PRINTER'S NO. 3337
THE GENERAL ASSEMBLY OF PENNSYLVANIA
HOUSE BILL
No.
2421
Session of
2024
INTRODUCED BY ROAE, FEE, GREINER, HAMM, MENTZER, KAUFFMAN, FINK,
ROWE, BANTA, COOK AND CUTLER, JUNE 20, 2024
REFERRED TO COMMITTEE ON HEALTH, JUNE 20, 2024
AN ACT
Prohibiting gender transition procedures for minors and coverage
for gender transition procedures for minors.
The General Assembly of the Commonwealth of Pennsylvania
hereby enacts as follows:
Section 1. Short title.
This act shall be known and may be cited as the Save
Adolescents from Experimentation Act.
Section 2. Declaration of purpose.
The General Assembly finds and declares as follows:
(1) The Commonwealth has a compelling government
interest in protecting the health and safety of vulnerable
minors.
(2) Gender transition procedures are permanent and often
irreversible treatments that carry serious known risks,
ranging from increased risks of various types of cancer to
infertility.
(3) The vast majority of minors who express distress in
identifying with their biological sex eventually come to
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identify with their biological sex in adolescence or
adulthood.
(4) Studies have refuted the misconception that
providing gender transition procedures to vulnerable minors
reduces risk of suicide, psychiatric morbidities and
mortality.
(5) The risks of performing gender transition procedures
on minors far outweigh any perceived benefits.
(6) The provisions of this act only apply to minors.
(7) An individual who has attained 18 years of age may
continue to obtain gender transition procedures.
Section 3. Definitions.
The following words and phrases when used in this act shall
have the meanings given to them in this section unless the
context clearly indicates otherwise:
"Biological sex." The biological indication of male and
female in the context of reproductive potential or capacity,
including sex chromosomes, naturally occurring sex hormones,
gonads and nonambiguous internal and external genitalia present
at birth, without regard to an individual's psychological,
chosen or subjective experience of gender.
"Cross-sex hormones." Any of the following:
(1) Testosterone or other androgens given to a
biological female at doses that are profoundly larger or more
potent than would normally occur naturally in a healthy
biological female.
(2) Estrogen given to a biological male at doses that
are profoundly larger or more potent than would normally
occur naturally in a healthy biological male.
"Gender." The psychological, behavioral, social and cultural
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aspects of being male or female.
"Gender transition." The process in which an individual goes
from identifying with and living as a gender that corresponds to
the individual's biological sex to identifying with and living
as a gender different from the individual's biological sex which
may involve social, legal or physical changes.
"Gender transition procedure." All forms of treatments
related to gender transition, including genital gender
reassignment surgery, nongenital gender reassignment surgery,
cross-sex hormones and puberty-blocking drugs.
"Genital gender reassignment surgery." A genital medical
procedure performed for the purpose of assisting an individual
with a gender transition, including any of the following:
(1) A surgical procedure, including penectomy,
orchiectomy, vaginoplasty, clitoroplasty or vulvoplasty, for
biologically male patients and hysterectomy or ovariectomy
for biologically female patients.
(2) Reconstruction of the fixed part of the urethra with
or without a metoidioplasty.
(3) Phalloplasty, vaginectomy, scrotoplasty or
implantation of erection or testicular prostheses for
biologically female patients.
"Government program." A program of government-sponsored or
government-subsidized health care coverage, including any of the
following:
(1) The children's health insurance program under
Article XXIII-A of the act of May 17, 1921 (P.L.682, No.284),
known as The Insurance Company Law of 1921.
(2) The medical assistance program under Subdivision (f)
of Article IV of the act of June 13, 1967 (P.L.31, No.21),
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known as the Human Services Code.
"Health care practitioner." As defined in section 103 of the
act of July 19, 1979 (P.L.130, No.48), known as the Health Care
Facilities Act.
"Health insurance policy." A policy, subscriber contract,
certificate or plan issued by an insurer that provides medical
or health care coverage. The term includes a dental only and a
vision only policy. The term does not include:
(1) An accident only policy.
(2) A credit only policy.
(3) A long-term care or disability income policy.
(4) A specified disease policy.
(5) A Medicare supplement policy.
