HB 342: "An Act relating to physician liability for sex-reassignment treatments or procedures performed on minors; relating to standardized informed consent forms for sex-reassignment treatments or procedures; relating to the duties of the State Medical Board; relating to informed consent for sex-reassignment treatments or procedures performed on minors; establishing the crime of criminal sex-reassignment treatment or procedure; and providing for an effective date."
00 HOUSE BILL NO. 342 01 "An Act relating to physician liability for sex-reassignment treatments or procedures 02 performed on minors; relating to standardized informed consent forms for sex- 03 reassignment treatments or procedures; relating to the duties of the State Medical 04 Board; relating to informed consent for sex-reassignment treatments or procedures 05 performed on minors; establishing the crime of criminal sex-reassignment treatment or 06 procedure; and providing for an effective date." 07 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF ALASKA: 08 * Section 1. AS 08.64.101(a) is amended to read: 09 (a) The board shall 10 (1) except as provided in regulations adopted by the board under (b) of 11 this section, examine and issue licenses to applicants; 12 (2) develop written guidelines to ensure that licensing requirements are 13 not unreasonably burdensome and the issuance of licenses is not unreasonably
01 withheld or delayed; 02 (3) after a hearing, impose disciplinary sanctions on persons who 03 violate this chapter or the regulations or orders of the board; 04 (4) adopt regulations ensuring that renewal of licenses is contingent on 05 proof of continued competency on the part of the licensee; 06 (5) under regulations adopted by the board, contract with private 07 professional organizations to establish an impaired medical professionals program to 08 identify, confront, evaluate, and treat persons licensed under this chapter who abuse 09 alcohol, other drugs, or other substances or are mentally ill or cognitively impaired; 10 (6) adopt regulations that establish guidelines for a physician or 11 physician assistant who is rendering a diagnosis, providing treatment, or prescribing, 12 dispensing, or administering a prescription drug to a person without conducting a 13 physical examination under AS 08.64.364; the guidelines must include a nationally 14 recognized model policy for standards of care of a patient who is at a different location 15 than the physician or physician assistant; 16 (7) require that a licensee who has a federal Drug Enforcement 17 Administration registration number register with the controlled substance prescription 18 database under AS 17.30.200(n); 19 (8) create a standardized informed consent form that complies 20 with AS 08.64.135 for a patient to complete before a physician performs a sex- 21 reassignment treatment or procedure. 22 * Sec. 2. AS 08.64 is amended by adding a new section to read: 23 Sec. 08.64.135. Standardized informed consent form for sex-reassignment 24 treatments or procedures. The board shall require a physician to provide a 25 standardized informed consent form to a patient at every visit for a sex-reassignment 26 treatment or procedure for a period of not less than one year. The form must state the 27 following in a font not smaller than 14 points: 28 (1) the United States Food and Drug Administration has not approved 29 the use of puberty blockers or the prescription or administration of hormones or 30 hormone antagonists for the purpose of treating gender dysphoria or gender 31 incongruence;
01 (2) governments of other countries, including the United Kingdom, 02 Sweden, and Finland, have studied the use of puberty blockers and the prescription or 03 administration of hormones or hormone antagonists and have concluded that there is 04 no reliable evidence to support the notion that the potential benefits of these treatments 05 outweigh the risks; these governments instead recommend psychotherapy as the first 06 line of treatment for minors with gender dysphoria; 07 (3) the use of puberty blockers or the prescription or administration of 08 hormones or hormone antagonists for the purpose of treating gender dysphoria or 09 gender incongruence 10 (A) increases the risk that a minor will become sterile, 11 preventing future conception of a child; 12 (B) carries the risk of physical harm, including decreased bone 13 density, heart disease, stroke, and cancer; 14 (C) has unknown effects on the brain development of minors. 15 * Sec. 3. AS 08.64.380 is amended by adding a new paragraph to read: 16 (8) "sex-reassignment treatment or procedure" means 17 (A) the prescription or administration of puberty blockers for 18 the purpose of delaying or stopping puberty in an individual to affirm an 19 individual's perception of the individual's sex if that perception is inconsistent 20 with the individual's sex; 21 (B) the prescription or administration of hormones or hormone 22 antagonists to affirm an individual's perception of the individual's sex if that 23 perception is inconsistent with the individual's sex; 24 (C) any surgical procedure used to affirm an individual's 25 perception of the individual's sex if that perception is inconsistent with the 26 individual's sex. 27 * Sec. 4. AS 09.10.055(b) is amended to read: 28 (b) This section does not apply if 29 (1) the personal injury, death, or property damage resulted from 30 (A) prolonged exposure to hazardous waste; 31 (B) an intentional act or gross negligence;
