Bill Summary – FastDemocracy

WEST VIRGINIA LEGISLATURE
REGULAR SESSION
          Committee Substitute for House Bill 5297
  By Delegates Foster, Brooks, Butler, Dillon, Martin,
  Kirby, Householder, Jeffries, Ridenour, and Horst [Originating in the Committee on Health and Human Resources; Reported on February 23, 2024]
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  A BILL to amend and reenact §30-3-20 of the Code of West Virginia, 1931, as amended; and to
         amend and reenact §30-14-17 of said code, all relating to prohibiting pubertal modulation
         and hormonal therapy when provided to assist in a gender transition; and removing an
         expired internal effective date.
     Be it enacted by the Legislature of West Virginia:
     ARTICLE 3. WEST VIRGINIA MEDICAL PRACTICE ACT.
     §30-3-20. Prohibited practice.
          (a) For the purposes of this section:
         "Biological sex" means the biological indication of male and female in the context of
  reproductive potential or capacity, such as 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 or gender.
         "Gender" means the psychological, behavioral, social, and cultural aspects of being male
  or female.
         "Gender altering medication" means the prescribing or administering of the following for
  the purpose of assisting an individual with a gender transition:
        (1) Puberty blocking medication to stop or delay normal puberty;
        (2) Supraphysiologic doses of testosterone or other androgens to females; and
        (3) Supraphysiologic doses of estrogen to males.
        "Gender transition" means the process in which a person goes from identifying with and
 living as a gender that corresponds to the person's biological sex to identifying with and living as a
 gender different from the person biological sex and may involve social, legal, or physical changes.
        "Irreversible gender reassignment surgery" means a medical procedure performed for the
 purpose of assisting an individual with a gender transition, including any of the following:
        (1) Penectomy, orchiectomy, vaginoplasty, clitoroplasty, or vulvoplasty for biologically male
 patients or hysterectomy or ovariectomy for biologically female patients(2) Metoidioplasty,
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 phalloplasty, vaginectomy, scrotoplasty, or implantation of erection or testicular prostheses for
 biologically female patients; and
           (3) Augmentation mammoplasty for biological male patient and subcutaneous mastectomy
 for female patients.
           (b) Except as otherwise provided in §30-3-20(c), a physician may not provide irreversible
 gender reassignment surgery or gender altering medication for the purpose of assisting an
 individual with a gender transition to a person who is under eighteen years of age.
           (c) A physician may provide any of the following to a person who is under 18 years of age:
           (1) Services provided to an individual born with a medically verifiable disorder of sex
 development, including, but not limited to, a person with external biological sex characteristics that
 are irresolvably ambiguous, such as an individual born with forty-six xx chromosomes with
 virilization, forty-six xy chromosomes with undervirilization, or having both ovarian and testicular
 tissue;
           (2) Services provided to an individual when a physician has otherwise diagnosed a
 disorder of sexual development and in which the physician has determined through genetic or
 biochemical testing that the individual does not have normal sex chromosome structure, sex
 steroid hormone production, or sex steroid hormone action;
           (3) 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 these
 procedures were performed in accordance with state and federal law; and
           (4) 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 person in
 imminent danger of death, or impairment of a major bodily function unless surgery is performed.
           (5) Pubertal modulating and hormonal therapy for severe gender dysphoria if:
           (A) The minor has been diagnosed as suffering from severe gender dysphoria by no fewer
 than two medical or mental health providers with at least one being a mental health provider or
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 adolescent medicine specialist, and both having relevant training in the diagnosis and treatment of
 severe gender dysphoria in adolescents;
        (B) The diagnosing medical professionals express in written opinions that treatment with
 pubertal modulating and hormonal therapy is medically necessary to treat the minor’s psychiatric
 symptoms and limit self-harm, or the possibility of self-harm, by the minor;
        (C) The minor, the minor’s parents, legal guardians, or person or other persons charged
 with medical decision-making for the minor, and the minor’s primary physician agree in writing with
 the treatment with pubertal modulating and hormonal therapy for the minor;
        (D) Any use of gender altering medication is for purposes of pubertal modulating and
 hormonal therapy limited to the lowest titratable dosage necessary to treat the psychiatric
 condition and not for purposes of gender transition; and
        (E) Notwithstanding the provisions of paragraphs (A) through (D) of this subdivision where
 the minor is prepubescent, hormonal treatment may not be provided.
