Senate File 110 - Introduced SENATE FILE 110 BY SALMON , EVANS , ALONS , GREEN , WESTRICH , J. TAYLOR , GUTH , DE WITT , and ROWLEY A BILL FOR An Act relating to gender-transition procedures, and including 1 effective date provisions. 2 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA: 3 TLSB 1134XS (5) 90 cm/ns

S.F. 110 Section 1. NEW SECTION . 144H.1 Definitions. 1 As used in this chapter, unless the context otherwise 2 requires: 3 1. “Biological sex” means the genetic classification of an 4 individual as male or female, as reflected in the organization 5 of the body of the individual for a reproductive role or 6 capacity, such as through sex chromosomes, naturally occurring 7 sex hormones, and internal and external genitalia present at 8 birth, without regard to the subjective sense of identity of 9 the individual. 10 2. a. “Gender-transition procedure” means any of the 11 following: 12 (1) The prescription or administration of puberty-blocking 13 drugs for the purpose of changing the body of an individual 14 so that it conforms to the subjective sense of identity of 15 the individual, in the case such identity is at odds with the 16 individual’s biological sex. 17 (2) The prescription or administration of cross-sex 18 hormones for the purpose of changing the body of an individual 19 so that it conforms to the subjective sense of identity of 20 the individual, in the case such identity is at odds with the 21 individual’s biological sex. 22 (3) A surgery to change the body of an individual so that it 23 conforms to the subjective sense of identity of the individual, 24 in the case such identity is at odds with the individual’s 25 biological sex. 26 b. “Gender-transition procedure” does not include an 27 intervention described in paragraph “a” that is performed in any 28 of the following circumstances: 29 (1) On an individual with biological sex characteristics 30 that are inherently ambiguous, such as those born with 31 forty-six XX chromosomes with virilization, with forty-six XY 32 chromosomes with undervirilization, or having both ovarian 33 and testicular tissue or an individual with respect to whom 34 a medical practitioner has determined through genetic or 35 -1- LSB 1134XS (5) 90 cm/ns 1/ 4

S.F. 110 biochemical testing that the individual does not have normal 1 sex chromosome structure, sex steroid hormone production, or 2 sex steroid hormone action, for a biological male or biological 3 female. 4 (2) For the treatment of any infection, injury, disease, or 5 disorder that has been caused or exacerbated by the performance 6 of an intervention described in paragraph “a” without regard to 7 whether the intervention was performed in accordance with state 8 or federal law or whether the intervention is covered by the 9 private right of action under section 144H.2. 10 (3) Using any procedure undertaken because the individual 11 suffers from a physical disorder, physical injury, or physical 12 illness that would, as certified by a medical practitioner, 13 place the individual in imminent danger of death or impairment 14 of major bodily function unless the procedure is performed. 15 3. “Medical practitioner” means a person who is licensed, 16 certified, or otherwise authorized by the laws of a state to 17 administer health care in the ordinary course of the practice 18 of the person’s profession. 19 Sec. 2. NEW SECTION . 144H.2 Private right of action for 20 gender-transition procedure performed on minor. 21 1. A medical practitioner who performs a gender-transition 22 procedure in this state on an individual who is less than 23 eighteen years of age shall, as described in subsection 2, be 24 liable to the individual if injured, including any physical, 25 psychological, emotional, or physiological harms, by such 26 procedure, related treatment, or subsequent effects of the 27 procedure or treatment. 28 2. An individual covered by subsection 1, who receives a 29 gender-transition procedure from a medical practitioner, or 30 the individual’s representative, including a legal guardian, 31 on behalf of such individual, may, not later than the day 32 that is thirty years after the date on which the individual 33 turns eighteen years of age, bring a civil action against such 34 medical practitioner in a court of competent jurisdiction 35 -2- LSB 1134XS (5) 90 cm/ns 2/ 4

S.F. 110 for declaratory or injunctive relief, compensatory damages, 1 punitive damages, and attorney fees and costs. 2 Sec. 3. NEW SECTION . 144H.3 Performance not required. 3 Notwithstanding any other provision of law to the contrary, 4 no provision of state law shall require, or be construed to 5 require, a medical practitioner to perform a gender-transition 6 procedure. 7 Sec. 4. NEW SECTION . 144H.4 Prohibition on funding. 8 Notwithstanding any other provision of law to the contrary, 9 any medical practitioner that performs any gender-transition 10 procedure on an individual in this state shall be ineligible 11 to receive any funding from the department of health and human 12 services. 13 Sec. 5. EFFECTIVE DATE. This Act, being deemed of immediate 14 importance, takes effect upon enactment. 15 EXPLANATION 16 The inclusion of this explanation does not constitute agreement with 17 the explanation’s substance by the members of the general assembly. 18 This bill creates a private right of action for 19 gender-transition procedures performed on a minor. The 20 bill provides that a medical practitioner who performs a 21 gender-transition procedure in this state on an individual who 22 is less than 18 years of age shall be liable to the individual 23 if injured, including any physical, psychological, emotional, 24 or physiological harms, by such procedure, related treatment, 25 or subsequent effects of the procedure or treatment. An 26 individual who receives a gender-transition procedure from 27 a medical practitioner, or the individual’s representative, 28 has 30 years after the date the individual turned 18 years of 29 age to bring a civil action against such medical practitioner 30 for declaratory or injunctive relief, compensatory damages, 31 punitive damages, and attorney fees and costs. 32 The bill provides that no state law shall require a medical 33 practitioner to perform a gender-transition procedure and that 34 any medical practitioner that performs a gender-transition 35 -3- LSB 1134XS (5) 90 cm/ns 3/ 4

S.F. 110 procedure on an individual in this state shall be ineligible 1 to receive any funding from the department of health and human 2 services. 3 The bill takes effect upon enactment. 4 -4- LSB 1134XS (5) 90 cm/ns 4/ 4