ 9 accordance ) ,/ate & ,f$]al law or :e!r or n fund+ = ! g5d] transition proc$ure is p]missible "u ?is section2 7iv7 any proc$ure und]tak5 because ! individual suff]s f a physical disord]1 physical injury1 or physical illness t w\ld1 z c]tifi$ by a physician1 place ! individual 9 imm95t dang] ( dea? or impairm5t ( major bodily function1 unless surg]y or treatm5t is p]=m$ = ! purpose ( a g5d] transition or = ! alleviation ( psy*ological1 physical1 or m5tal di/ress2 7v7 pub]ty suppression or block+ prescription drugs = ! purpose ( normaliz+ pub]ty = a m9or exp]i5c+ precoci\s pub]ty2 or 7vi7 male circumcision4 7,d7 ,g5ital g5d] transition surg]y ,= purposes ( subp>agraph 7,b71 ! t]m g5ital g5d] transition surg]y means a surgical proc$ure p]=m$ = ! purpose ( assi/+ an individual ) a g5d] transition1 includ+-- 7i7 = male pati5ts1 ca/ration1 a vasectomy1 p5ectomy1 or*iectomy1 vag9opla/y1 clitoropla/y1 & vulvopla/y2 & 7ii7 = female pati5ts1 a ma/ectomy1 hy/]ectomy_/ov>iectomy1 recon/ruction ( ! fix$ "p ( ! ure?ra ) or )\t a metoidiopla/y or a phallopla/y1 vag9ectomy1 scrotopla/y1 & implantation ( erection or te/icul> pro/heses4 7,e7 ,non-g5ital g5d] transition surg]y ,= purposes ( subp>agraph 7,b71 ! t]m non-g5ital g5d] transition surg]y means a surgical proc$ure p]=m$ = ! purpose ( assi/+ an individual ) a g5d] transition1 includ+-- 7i7 = male pati5ts1 augm5tation mammopla/y1 facial fem9ization surg]y1 liposuction1 lip(ill+1 voice surg]y1 ?yroid c>tilage r$uction1 gluteal augm5tation 7implants_/lip(ill+71 hair recon/ruction1 & v>i\s ae/hetic proc$ures2 & 7ii7 = female pati5ts1 subcutane\s ma/ectomy1 voice surg]y1 liposuction1 lip(ill+1 pectoral implants1 & v>i\s ae/hetic proc$ures4 7#aj7 ,male ,! t]m male1 :5 us$ to ref] to a natural p]son1 means an individual :o naturally has1 _h1 w h1 or w\ld h1 b = a cong5ital anomaly or int5tional or un9t5tional disruption1 ! reproductive sy/em t at "s po9t produces1 transports1 & utilizes sp]m = f]tilization4 7#aa7 ,m9or ,! t]m m9or means an individual "u ! age ( #ah4 7#ab7 ,pub]ty-block+ drugs ,! t]m pub]ty-block+ drugs means-- 7,a7 gonadotrop9-releas+ hormone 7,gn,r,h7 analogues or o!r syn!tic drugs us$ 9 males to /op lute9iz+ hormone secretion & !re=e te/o/]one secretion2 & 7,b7 syn!tic drugs us$ 9 females t /op ! production ( e/rog5 & proge/]one1 :5 us$ to delay or suppress pub]tal developm5t 9 *ildr5 = ! purpose ( assi/+ an individual ) a g5d] transition4 7#ac7 ,secret>y ,! t]m ,secret>y means ! ,secret>y ( ,heal? & ,human ,s]vices4 7#ad7 ,sex ,! t]m sex1 :5 ref]r+ to an individual's sex1 means to ref] to ei!r male or female1 z biologically det]m9$ & def9$ 9 ?is section4 #c4 ,g5d] transition proc$ures on m9ors 7a7 ,prohibition 7#a7 ,9 g5]al ,no p]son may1 9 any circum/ance describ$ 9 p>agraph 7#b71 kn[+ly p]=m1 attempt to p]=m1 conspire to p]=m1 or provide a ref]ral = any g5d] transition proc$ure on a m9or4 7#b7 ,circum/ances describ$ ,a circum/ance ref]r$ to 9 p>agraph 7#a7 is any ! foll[+3 7,a7 ,! p]son1 or ! m9or on :om ! g5d] transition proc$ure 0 p]=m$1 