65-28,139.

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65-28,139. Prohibited surgical procedures and medications; exceptions.

(a)Except as provided in subsection

(c)or (d), a healthcare provider shall not knowingly perform the following surgical procedures or prescribe, dispense or administer the following medications to a female child for the purpose of treatment for distress arising from such female child's perception that such child's gender or sex is not female:

(1)Surgical procedures, including, but not limited to, a vaginectomy, hysterectomy, oophorectomy, ovariectomy, reconstruction of the urethra, metoidioplasty, phalloplasty, scrotoplasty, implantation of erection or testicular protheses, subcutaneous mastectomy, voice surgery, liposuction, lipofilling or pectoral implants;

(2)supraphysiologic doses of testosterone or other androgens; or

(3)puberty blockers such as GnRH agonists or other synthetic drugs that suppress the production of estrogen and progesterone to delay or suppress pubertal development in female children.

(b)Except as provided in subsection

(c)or (d), a healthcare provider shall not knowingly perform the following surgical procedures or prescribe, dispense or administer the following medications to a male child for the purpose of treatment for distress arising from such male child's perception that such child's gender or sex is not male:

(1)Surgical procedures, including, but not limited to, a penectomy, orchiectomy, vaginoplasty, clitoroplasty, vulvoplasty, augmentation mammoplasty, facial feminization surgery, liposuction, lipofilling, voice surgery, thyroid cartilage reduction or gluteal augmentation;

(2)supraphysiologic doses of estrogen; or

(3)puberty blockers such as GnRH agonists or other synthetic drugs that suppress the production of testosterone or delay or suppress pubertal development in male children.

(c)The treatments prohibited by subsections

(a)and

(b)shall not apply to treatment provided for other purposes, including:

(1)Treatment for individuals born with a medically verifiable disorder of sex development, including:

(A)An individual born with external biological sex characteristics that are irresolvably ambiguous, including an individual born with 46 XX chromosomes with virilization, 46 XY chromosomes with under virilization or having both ovarian and testicular tissue; or

(B)an individual whom a physician has otherwise diagnosed with a disorder of sexual development that the physician has determined through genetic or biochemical testing that such individual does not have normal sex chromosome structure, sex steroid hormone production or sex steroid hormone action for a male or female; and

(2)treatment of any infection, injury, disease or disorder that has been caused or exacerbated by the performance of a procedure listed in subsections

(a)or (b).

(d)If a healthcare provider has initiated a course of treatment for a child that includes prescribing, administering or dispensing of a drug prohibited by subsection (a)(2), (a)(3), (b)(2) or (b)(3) prior to the effective date of this act, the healthcare provider may continue such course of treatment if the healthcare provider:

(1)Develops a plan to systematically reduce the child's use of such drug;

(2)determines and documents in the child's medical record that immediately terminating the child's use of such drug would cause harm to the child; and

(3)such course of treatment shall not extend beyond December 31, 2025.