APPROVED CHAPTER
JULY 11, 2023 413
BY GOVERNOR PUBLIC LAW
STATE OF MAINE
_____
IN THE YEAR OF OUR LORD
TWO THOUSAND TWENTY-THREE
_____
H.P. 340 - L.D. 535
An Act Regarding Consent for Gender-affirming Hormone Therapy for
Certain Minors
Be it enacted by the People of the State of Maine as follows:
Sec. 1. 22 MRSA §1508 is enacted to read:
§1508. Consent for gender-affirming hormone therapy
1. Definitions. As used in this section, unless the context otherwise indicates, the
following terms have the following meanings.
A. "Gender-affirming hormone therapy" means nonsurgical, medically necessary
health care that respects the gender identity of the patient, as experienced and defined
by the patient, that includes, but is not limited to, the following health care:
(1) Interventions to suppress the development of endogenous secondary sex
characteristics;
(2) Interventions to align the patient's appearance or physical body with the
patient's gender identity; or
(3) Interventions to alleviate symptoms of clinically significant distress resulting
from gender dysphoria.
B. "Gender dysphoria" means a clinical diagnosis of gender dysphoria as defined either
in the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders
published by the American Psychiatric Association or in the Standards of Care for the
Health of Transgender and Gender Diverse People, Version 8 or subsequent version,
published by the World Professional Association for Transgender Health.
C. "Health care professional" means a person qualified by training and experience to
provide and monitor the provision of gender-affirming hormone therapy who is
authorized by law to prescribe medication and who is:
(1) Licensed by the Board of Licensure in Medicine under Title 32, chapter 48;
(2) Licensed by the Board of Osteopathic Licensure under Title 32, chapter 36; or
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 (3) Licensed by the State Board of Nursing as an advanced practice registered nurse
under Title 32, chapter 31.
2. Authority of minor to consent. A health care professional may provide gender-
affirming hormone therapy and follow-up care to a minor without obtaining the consent of
the parent or guardian of the minor only if:
A. The minor is at least 16 years of age;
B. The minor has been diagnosed with gender dysphoria by a health care professional;
C. In the judgment of the health care professional, the minor is experiencing harm
from or is expected to experience harm from not receiving gender-affirming hormone
therapy;
D. The minor informs the health care professional that the minor has discussed the
minor's gender dysphoria with a parent or guardian of the minor and that parent or
guardian refused to support treatment of the minor's gender dysphoria; and
E. The minor provides informed written consent to the receipt of gender-affirming
hormone therapy in accordance with the requirements of subsection 3; the health care
professional makes the written consent that is set forth in a writing containing the
information and statements required by subsection 3, paragraph B and that is signed by
the minor a part of the minor's health record; and the minor, under all the surrounding
circumstances, is mentally and physically competent to give consent.
3. Informed consent. A minor who meets the requirements of subsection 2,
paragraphs A to D may provide informed written consent to gender-affirming hormone
therapy and follow-up care only in accordance with the requirements of this subsection.
A. A health care professional shall, in a manner that the health care professional
believes is not misleading and will be understood by the minor:
(1) Explain that the information being given to the minor is not intended to coerce,
persuade or induce the minor to consent to gender-affirming hormone therapy;
(2) Explain that the minor may withdraw the decision to commence or to continue
to receive gender-affirming hormone therapy at any time either before the therapy
begins or during the course of the therapy;
(3) Clearly and fully explore with the minor the alternative choices available for
managing and treating gender dysphoria;
(4) Explain the physiological effects, benefits and possible consequences of
gender-affirming hormone therapy and follow-up care, including the physiological
effects, benefits and possible consequences of discontinuing the therapy;
(5) Discuss the possibility of involving the minor's parents or guardians in the
minor's decision making about gender-affirming hormone therapy and follow-up
care and explore whether the minor believes that parent or guardian involvement
would be in the minor's best interests; and
(6) Provide an adequate opportunity for the minor to ask any questions concerning
gender dysphoria, gender-affirming hormone therapy and follow-up care and
provide the information the minor seeks or, if the health care professional cannot
provide the information, explain where the minor can obtain the information.
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 B. After providing the information and counseling required by paragraph A, the health
care professional shall have the minor sign and date a form stating:
(1) The business address and telephone number of the health care professional who
provided the information and counseling required by paragraph A;
(2) The minor has received information on gender-affirming hormone therapy and
follow-up care, including the benefits and possible consequences of and
alternatives to gender-affirming hormone therapy;
(3) The minor has received an explanation that the minor may withdraw consent to
gender-affirming hormone therapy at any time, including after therapy begins;
(4) The alternatives for managing gender dysphoria have been clearly and fully
explored with the minor;
(5) The minor has discussed with the health care professional the possibility of
involving the minor's parents or guardians in the minor's decision making about
gender-affirming hormone therapy and follow-up care. If the minor has chosen not
to involve the minor's parents or guardians, the reasons for making that choice must
be stated in writing on the form; and
(6) The minor has been given an adequate opportunity to ask questions and receive
answers about gender dysphoria, gender-affirming hormone therapy and follow-up
care.
C. The health care professional who provided the information and counseling required
by paragraph A shall also sign and date the form signed by the minor under paragraph
B. The health care professional shall retain a copy of the form in that health care
professional's files and shall give the form to the minor. If the health care professional
who provided the information and counseling required by paragraph A is not the health
care professional who will provide gender-affirming hormone therapy to the minor, at
the minor's request the health care professional shall transmit the form to the health
care professional who will provide gender-affirming hormone therapy to the minor.
4. Rebuttable presumption of validity. A written consent of a minor who meets the
requirements of subsection 2 that is set forth in a writing containing the information and
statements required by subsection 3, paragraph B and that is signed by the minor is
presumed to be a valid, informed consent to treatment for gender-affirming hormone
therapy and bars an action by a parent or guardian of the minor on the grounds of battery,
malpractice or any other claim for providing gender-affirming hormone therapy without
consent from a parent or guardian. The presumption of validity established in this
subsection may be rebutted only by evidence that the minor's consent was obtained through
fraud, deception or misrepresentation of material fact.
5. Disallowance of recovery. Recovery is not allowed against a health care
professional upon the grounds that gender-affirming hormone therapy of a minor who
meets the requirements of subsection 2 was rendered without the informed consent of the
minor when:
A. The health care professional, in obtaining the minor's consent, complied with the
terms of this section and the standards of care among members of the same health care
profession with similar training and experience situated in the same or similar
communities; or
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 B. The health care professional received and acted in good faith on the informed written
consent to gender-affirming hormone therapy given by the minor to another health care
professional that contains the information and statements required by subsection 3,
paragraph B.
6. Nonseverability. In the event that any portion of subsections 1 to 5 is held invalid,
it is the intent of the Legislature that this entire section, other than subsection 7, is invalid.
7. Authority of parent to consent unaffected. This section does not affect the legal
authority of a parent or guardian to consent to gender-affirming hormone therapy for a
minor in accordance with established standards of care.
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