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
1 Prohibiting gender transition procedures for minors and coverage
2 for gender transition procedures for minors.
3 The General Assembly of the Commonwealth of Pennsylvania
4 hereby enacts as follows:
5 Section 1. Short title.
6 This act shall be known and may be cited as the Save
7 Adolescents from Experimentation Act.
8 Section 2. Declaration of purpose.
9 The General Assembly finds and declares as follows:
10 (1) The Commonwealth has a compelling government
11 interest in protecting the health and safety of vulnerable
12 minors.
13 (2) Gender transition procedures are permanent and often
14 irreversible treatments that carry serious known risks,
15 ranging from increased risks of various types of cancer to
16 infertility.
17 (3) The vast majority of minors who express distress in
18 identifying with their biological sex eventually come to
 1 identify with their biological sex in adolescence or
2 adulthood.
3 (4) Studies have refuted the misconception that
4 providing gender transition procedures to vulnerable minors
5 reduces risk of suicide, psychiatric morbidities and
6 mortality.
7 (5) The risks of performing gender transition procedures
8 on minors far outweigh any perceived benefits.
9 (6) The provisions of this act only apply to minors.
10 (7) An individual who has attained 18 years of age may
11 continue to obtain gender transition procedures.
12 Section 3. Definitions.
13 The following words and phrases when used in this act shall
14 have the meanings given to them in this section unless the
15 context clearly indicates otherwise:
16 "Biological sex." The biological indication of male and
17 female in the context of reproductive potential or capacity,
18 including sex chromosomes, naturally occurring sex hormones,
19 gonads and nonambiguous internal and external genitalia present
20 at birth, without regard to an individual's psychological,
21 chosen or subjective experience of gender.
22 "Cross-sex hormones." Any of the following:
23 (1) Testosterone or other androgens given to a
24 biological female at doses that are profoundly larger or more
25 potent than would normally occur naturally in a healthy
26 biological female.
27 (2) Estrogen given to a biological male at doses that
28 are profoundly larger or more potent than would normally
29 occur naturally in a healthy biological male.
30 "Gender." The psychological, behavioral, social and cultural
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 1 aspects of being male or female.
2 "Gender transition." The process in which an individual goes
3 from identifying with and living as a gender that corresponds to
4 the individual's biological sex to identifying with and living
5 as a gender different from the individual's biological sex which
6 may involve social, legal or physical changes.
7 "Gender transition procedure." All forms of treatments
8 related to gender transition, including genital gender
9 reassignment surgery, nongenital gender reassignment surgery,
10 cross-sex hormones and puberty-blocking drugs.
11 "Genital gender reassignment surgery." A genital medical
12 procedure performed for the purpose of assisting an individual
13 with a gender transition, including any of the following:
14 (1) A surgical procedure, including penectomy,
15 orchiectomy, vaginoplasty, clitoroplasty or vulvoplasty, for
16 biologically male patients and hysterectomy or ovariectomy
17 for biologically female patients.
18 (2) Reconstruction of the fixed part of the urethra with
19 or without a metoidioplasty.
20 (3) Phalloplasty, vaginectomy, scrotoplasty or
21 implantation of erection or testicular prostheses for
22 biologically female patients.
23 "Government program." A program of government-sponsored or
24 government-subsidized health care coverage, including any of the
25 following:
26 (1) The children's health insurance program under
27 Article XXIII-A of the act of May 17, 1921 (P.L.682, No.284),
28 known as The Insurance Company Law of 1921.
29 (2) The medical assistance program under Subdivision (f)
30 of Article IV of the act of June 13, 1967 (P.L.31, No.21),
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 1 known as the Human Services Code.
2 "Health care practitioner." As defined in section 103 of the
3 act of July 19, 1979 (P.L.130, No.48), known as the Health Care
4 Facilities Act.
5 "Health insurance policy." A policy, subscriber contract,
6 certificate or plan issued by an insurer that provides medical
7 or health care coverage. The term includes a dental only and a
8 vision only policy. The term does not include:
9 (1) An accident only policy.
10 (2) A credit only policy.
11 (3) A long-term care or disability income policy.
12 (4) A specified disease policy.
13 (5) A Medicare supplement policy.
14 (6) A TRICARE policy, including a Civilian Health and
15 Medical Program of the Uniformed Services (CHAMPUS)
16 supplement policy.
17 (7) A fixed indemnity policy.
18 (8) A hospital indemnity policy.
19 (9) A worker's compensation policy.