attempt$ to be p]=m$1 conspir$ to be p]=m$1 or = :om a ref]ral = any g5d] transition proc$ure 0 provid$1 travel$ 9 int]/ate or =eign comm]ce1 or travel$ us+ a means1 *annel1 facility1 or in/rum5tality ( int]/ate or =eign comm]ce1 9 fur!rance ( or 9 connection ) ! conduct describ$ 9 p>agraph 7#a74 7,b7 ,! p]son1 or ! m9or on :om ! g5d] transition proc$ure 0 p]=m$1 attempt$ to be p]=m$1 conspir$ to be p]=m$1 or = :om a ref]ral = any g5d] transition proc$ure 0 provid$1 us$ a means1 *annel1 facility1 or in/rum5tality ( int]/ate or =eign comm]ce 9 fur!rance ( or 9 connection ) ! conduct describ$ 9 p>agraph 7#a74 7,c7 ,a paym5t ( any k9d 0 made1 directly or indirectly1 9 fur!rance ( or 9 connection ) ! conduct describ$ 9 p>agraph 7#a71 us+ any means1 *annel1 facility1 or in/rum5tality ( int]/ate or =eign comm]ce or 9 or affect+ int]/ate or =eign comm]ce4 7,d7 ,! p]son1 or ! m9or on :om ! g5d] transition proc$ure 0 p]=m$1 attempt$ to be p]=m$1 conspir$ to be p]=m$1 or = :om a ref]ral = any g5d] transition proc$ure 0 provid$1 transmitt$ 9 int]/ate or =eign comm]ce any communication relat+ to or 9 fur!rance ( ! conduct describ$ 9 p>agraph 7#a7 us+ any means1 *annel1 facility1 or in/rum5tality ( int]/ate or =eign comm]ce or 9 or affect+ int]/ate or =eign comm]ce by any means or 9 mann]1 includ+ by comput]1 mail1 wire1 or electromagnetic transmission4 7,e7 ,any in/rum5t1 item1 sub/ance1 or o!r object t has travel$ 9 int]/ate or =eign comm]ce 0 us$ to p]=m ! conduct describ$ 9 p>agraph 7#a74 7,f7 ,! conduct describ$ 9 p>agraph 7#a7 occurr$ )9 ! special m>itime & t]ritorial jurisdiction ( ! ,unit$ ,/ates or any t]ritory or possession ( ! ,unit$ ,/ates4 7,g7 ,! conduct describ$ 9 p>agraph 7#a7 o!rwise occurr$ 9 or affect$ int]/ate or =eign comm]ce4 7#c7 ,kn[+ly ,= purposes ( p>agraph 7#a71 a p]son acts kn[+ly :5-- 7,a7 ! p]son has actual k ( ! facts giv+ rise to ! violation2 or 7,b7 a reasonable p]son act+ 9 ! circum/ances & ex]cis+ reasonable c>e w\ld h t k4 7#d7 ,application to employ]s 7,a7 ,9 g5]al ,a violation ( p>agraph 7#a7 by a p]son act+ 9 ! scope ( _! employm5t = an employ] %all also be consid]$ a violation ( su* p>agraph by su* employ]4 7,b7 ,liability ,9 ! case ( a violation describ$ 9 subp>agraph 7,a71 ! p]son & ! employ] %all be jo9tly & sev]ally liable = any civil p5alty "u subsection 7b7 & any private "r ( action "u subsection 7c74 7b7 ,civil p5alties 7#a7 ,9 g5]al ,! ,secret>y may impose a civil p5alty on any p]son ^u mak+ a det]m9ation1 aft] writt5 notice & an opportunity = a he>+1 t ! p]son has violat$ a requirem5t ( subsection 7a77#a74 7#b7 ,am\nt ( civil p5alties 7,a7 ,9 g5]al ,! am\nt ( a civil p5alty "u p>agraph 7#a7 %all be n less ?an #ajj1jjj = ea* violation4 7,b7 ,p5alty consid]ations ,9 det]m9+ ! am\nt ( a civil p5alty "u ?is subsection1 ! ,secret>y %all consid]-- 7i7 ! nature1 circum/ances1 ext5t1 & gravity ( ! violation2 7ii7 ) respect to ! violator1 ! degree ( culpability1 any hi/ory ( prior violations1 & any effect on ! ability to cont9ue to d bus9ess2 & 7iii7 o!r matt]s t