Text to be removed highlighted in red.
1 New Subdivision; Limitations on Breast Surgeries for Minors. Amend RSA 329 by inserting after section 50 the following new subdivision:
Limitations on Breast Surgeries for Minors
329:51 Limitations on Breast Surgery for Minors. This subdivision is intended to limit permissible breast surgeries on people under the age of 18 to only those procedures needed to treat malignancy, injury, infection, or malformation and those needed to reconstruct the breasts after such procedures.
329:52 Definitions. In this subdivision:
I. "Abnormal development" means:
(a) "Gynecomastia" which is the abnormal development of breast tissue in biologic males;
(b) "Macromastia" which is excessive development of breast tissue in biologic females and includes juvenile hypertrophy of the breast and gigantomastia; or
(c) "Symptomatic macromastia" is macromastia which causes pain, deformity and/or recurrent skin infection.
II. "Breast surgery" includes:
(a) "Mammaplasty" which means surgery to reshape or reside the breasts by removing or transplanting tissue or inserting implants;
(b) "Mastectomy" which means surgery to remove all breast tissue; and/or
(c) "Mastopexy" which means surgery to lift the breast.
III. "Malignant" means cancerous or otherwise dangerous to the physical health of the person including physiology compromised by infection, lack of blood flow, or physical injury.
VI. "Margin" means the healthy tissue removed around malignant tissue to ensure that all malignancy has been removed, and any additional tissue as recommended by relevant medical guidelines.
VI. "Transgender chest surgery" means surgery to remove the breasts of a biologic female through mastectomy or to increase the size of breasts of a biologic male through augmentation mammaplasty.
329:53 Prohibitions and Enforcement.
I. Pursuant to this subdivision and RSA 332-M, no physician shall perform transgender chest surgery on a person under 18 years of age.
II. No physician shall perform breast surgery on a person under 18 years of age unless one or more of the following conditions are met:
(a) The procedure is subsequent to a diagnosis of cancer which necessitates such a procedure as part of a treatment plan;
(b) The procedure is needed to remove malignant tissue and an appropriate margin;
(c) Reconstruction of breast tissue to restore the breasts after injury or infection which requires the removal of breast tissue to restore the physical health of the person;
(d) The procedure is needed to correct gynecomastia and symptomatic macromastia; or
(e) Treatment of congenital deformities of the breast and/or chest wall.
III. A violation of this subdivision is unprofessional conduct and is subject to discipline by the board of medicine and/or the office of professional licensure and certification.
IV. Any person aggrieved by violation of this subdivision may initiate an action against the surgeon and may recover court costs and reasonable attorney's fees as the prevailing party. Nothing in this section shall supersede or replace existing rights or remedies under any other law.
2 Title Change. Amend the title of RSA 332-M to read as follows:
CHAPTER 332-M
PROHIBITING GENITAL GENDER REASSIGNMENT SURGERY ON MINORS
3 Definition of Gender Reassignment Surgery Added. Amend RSA 332-M:2 by inserting after paragraph III the following new paragraph:
III-a. "Gender surgery" includes genital gender reassignment surgery, transgender chest surgery as defined in RSA 329:53, X, facial feminization or masculinization surgery, and/or removal of the reproductive organs for the purposes of gender identity including hysterectomy, oophorectomy, salpingo-oorphorectomy, and/or orchiectomy.
4 Prohibition of Gender Surgery on Minors. Amend RSA 332-M:3 to read as follows:
332-M:3 Prohibition of Genital Gender Reassignment Surgery on Minors.
I. A physician shall not perform genital gender reassignment surgery on minors in the state of New Hampshire.
II. Physicians are not prohibited from performing:
(a) Reconstructive surgeries on the genitalia of minors to correct malformation, malignancy, injury or physical disease;
(b) Removal of malignant, malformed, or otherwise damaged genitalia ;
(c) Genital surgeries on minors with disorders of sex development; or
(d) Male circumcision
.
5 Enforcement. Amend RSA 332-M:4, I to read as follows:
I. Any referral for or provision of genital gender reassignment surgery to an individual under 18 years of age is unprofessional conduct and is subject to discipline by the appropriate licensing entity or disciplinary review board with competent jurisdiction in this state.
6 Effective Date.
I. Section 1 of this act shall take effect 60 days after its passage.
II. The remainder of this act shall take effect January 1, 2026.
Text to be added highlighted in green.
