Revision: March 20, 2024, 3:31 p.m.
Rep. Hoell, Merr. 27
March 20, 2024
2024-1273h
09/05
Floor Amendment to HB 1664-FN
Amend the bill by replacing all after the enacting clause with the following:
1 Legislative Findings. The general court hereby finds:
I. The United Kingdom recently banned all surgery, hormone treatments, and puberty blockers for those under the age of 18.
II. The recent studies coming from California have called into question the medical science supporting gender transition treatments.
III. There are hospitals within the state of New Hampshire practicing these treatments.
IV. The recent World Professional Association for Transgender Health (WPATH) file release has shown that there may be greater concerns for the individuals who seek gender transition treatments for gender dysphoria.
V. The studies for long-term benefits are not definitive in nature, and the patient needs to be fully informed of the potential for long-term consequences.
2 Medical Injury Actions; Definitions. Amend RSA 507-E:1 to read as follows:
507-E:1 Definitions.
As used in this chapter:
I. "Action for medical injury" means any action against a medical care provider, whether based in tort, contract or otherwise, to recover damages on account of medical injury.
I-a. “Cross-sex hormones” means testosterone, estrogen, or other androgens given to an individual in amounts that are greater or more potent than would normally occur naturally in a healthy individual of the same age and sex as defined in RSA 354-A:2, XIV-f for the purpose of assisting an individual in changing his or her gender identity.
I-b. “Gender transition surgery” means a procedure which surgically removes an individual’s reproductive organs or secondary sex characteristics for the purpose of assisting an individual in changing his or her gender identity.
II. "Medical care provider" means a physician, physician's assistant, registered or licensed practical nurse, hospital, clinic or other health care agency licensed by the state or otherwise lawfully providing medical care or services, or an officer, employee or agent thereof acting in the course and scope of employment.
II-a. “Medical detransition” means treatment received by an individual for the purpose of reversing or mitigating the effects of gender transition surgery, cross-sex hormones, or puberty-blocking drugs and of restoring the secondary sex characteristics corresponding to the individual’s sex as defined in RSA 354-A:2, XIV-f.
III. "Medical injury" or "injury" means any adverse, untoward or undesired consequences arising out of or sustained in the course of professional services rendered by a medical care provider, whether resulting from negligence, error, or omission in the performance of such services; from rendition of such services without informed consent or in breach of warranty or in violation of contract; from failure to diagnose; from premature abandonment of a patient or of a course of treatment; from failure properly to maintain equipment or appliances necessary to the rendition of such services; or otherwise arising out of or sustained in the course of such services.
IV. “Puberty-blocking drugs” means gonadotropin-releasing hormone analogues or other synthetic drugs used to stop luteinizing hormone secretion and follicle stimulating hormone secretion, synthetic antiandrogen drugs to block the androgen receptor, or any other drug used to delay or suppress pubertal development in children for the purpose of assisting an individual in changing his or her gender identity.
3 New Section; Actions, Process, and Service of Process; Medical Injury Actions; Actions for Medical Detransitioning. Amend RSA 507-E by inserting after section 4 the following new section:
507-E:5 Actions for Medical Detransition.
I. Any action for a medical injury resulting from the administration or prescription of gender transition surgery, cross-sex hormones, or puberty-blocking drugs to a person 21 years of age or younger shall accrue under RSA 508:4, I no earlier than the time the plaintiff begins a medical detransition.
II. A plaintiff who brings any action listed in paragraph I shall be presumed to have met the plaintiff’s burden under RSA 507-E:2, I if the individual is infertile as a result of the treatment. Such presumption may be rebutted only by clear and convincing evidence.
III. This section shall not apply to any of the following procedures which are not gender transition procedures provided to a person 21 years of age or younger:
(a) Services to persons born with a medically verifiable disorder of sex development, including a person with external biological sex characteristics that are ambiguous, such as those born with 46 XX chromosomes with virilization, 46 XY chromosomes with undervirilization, or having both ovarian and testicular tissue;
(b) Services provided when a physician has otherwise diagnosed a disorder of sexual development that the physician has determined through genetic or biochemical testing that the person does not have normal sex chromosome structure, sex steroid hormone production, or sex steroid hormone action;
(c) The treatment of any infection, injury, disease, or disorder that has been caused by or exacerbated by the performance of gender transition procedures, whether or not the gender transition procedure was performed in accordance with state and federal law;
(d) Any procedure undertaken because the individual suffers from a physical disorder, physical injury, or physical illness that would, as certified by a physician, place the individual in imminent danger of death or impairment of major bodily function unless surgery is performed; or
(e) Treatment of precocious puberty.
4 State Commission for Human Rights; Definitions. Amend RSA 354-A:2, XIV-e to read as follows:
XIV-e. "Gender identity" means a person's gender-related identity, [appearance, or behavior,] whether or not that gender-related identity[, appearance, or behavior] is different from that traditionally associated with the person's physiology or [assigned] sex [at birth]. Gender-related identity may be shown by providing evidence including, but not limited to, medical history, care or treatment of the gender-related identity, consistent and uniform assertion of the gender-related identity, or any other evidence that the gender-related identity is sincerely held as part of a person's core identity [provided, however, that gender-related identity shall not be asserted for any improper purpose]. Discrimination because a person has undergone a medical detransition as defined in RSA 507-E:1, II-a, shall be considered discrimination because of gender identity.
5 New Paragraph; State Commission for Human Rights; Definitions. Amend RSA 354-A:2 by inserting after paragraph XIV-e the following new paragraph:
XIV-f. “Sex” means the male and female biological sexes, as distinct from an individual's psychological or subjective experience of gender-related identity.
6 Effective Date. This act shall take effect 60 days after its passage.