ju/ice requires4 7#c7 ,civil action to collect 7,a7 ,9 g5]al ,! ,attorney ,g5]al may br+ a civil action 9 an appropriate di/rict c\rt ( ! ,unit$ ,/ates to collect a civil p5alty "u ?is subsection & any accru$ int]e/ on ! civil p5alty z assess$ by ! ,secret>y4 ,9 su* a civil action1 ! am\nt & appropriat5ess ( ! civil p5alty %all n be subject to review4 7,b7 ,compromise ,! ,secret>y may compromise ! am\nt ( a civil p5alty impos$ "u ?is subsection be=e ref]ral to ! ,attorney ,g5]al "u subp>agraph 7,a71 on ! condition t su* am\nt %all be n less ?an #ajj1jjj4 7#d7 ,liability = proc$ures requir$ z a matt] ( /&>d practice ,x %all n be a def5se 9 a he>+ "u ?is subsection t g5d] transition proc$ures are requir$ z a matt] ( /&>d practice4 7#e7 ,prohibition on imposition ( civil p5alty on a p]son on :om proc$ures are p]=m$ ,no p]son on :om a g5d] transition proc$ure is p]=m$ 9 violation ( subsection 7a77#a71 & no p>5t1 gu>dian1 or c>etak] ( su* a p]son1 may be held liable = a civil p5alty "u ?is subsection4 7#f7 ,deposit+ am\nts collect$ 7,a7 ,9 g5]al ,am\nts collect$ "u ?is subsection %all be deposit$ 9 ! fund e/abli%$ "u subp>agraph 7,b74 7,b7 ,e/abli%m5t ( ,fund 7i7 ,9 g5]al ,!re is e/abli%$ 9 ! ,treasury ( ! ,unit$ ,/ates a fund1 to be kn[n z ! ,ju/ice = ,victims ,fund1 :i* %all consi/ ( am\nts deposit$ 9 ! fund pursuant to subp>agraph 7,a74 7ii7 ,availability ( funds ,am\nts 9 ! fund e/abli%$ "u clause 7i7 %all be made available = exp5diture = fiscal ye> #bjbe & ea* fiscal ye> !reaft]1 )\t fur!r appropriation or fiscal ye> limitation = exp5diture by ! ,secret>y to c>ry out section #d4 7c7 ,private civil action ,a p]son on :om a g5d] transition proc$ure is p]=m$ 9 violation ( subsection 7a77#a71 or ! p>5t1 gu>dian1 or c>etak] ( su* a p]son if su* p]son is a m9or1 may br+ a civil action 9 an appropriate di/rict c\rt ( ! ,unit$ ,/ates = appropriate relief aga9/ any p]son 9 violation ( subsection 7a77#a74 7d7 ,p5alty = ob/ruction ( inve/igations 7#a7 ,9 g5]al ,! ,secret>y may impose a civil p5alty on any p]son :o ob/ructs or prev5ts ! ,secret>y f c>ry+ out an inve/igation into an alleg$ violation ( subsection 7a77#a74 7#b7 ,def9ition ( ob/ruct ,9 ?is subsection1 ! t]m ob/ruct means to take an action t 0 kn[n1 or reasonably %\ld h be5 kn[n1 to prev5t1 h9d]1 or imp$e an inve/igation4 7e7 ,sev]ability ,if any provision ( ?is ,act1 or ! application ( su* provision to any p]son or circum/ance1 is held to be or made invalid1 ! rema9d] ( ?is ,act1 & ! application ( ! provision to any o!r p]son or circum/ance1 %all n be affect$4 #d4 ,op5+ av5ues = victims 7a7 ,purpose ,! purpose ( ?is section is to support1 enc\rage1 & assi/ individuals 9 _! ef=ts to rev]se g5d] transition proc$ures4 7b7 ,e/abli%m5t ( grant program ,! ,secret>y %all e/abli% a grant program "u :i* ! ,secret>y %all aw>d grants to eligible entities to c>ry out ! activities describ$ 9 subsection 7d74 7c7 ,eligibility 7#a7 ,eligible entities ,to be eligible = a grant "u ?is section1 an entity %all-- 7,a7 be a nonpr(it organization2 7,b7 support1 