01 (C) fraud or misrepresentation; 02 (D) breach of an express warranty or guarantee; 03 (E) a defective product; in this subparagraph, "product" means 04 an object that has intrinsic value, is capable of delivery as an assembled whole 05 or as a component part, and is introduced into trade or commerce; or 06 (F) breach of trust or fiduciary duty; 07 (2) the facts that would give notice of a potential cause of action are 08 intentionally concealed; 09 (3) a shorter period of time for bringing the action is imposed under 10 another provision of law; 11 (4) the provisions of this section are waived by contract; [OR] 12 (5) the facts that would constitute accrual of a cause of action of a 13 minor are not discoverable in the exercise of reasonable care by the minor's parent or 14 guardian; or 15 (6) the action is brought under AS 09.65.175. 16 * Sec. 5. AS 09.55.549(f) is amended to read: 17 (f) The limitation on noneconomic damages in this section does not apply if 18 the damages resulted from an act or omission that constitutes reckless or intentional 19 misconduct or from an action brought under AS 09.65.175. 20 * Sec. 6. AS 09.55.556 is amended by adding a new subsection to read: 21 (c) An individual under 18 years of age may not consent to a sex-reassignment 22 treatment or procedure. In this section, "sex-reassignment treatment or procedure" 23 means 24 (1) the prescription or administration of puberty blockers for the 25 purpose of delaying or stopping puberty in an individual to affirm an individual's 26 perception of the individual's sex if that perception is inconsistent with the individual's 27 sex; 28 (2) the prescription or administration of hormones or hormone 29 antagonists to affirm an individual's perception of the individual's sex if that 30 perception is inconsistent with the individual's sex; 31 (3) any surgical procedure used to affirm an individual's perception of
01 the individual's sex if that perception is inconsistent with the individual's sex. 02 * Sec. 7. AS 09.65 is amended by adding a new section to read: 03 Sec. 09.65.175. Civil liability for sex-reassignment treatments or 04 procedures performed on minors. (a) An individual who, as a minor under 18 years 05 of age, received a sex-reassignment treatment or procedure may maintain a claim for 06 recovery of damages against the physician who performed the procedure for an injury 07 or condition suffered as a result of the procedure. An action brought under this section 08 must be commenced within 20 years after the accrual of the cause of action. 09 (b) If an individual who received a sex-reassignment treatment or procedure as 10 a minor is incompetent because of mental illness or mental disability, the individual's 11 parent or legal guardian may bring an action under this section on behalf of the 12 individual. 13 (c) The cause of action created by this section does not apply to a medical 14 treatment or procedure to treat an individual who was born with a medically verifiable 15 sexual development genetic disorder, including 16 (1) ambiguous external biological sex characteristics; 17 (2) a sexual development disorder 18 (A) caused by abnormal sex chromosome structures, sex 19 steroid production, or sex steroid hormone action for the individual's sex; and 20 (B) discovered through genetic or biochemical testing; 21 (3) an infection, injury, disease, or disorder caused or exacerbated by a 22 previous sex-reassignment treatment or procedure; or 23 (4) a physical disorder, physical injury, or physical illness that would 24 place the individual in imminent danger of death or impairment of a major bodily 25 function without the sex-reassignment treatment or procedure. 26 (d) In this section, 27 (1) "minor" means an individual under 18 years of age who is not an 28 emancipated minor; 29 (2) "physician" means a person licensed as a physician under 30 AS 08.64; 31 (3) "sex" means the classification of an individual as male or female
01 based on the individual's reproductive role, indicated by the individual's sex 02 chromosomes, naturally occurring sex hormones, and internal and external genitalia 03 present at birth; 04 (4) "sex-reassignment treatment or procedure" means 05 (A) the prescription or administration of puberty blockers for 06 the purpose of delaying or stopping puberty in an individual to affirm an 07 individual's perception of the individual's sex if that perception is inconsistent 08 with the individual's sex; 09 (B) the prescription or administration of hormones or hormone 10 antagonists to affirm an individual's perception of the individual's sex if that 11 perception is inconsistent with the individual's sex; 12 (C) any surgical procedure used to affirm an individual's 13 perception of the individual's sex if that perception is inconsistent with the 14 individual's sex. 15 * Sec. 8. AS 11.41 is amended by adding a new section to read: 16 Sec. 11.41.245. Criminal sex-reassignment treatment or procedure. (a) A 17 person commits the crime of criminal sex-reassignment treatment or procedure if the 18 person knowingly performs a sex-reassignment treatment or procedure on 19 (1) a minor; or 20 (2) an individual over 18 years of age without the voluntary, informed, 21 and written consent of the individual. 22 (b) For the purposes of this section, consent is considered voluntary, informed, 23 and written if, before an individual's initial sex-reassignment treatment or procedure, 24 the physician performing the sex-reassignment treatment or procedure, while 25 physically present in the same room as the individual, 26 (1) informs the individual of the nature and risks of the sex- 27 reassignment treatment or procedure; 28 (2) provides the individual with a standardized informed consent form 29 created by the State Medical Board under AS 08.64.101(a)(8); and 30 (3) receives the individual's written acknowledgment that the 31 individual received the information required by this subsection.
