88R10569 EAS-D     By: Leach H.B. No. 4624       A BILL TO BE ENTITLED   AN ACT   relating to gender modification procedures and treatments for   certain minors; providing a civil penalty.          BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:          SECTION 1.  GENDER MODIFICATION PROCEDURES AND   TREATMENTS.  Chapter 161, Health and Safety Code, is amended by   adding Subchapter X to read as follows:   SUBCHAPTER X. GENDER MODIFICATION PROCEDURES AND TREATMENTS ON   MINORS          Sec. 161.701.  DEFINITIONS.  In this subchapter:                (1)  "Congenital defect" means a physical or chemical   abnormality present in a minor that is inconsistent with the normal   development of a human being of the minor's sex, including   abnormalities caused by a medically verifiable disorder of sex   development. The term does not include gender dysphoria, gender   identity disorder, gender incongruence, or any mental condition,   disorder, disability, or abnormality.                (2)  "Gender modification procedure or treatment"   means a health care procedure or treatment performed or   administered for the purpose of:                      (A)  enabling a minor to identify with, or live   as, a purported identity inconsistent with the minor's sex; or                      (B)  treating purported discomfort or distress   from a discordance between the minor's sex and asserted identity.                (3)  "Health care procedure or treatment" includes:                      (A)  surgically removing, modifying, altering, or   entering into tissues, cavities, or organs of a human being; or                      (B)  prescribing, administering, or dispensing   any drug or device to a human being.                (4)  "Health care provider" means an individual or   facility licensed, certified, or otherwise authorized by this   state's laws 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.                (5)  "Minor" means an individual who is younger than 18   years of age for whom the disabilities of minority have not been   removed.                (6)  "Sex" means an individual's immutable   characteristics of the reproductive system that define the   individual as male or female, as determined by anatomy and genetics   existing at the time of birth.          Sec. 161.702.  CONSTRUCTION OF SUBCHAPTER. (a)  This   subchapter is remedial in nature and must be liberally construed to   accomplish its purposes.          (b)  This subchapter may not be construed to impose liability   on a minor on whom a gender modification procedure or treatment is   performed or administered in violation of Section 161.703.          Sec. 161.703.  PROHIBITED GENDER MODIFICATION PROCEDURES   AND TREATMENTS FOR CERTAIN MINORS. Except as provided by Section   161.704, a health care provider may not perform or offer to perform   on a minor, or administer or offer to administer to a minor, a   gender modification procedure or treatment.          Sec. 161.704.  EXCEPTIONS. (a)  This subchapter does not   apply to a health care provider performing, offering to perform,   administering, or offering to administer a health care procedure or   treatment to a minor if the performance or administration of the   procedure or treatment is to treat a minor's congenital defect,   disease, or physical injury.          (b)  For purposes of Subsection (a), "disease" does not   include:                (1)  gender dysphoria, gender identity disorder, or   gender incongruence; or                (2)  any mental condition, disorder, disability, or   abnormality.          (c)  This subchapter does not apply to a health care provider   performing, offering to perform, administering, or offering to   administer a health care procedure or treatment to a minor if the   performance or administration of the procedure or treatment is   continuing a procedure or treatment on the minor that began before   September 1, 2023, and the minor's treating physician certifies in   writing that, in the physician's good-faith medical judgment, based   on the facts known to the physician at the time, ending the   procedure or treatment would be harmful to the minor.          (c-1)  The certification under Subsection (c) must include   the physician's findings supporting the certification and must be   placed in the minor's medical record.          (c-2)  Subsection (c) may not be construed to:                (1)  allow a health care provider to perform or   administer a gender modification procedure or treatment that is   different from the gender modification procedure or treatment   performed before September 1, 2023; and                (2)  waive a minor's right to bring an action under   Section 161.706 for a gender modification procedure or treatment   that does not comply with this subchapter after September 1, 2023.          (c-3)  This subsection and Subsections (c), (c-1), and (c-2)   expire September 1, 2033.          Sec. 161.705.  EFFECT OF CONSENT. (a)  It is not a defense to   any legal liability incurred as the result of a violation of Section   161.703 that the minor, or a parent, legal guardian, or conservator   of the minor, consented to the conduct that constituted the   violation.          (b)  This subchapter supersedes any other law regarding a   minor's ability to consent to a gender modification procedure or   treatment.          Sec. 161.706.  