enc\rage1 & assi/ individuals 9 _! ef=ts to rev]se g5d] transition proc$ures2 7,c7 agree to be subject to su* monitor+ & review z ! ,secret>y may require "u subsection 7g72 7,d7 agree to n *>ge individuals = s]vices provid$ ?r\gh ! grant2 7,e7 provide ea* individual c\nsel$ ?r\gh ! grant ) accurate in=mation on ! prop] m$ical proc$ures to rev]se g5d] transition proc$ures2 & 7,f7 h a privacy policy & proc$ures 9 place to ensure t-- 7i7 ! "n1 address1 telephone numb]1 or any o!r in=mation t might id5tify any individual seek+ s]vices support$ ?r\gh ! grant is n made public or %>$ ) any o!r entity )\t ! writt5 cons5t ( ! individual2 & 7ii7 ! grantee adh]es to requirem5ts comp>able to ^? applicable "u ! ,,hipaa privacy regulation 7z def9$ 9 section #aahj7;b77#c7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acbj;d-#i7;b77#c777 to cov]$ entities 7z def9$ = purposes ( su* regulation74 7#b7 ,ineligible entities ,an entity %all be ineligible to receive a grant "u ?is section if ! entity or any affiliate1 subsidi>y1 successor1 or cl9ic !re(-- 7,a7 p]=ms1 induces1 ref]s =1 or c\nsels 9 favor ( g5d] transition proc$ures2 or 7,b7 provides f9ancial support to any o!r entity t conducts any activity describ$ 9 subp>agraph 7,a74 7#c7 ,f9ancial records ,z a condition on receipt ( a grant "u ?is section1 an eligible entity %all agree to ma9ta9 & make available to ! ,secret>y records1 includ+ f9ancial records1 t demon/rate t ! entity satisfies ! requirem5ts ( p>agraph 7#a7 & is n ineligible by op]ation ( p>agraph 7#b74 7d7 ,use ( grant funds 7#a7 ,requir$ in=mation & ref]ral ,= ! purpose describ$ 9 subsection 7a71 an eligible entity receiv+ a grant "u ?is section %all use ! grant funds to provide to individuals :o are explor+ detransition in=mation on1 & ref]ral to1 ea* ( ! foll[+ s]vices3 7,a7 ,m$ical advice & c>e4 7,b7 ,nutritional s]vices4 7,c7 ,education & employm5t assi/ance1 includ+ s]vices t support ! cont9uation & completion ( high s*ool4 7,d7 ,p>5t+ education & support s]vices4 7,e7 ,volunt>y sub/ance abuse c\nsel+ & treatm5t4 7#b7 ,p]missible direct provision ( s]vices ,= ! purpose describ$ 9 subsection 7a71 9 addition to us+ grant funds "u ?is section z describ$ 9 p>agraph 7#a71 an eligible entity receiv+ a grant "u ?is section may use ! grant funds = ! direct provision ( "o or m s]vices describ$ 9 p>agraph 7#a74 7e7 ,prohibit$ uses ( funds ,none ( ! funds made available "u ?is section %all be us$ = g5d] transition proc$ures4 7f7 ,consid]ation ,9 select+ ! recipi5ts ( grants "u ?is section1 ! ,secret>y %all consid] ea* applicant's demon/rat$ capacity 9 provid+ s]vices to assi/ individuals :o are explor+ & seek+ m$ical advice 9 _! ef=ts to rev]se g5d] transition proc$ures4 7g7 ,monitor+ & review ,! ,secret>y %all-- 7#a7 monitor & review ea* program fund$ ?r\gh a grant "u ?is section to ensure t ! grantee c>efully adh]es to-- 7,a7 ! purpose describ$ 9 subsection 7a72 & 7,b7 ! requirem5ts ( ?is section2 & 7#b7 cease to fund a program "u ?is section if ! grantee fails to adh]e to su* purpose & requirem5ts4