01 (c) In a prosecution under this section, it is an affirmative defense that the 02 defendant is a physician who provided a medical treatment or procedure to treat 03 (1) a minor with ambiguous external biological sex characteristics; 04 (2) a minor with a sexual development disorder discovered through 05 genetic or biochemical testing, caused by abnormal sex chromosome structures, sex 06 steroid production, or sex steroid hormone action for the sex of the minor at birth; 07 (3) an infection, injury, disease, or disorder caused or exacerbated by a 08 previous sex-reassignment treatment or procedure; or 09 (4) a physical disorder, physical injury, or physical illness that would 10 place the individual in imminent danger of death or impairment of a major bodily 11 function without the sex-reassignment treatment or procedure. 12 (d) In this section, 13 (1) "minor" means an individual under 18 years of age who is not an 14 emancipated minor; 15 (2) "physician" means a person licensed as a physician under 16 AS 08.64; 17 (3) "sex" means the classification of an individual as male or female 18 based on the individual's reproductive role, indicated by the individual's sex 19 chromosomes, naturally occurring sex hormones, and internal and external genitalia 20 present at birth; 21 (4) "sex-reassignment treatment or procedure" means 22 (A) the prescription or administration of puberty blockers for 23 the purpose of delaying or stopping puberty in an individual to affirm an 24 individual's perception of the individual's sex if that perception is inconsistent 25 with the individual's sex; 26 (B) the prescription or administration of hormones or hormone 27 antagonists to affirm an individual's perception of the individual's sex if that 28 perception is inconsistent with the individual's sex; 29 (C) any surgical procedure used to affirm an individual's 30 perception of the individual's sex if that perception is inconsistent with the 31 individual's sex.
01 (e) Criminal sex-reassignment treatment or procedure is a class C felony. 02 * Sec. 9. The uncodified law of the State of Alaska is amended by adding a new section to 03 read: 04 APPLICABILITY. (a) AS 09.65.175, enacted by sec. 7 of this Act, applies to a sex- 05 reassignment treatment or procedure that began or was completed on or after the effective 06 date of this Act. 07 (b) AS 11.41.245, enacted by sec. 8 of this Act, applies to an offense committed on or 08 after the effective date of this Act. 09 * Sec. 10. The uncodified law of the State of Alaska is amended by adding a new section to 10 read: 11 TRANSITION: REGULATIONS ON STANDARDS OF CARE. Notwithstanding 12 AS 09.55.556(c), enacted by sec. 6 of this Act, AS 09.65.175, enacted by sec. 7 of this Act, 13 and AS 11.41.245, enacted by sec. 8 of this Act, the State Medical Board shall adopt 14 regulations establishing standards of care under which a physician may, for a period ending 15 six months after the effective date of this Act, under regulations adopted by the State Medical 16 Board, temporarily continue to prescribe or administer a puberty blocker, hormone, or 17 hormone antagonist as part of a sex-reassignment treatment or procedure for a minor patient 18 whom the physician began treating with the puberty blocker, hormone, or hormone antagonist 19 before the effective date of this Act, for the sole purpose of reducing and discontinuing the 20 minor's use of the puberty blocker, hormone, or hormone antagonist. In adopting regulations 21 under this section, the board shall prioritize the provision of professional counseling services 22 for the patient during and after the patient's use of the prescription treatment. In this section, 23 "sex-reassignment treatment or procedure" means 24 (1) the prescription or administration of puberty blockers for the purpose of 25 delaying or stopping puberty in an individual to affirm an individual's perception of the 26 individual's sex if that perception is inconsistent with the individual's sex; 27 (2) the prescription or administration of hormones or hormone antagonists to 28 affirm an individual's perception of the individual's sex if that perception is inconsistent with 29 the individual's sex; 30 (3) any surgical procedure used to affirm an individual's perception of the 31 individual's sex if that perception is inconsistent with the individual's sex.
01 * Sec. 11. This Act takes effect immediately under AS 01.10.070(c).