20 (10) An automobile medical payment policy under 75
21 Pa.C.S. (relating to vehicles).
22 (11) A homeowner's insurance policy.
23 (12) Any other similar policies providing for limited
24 benefits.
25 "Insurer." An entity licensed by the Insurance Department
26 that offers, issues or renews a health insurance policy and is
27 governed under any of the following:
28 (1) The act of December 29, 1972 (P.L.1701, No.364),
29 known as the Health Maintenance Organization Act.
30 (2) 40 Pa.C.S. Ch. 61 (relating to hospital plan
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 1 corporations).
2 (3) 40 Pa.C.S. Ch. 63 (relating to professional health
3 services plan corporations).
4 "Licensing board." Each licensing board within the Bureau of
5 Professional and Occupational Affairs of the Department of State
6 with jurisdiction over a health care practitioner.
7 "Minor." An individual who is younger than 18 years of age.
8 "Nongenital gender reassignment surgery." A nongenital
9 medical procedure performed for the purpose of assisting an
10 individual with a gender transition, including any of the
11 following:
12 (1) A surgical procedure for a biologically male
13 patient, including augmentation mammoplasty, facial
14 feminization surgery, liposuction, lipofilling, voice
15 surgery, thyroid cartilage reduction, gluteal augmentation,
16 hair reconstruction or various aesthetic procedures.
17 (2) A surgical procedure for a biologically female
18 patient, including subcutaneous mastectomy, voice surgery,
19 liposuction, lipofilling, pectoral implants or various
20 aesthetic procedures.
21 "Pharmacist." An individual duly licensed by the State Board
22 of Pharmacy to engage in the practice of pharmacy.
23 "Physician." A medical doctor or doctor of osteopathy.
24 "Puberty-blocking drugs." Any of the following:
25 (1) Gonadotropin-releasing hormone analogs or other
26 synthetic drugs used in a biological male patient to stop
27 luteinizing hormone secretion and, therefore, testosterone
28 secretion.
29 (2) Synthetic drugs used in biological females that stop
30 the production of estrogens and progesterone when used to
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 1 delay or suppress pubertal development in children for the
2 purpose of assisting an individual with a gender transition.
3 Section 4. Prohibition on gender transition procedures for
4 minors.
5 (a) Prohibition on health care practitioners.--
6 (1) A health care practitioner may not perform gender
7 transition procedures on a minor or refer a minor to receive
8 gender transition procedures.
9 (2) A health care practitioner with prescriptive
10 authority may not prescribe cross-sex hormones or puberty-
11 blocking drugs to a minor or refer a minor to be prescribed
12 cross-sex hormones or puberty-blocking drugs.
13 (b) Prohibition on pharmacists.--A pharmacist may not
14 dispense cross-sex hormones or puberty-blocking drugs to a
15 minor.
16 (c) Construction.--Nothing in this section shall be
17 construed to restrict any of the following:
18 (1) Services provided to an individual born with a
19 medically verifiable disorder of sex development, sex
20 chromosome structure, sex steroid hormone production or sex
21 steroid hormone action.
22 (2) The treatment of an infection, injury, disease or
23 disorder that has been caused or exacerbated by the
24 performance of gender transition procedures.
25 (3) Medically necessary procedures, as determined by a
26 physician, undertaken to prevent death or impairment of a
27 major bodily function.
28 (4) Mental health treatment that is not prohibited under
29 subsection (a).
30 (d) Penalties.--A health care practitioner who violates
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 1 subsection (a) shall be subject to discipline by the applicable
2 licensing board with jurisdiction over the health care
3 practitioner. A licensing board with jurisdiction over a health
4 care practitioner who violates subsection (a) shall consider the
5 violation to be a violation of the health care practitioner's
6 scope of practice as specified under State law and grounds for
7 sanctions as specified under State law.
8 Section 5. Prohibition on coverage for gender transition
9 procedures for minors.
10 (a) Prohibition on insurers.--Except as authorized under
11 section 4(c), an insurer may not provide a health insurance
12 policy to provide coverage for gender transition procedures.
13 (b) Prohibition on government programs.--Except as
14 authorized under section 4(c), a government program may not
15 provide coverage for gender transition procedures.
16 Section 6. Severability.
17 The provisions of this act are severable. If any provision of
18 this act or its application to any person or circumstance is
19 held invalid, the invalidity shall not affect other provisions
20 or applications of this act which can be given effect without
21 the invalid provision or application.
22 Section 7. Effective date.
23 This act shall take effect in 60 days.
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