        (d)   The provisions of   this section are effective on   January   1,   2024.
     ARTICLE 14. OSTEOPATHIC PHYSICIANS AND SURGEONS.
     §30-14-17. Prohibited practice.
         (a) For the purposes of this section:
         "Biological sex" means the biological indication of male and female in the context of
  reproductive potential or capacity, such as 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 or gender.
         "Gender" means the psychological, behavioral, social, and cultural aspects of being male
  or female.
         "Gender altering medication" means the prescribing or administering of the following for
  the purpose of assisting an individual with a gender transition:
        (1) Puberty blocking medication to stop or delay normal puberty;
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        (2) Supraphysiologic doses of testosterone or other androgens to females; and
        (3) Supraphysiologic doses of estrogen to males.
        "Gender transition" means the process in which a person goes from identifying with and
 living as a gender that corresponds to the person's biological sex to identifying with and living as a
 gender different from the person biological sex and may involve social, legal, or physical changes.
        "Irreversible gender reassignment surgery" means a medical procedure performed for the
 purpose of assisting an individual with a gender transition, including any of the following:
        (1) Penectomy, orchiectomy, vaginoplasty, clitoroplasty, or vulvoplasty for biologically male
 patients or hysterectomy or ovariectomy for biologically female patients;
        (2) Metoidioplasty, phalloplasty, vaginectomy, scrotoplasty, or implantation of erection or
 testicular prostheses for biologically female patients; and
        (3) Augmentation mammoplasty for biological male patient and subcutaneous mastectomy
 for female patients.
        (b) Except as otherwise provided in §30-14-17(c), a physician may not provide irreversible
 gender reassignment surgery or gender altering medication for the purpose of assisting an
 individual with a gender transition to a person who is under eighteen years of age.
        (c) A physician may provide any of the following to a person who is under 18 years of age:
        (1) Services provided to an individual born with a medically verifiable disorder of sex
 development, including, but not limited to, a person with external biological sex characteristics that
 are irresolvably ambiguous, such as an individual born with forty-six xx chromosomes with
 virilization, forty-six xy chromosomes with undervirilization, or having both ovarian and testicular
 tissue;(2) Services provided to an individual when a physician has otherwise diagnosed a disorder
 of sexual development and in which the physician has determined through genetic or biochemical
 testing that the individual does not have normal sex chromosome structure, sex steroid hormone
 production, or sex steroid hormone action;
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        (3) 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 these
 procedures were performed in accordance with state and federal law; and
        (4) 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 person in
 imminent danger of death, or impairment of a major bodily function unless surgery is performed.
        (5) Pubertal modulating and hormonal therapy for severe gender dysphoria if:
        (A) The minor has been diagnosed as suffering from severe gender dysphoria by no fewer
 than two medical or mental health providers with at least one being a mental health provider or
 adolescent medicine specialist and both having relevant training in the diagnosis and treatment of
 severe gender dysphoria in adolescents;
        (B) The diagnosing medical professionals express in written opinions that treatment with
 pubertal modulating and hormonal therapy is medically necessary to treat the minor’s psychiatric
 symptoms and limit self-harm, or the possibility of self-harm, by the minor;
        (C) The minor, the minor’s parents, legal guardians, or person or persons charged with
 medical decision-making for the minor and the minor’s primary physician agree in writing with the
 treatment with gender altering medication for the minor;
        (D) Any use of gender altering medication is for purposes of pubertal modulating and
 hormonal therapy and is limited to the lowest titratable dosage necessary to treat the psychiatric
 condition and not for purposes of gender transition; and
        (E) Notwithstanding the provisions of paragraphs (A) through (D) of this subdivision where
 the minor is prepubescent, hormonal treatment may not be provided.
        (d) The provisions of this section are effective on January 1, 2024.
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Statutes affected: 
Introduced Version: 30-3-20, 30-14-17
Committee Substitute: 30-3-20, 30-14-17