(6) A TRICARE policy, including a Civilian Health and
Medical Program of the Uniformed Services (CHAMPUS)
supplement policy.
(7) A fixed indemnity policy.
(8) A hospital indemnity policy.
(9) A worker's compensation policy.
(10) An automobile medical payment policy under 75
Pa.C.S. (relating to vehicles).
(11) A homeowner's insurance policy.
(12) Any other similar policies providing for limited
benefits.
"Insurer." An entity licensed by the Insurance Department
that offers, issues or renews a health insurance policy and is
governed under any of the following:
(1) The act of December 29, 1972 (P.L.1701, No.364),
known as the Health Maintenance Organization Act.
(2) 40 Pa.C.S. Ch. 61 (relating to hospital plan
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corporations).
(3) 40 Pa.C.S. Ch. 63 (relating to professional health
services plan corporations).
"Licensing board." Each licensing board within the Bureau of
Professional and Occupational Affairs of the Department of State
with jurisdiction over a health care practitioner.
"Minor." An individual who is younger than 18 years of age.
"Nongenital gender reassignment surgery." A nongenital
medical procedure performed for the purpose of assisting an
individual with a gender transition, including any of the
following:
(1) A surgical procedure for a biologically male
patient, including augmentation mammoplasty, facial
feminization surgery, liposuction, lipofilling, voice
surgery, thyroid cartilage reduction, gluteal augmentation,
hair reconstruction or various aesthetic procedures.
(2) A surgical procedure for a biologically female
patient, including subcutaneous mastectomy, voice surgery,
liposuction, lipofilling, pectoral implants or various
aesthetic procedures.
"Pharmacist." An individual duly licensed by the State Board
of Pharmacy to engage in the practice of pharmacy.
"Physician." A medical doctor or doctor of osteopathy.
"Puberty-blocking drugs." Any of the following:
(1) Gonadotropin-releasing hormone analogs or other
synthetic drugs used in a biological male patient to stop
luteinizing hormone secretion and, therefore, testosterone
secretion.
(2) Synthetic drugs used in biological females that stop
the production of estrogens and progesterone when used to
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delay or suppress pubertal development in children for the
purpose of assisting an individual with a gender transition.
Section 4. Prohibition on gender transition procedures for
minors.
(a) Prohibition on health care practitioners.--
(1) A health care practitioner may not perform gender
transition procedures on a minor or refer a minor to receive
gender transition procedures.
(2) A health care practitioner with prescriptive
authority may not prescribe cross-sex hormones or puberty-
blocking drugs to a minor or refer a minor to be prescribed
cross-sex hormones or puberty-blocking drugs.
(b) Prohibition on pharmacists.--A pharmacist may not
dispense cross-sex hormones or puberty-blocking drugs to a
minor.
(c) Construction.--Nothing in this section shall be
construed to restrict any of the following:
(1) Services provided to an individual born with a
medically verifiable disorder of sex development, sex
chromosome structure, sex steroid hormone production or sex
steroid hormone action.
(2) The treatment of an infection, injury, disease or
disorder that has been caused or exacerbated by the
performance of gender transition procedures.
(3) Medically necessary procedures, as determined by a
physician, undertaken to prevent death or impairment of a
major bodily function.
(4) Mental health treatment that is not prohibited under
subsection (a).
(d) Penalties.--A health care practitioner who violates
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subsection (a) shall be subject to discipline by the applicable
licensing board with jurisdiction over the health care
practitioner. A licensing board with jurisdiction over a health
care practitioner who violates subsection (a) shall consider the
violation to be a violation of the health care practitioner's
scope of practice as specified under State law and grounds for
sanctions as specified under State law.
Section 5. Prohibition on coverage for gender transition
procedures for minors.
(a) Prohibition on insurers.--Except as authorized under
section 4(c), an insurer may not provide a health insurance
policy to provide coverage for gender transition procedures.
(b) Prohibition on government programs.--Except as
authorized under section 4(c), a government program may not
provide coverage for gender transition procedures.
Section 6. Severability.
The provisions of this act are severable. If any provision of
this act or its application to any person or circumstance is
held invalid, the invalidity shall not affect other provisions
or applications of this act which can be given effect without
the invalid provision or application.
Section 7. Effective date.
This act shall take effect in 60 days.
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