1 New Subdivision; Limitations on Breast Surgeries for Minors. Amend RSA 329 by inserting after section 50 the following new subdivision:
Limitations on Breast Surgeries for Minors
329:51 Limitations on Breast Surgery for Minors. This subdivision is intended to limit permissible breast surgeries on people under the age of 18 to only those procedures needed to treat malignancy, injury, infection, or malformation and those needed to reconstruct the breasts after such procedures.
329:52 Definitions. In this subdivision:
I. "Abnormal development" means:
(a) "Gynecomastia" which is the abnormal development of breast tissue in biologic males;
(b) "Macromastia" which is excessive development of breast tissue in biologic females and includes juvenile hypertrophy of the breast and gigantomastia; or
(c) "Symptomatic macromastia" is macromastia which causes pain, deformity and/or recurrent skin infection.
II. "Breast surgery" includes:
(a) "Mammaplasty" which means surgery to reshape or reside the breasts by removing or transplanting tissue or inserting implants;
(b) "Mastectomy" which means surgery to remove all breast tissue; and/or
(c) "Mastopexy" which means surgery to lift the breast.
III. "Malignant" means cancerous or otherwise dangerous to the physical health of the person including physiology compromised by infection, lack of blood flow, or physical injury.
VI. "Margin" means the healthy tissue removed around malignant tissue to ensure that all malignancy has been removed, and any additional tissue as recommended by relevant medical guidelines.
VI. "Transgender chest surgery" means surgery to remove the breasts of a biologic female through mastectomy or to increase the size of breasts of a biologic male through augmentation mammaplasty.
329:53 Prohibitions and Enforcement.
I. Pursuant to this subdivision and RSA 332-M, no physician shall perform transgender chest surgery on a person under 18 years of age.
II. No physician shall perform breast surgery on a person under 18 years of age unless one or more of the following conditions are met:
(a) The procedure is subsequent to a diagnosis of cancer which necessitates such a procedure as part of a treatment plan;
(b) The procedure is needed to remove malignant tissue and an appropriate margin;
(c) Reconstruction of breast tissue to restore the breasts after injury or infection which requires the removal of breast tissue to restore the physical health of the person;
(d) The procedure is needed to correct gynecomastia and symptomatic macromastia; or
(e) Treatment of congenital deformities of the breast and/or chest wall.
III. A violation of this subdivision is unprofessional conduct and is subject to discipline by the board of medicine and/or the office of professional licensure and certification.
IV. Any person aggrieved by violation of this subdivision may initiate an action against the surgeon and may recover court costs and reasonable attorney's fees as the prevailing party. Nothing in this section shall supersede or replace existing rights or remedies under any other law.
2 Title Change. Amend the title of RSA 332-M to read as follows:
CHAPTER 332-M
PROHIBITING GENDER SURGERY ON MINORS
3 Definition of Gender Reassignment Surgery Added. Amend RSA 332-M:2 by inserting after paragraph III the following new paragraph:
III-a. "Gender surgery" includes genital gender reassignment surgery, transgender chest surgery as defined in RSA 329:53, X, facial feminization or masculinization surgery, and/or removal of the reproductive organs for the purposes of gender identity including hysterectomy, oophorectomy, salpingo-oorphorectomy, and/or orchiectomy.
4 Prohibition of Gender Surgery on Minors. Amend RSA 332-M:3 to read as follows:
332-M:3 Prohibition of Gender Surgery on Minors.
I. A physician shall not perform gender surgery on minors in the state of New Hampshire.
II. Physicians are not prohibited from performing:
(a) Reconstructive surgeries on minors to correct malformation, malignancy, injury or physical disease;
(b) Removal of malignant, malformed, or otherwise damaged tissue ;
(c) Genital surgeries on minors with disorders of sex development; or
(d) Male circumcision ; or
(e) Breast surgery subject to the conditions of RSA 329:54, II(a)-(f) .
5 Enforcement. Amend RSA 332-M:4, I to read as follows:
I. Any referral for or provision of gender surgery to an individual under 18 years of age is unprofessional conduct and is subject to discipline by the appropriate licensing entity or disciplinary review board with competent jurisdiction in this state.
6 Effective Date.
I. Section 1 of this act shall take effect 60 days after its passage.
II. The remainder of this act shall take effect January 1, 2026.