CIVIL ACTION; EFFECT ON IMMUNITY. (a)  A   minor injured as a result of a violation of Section 161.703, or a   parent, legal guardian, or managing conservator of the minor, other   than a parent, guardian, or conservator described by Subdivision   (2), may bring a civil action against:                (1)  a health care provider who violated Section   161.703; and                (2)  the minor's parent, legal guardian, or conservator   who consented to the conduct that constituted the violation.           (b)  Subsection (a)(2) waives any common law immunity   granted to a parent, legal guardian, or conservator to the extent of   liability created by this section.          Sec. 161.707.  WRONGFUL DEATH ACTION. A parent, legal   guardian, or conservator or next of kin of a minor may bring a   wrongful death action under Section 161.706 in accordance with   Subchapter A, Chapter 71, Civil Practice and Remedies Code, against   a health care provider who violates Section 161.703 if the minor who   is the subject of the action is deceased and:                (1)  the minor's death is the result of the physical or   emotional harm inflicted on the minor by the violation; and                (2)  the parent, guardian, or conservator did not   consent to the conduct that constituted the violation.          Sec. 161.708.  LIMITATIONS PERIOD. Notwithstanding any   other law, a claimant must bring an action under Section 161.706 not   later than the earlier of:                (1)  the 30th anniversary of the date the minor who is   the subject of the action becomes 18 years of age; or                (2)  the 10th anniversary of the minor's death.          Sec. 161.709.  DAMAGES. (a)  A claimant may recover   compensatory damages, exemplary damages, and reasonable attorney's   fees, court costs, and expenses in an action brought under Section   161.706.          (b)  Compensatory damages include:                (1)  reasonable economic losses caused by the   emotional, mental, or physical effects of the violation, including:                      (A)  the cost of counseling, hospitalization, and   any other medical expenses connected with treating the harm caused   by the violation;                      (B)  out-of-pocket costs of the minor paid to the   health care provider for the prohibited medical procedure; and                      (C)  loss of income caused by the violation; and                (2)  noneconomic damages caused by the violation,   including psychological and emotional anguish.          Sec. 161.710.  REQUIRED NOTICE OF KNOWING OR INTENTIONAL   VIOLATION. If a court finds that a defendant knowingly or   intentionally violated Section 161.703 in an action brought under   Section 161.706, the court shall notify the appropriate state   regulatory authority for the defendant and the attorney general by   mailing a certified copy of the signed judgment for the action to   the state regulatory authority and the attorney general.          Sec. 161.711.  ATTORNEY GENERAL POWERS AND DUTIES; CIVIL   PENALTY.  (a)  The attorney general shall establish a process by   which knowing or intentional violations of Section 161.703 are   reported.          (b)  The attorney general may bring an action against a   health care provider who knowingly or intentionally violates   Section 161.703 not later than the 20th anniversary of the   violation to:                (1)  enjoin further violations;                (2)  recover any profits received due to the procedure   or treatment that is the subject of the violation; and                (3)  recover a civil penalty in an amount of $25,000 per   violation.          (c)  The attorney general shall deposit a civil penalty   collected under this section in the general revenue fund.          (d)  The attorney general is entitled to reasonable   attorney's fees, court costs, and expenses if the attorney general   prevails in an action brought under this section.          (e)  Venue for an action brought under this section is in a   district court of Williamson County or the county where the   violation occurred.           Sec. 161.712.  STATE REGULATORY AUTHORITY EMERGENCY ACTION.   A violation of Section 161.703 constitutes a potential threat to   public health, safety, and welfare and requires emergency action by   the health care provider's appropriate state regulatory authority.   On receiving notification under Section 161.710 or when the   authority otherwise becomes aware of the violation, the authority   shall take appropriate disciplinary action against the provider.          SECTION 2.  SEVERABILITY. If any provision of this Act or   its application to any person or circumstance is held invalid, the   invalidity does not affect other provisions or applications of this   Act that can be given effect without the invalid provision or   application, and to this end the provisions of this Act are declared   to be severable.          SECTION 3.  TRANSITIONS. (a)  Subchapter X, Chapter 161,   Health and Safety Code, as added by this Act, applies only to a   medical procedure or treatment performed or administered on or   after the effective date of this Act.          (b)  Subchapter X, Chapter 161, Health and Safety Code, as   added by this Act, applies only to a cause of action that accrues on   or after the effective date of this Act.          SECTION 4.  EFFECTIVE DATE. This Act takes effect September   1, 2023.