Today's Law As Amended


PDF |Add To My Favorites |Track Bill | print page

SB-201 Medical procedures: treatment or intervention: sex characteristics of a minor.(2019-2020)



As Amends the Law Today


SECTION 1.

 Section 2295 is added to the Business and Professions Code, to read:

2295.
 (a) Consistent with Senate Concurrent Resolution 110 of the 2017–18 Regular Session (Resolution Chapter 225 of the Statutes of 2018), the Legislature hereby finds and declares all of the following:
(1) The Legislature opposes all forms of prejudice, bias, or discrimination and affirms its commitment to the dignity and autonomy of all people, including those born with variations in their physical sex characteristics.
(2) People born with variations in their physical sex characteristics, many of whom identify with the term “intersex,” are a part of the fabric of our state’s diversity, rather than an aberration to be corrected.
(3) People born with variations in their physical sex characteristics should be free to choose whether to undergo life-altering surgeries and other treatments or interventions on their physical sexual characteristics that irreversibly, and sometimes irreparably, cause harm.
(4) The enactment of legislation is necessary to ensure the right of people born with variations in their physical sex characteristics to participate in decisions about surgery and other medical treatments or interventions on their physical sex characteristics.
(5) “Variations in physical sex characteristics” is an umbrella term used to describe a wide range of natural bodily variations. In some cases, variations in physical sex characteristics are visible at birth, while in others, they are not apparent until puberty. Some chromosomal variations may not be physically apparent at all.
(b) The following definitions apply for purposes of this section:
(1) “Person born with variations in their physical sex characteristics” means an individual born with sex characteristics, including genitals, gonads, and chromosome patterns, that do not fit typical binary notions of male or female bodies, including differences of sex development resulting from androgen insensitivity syndrome, congenital adrenal hyperplasia, and proximal hypospadias.
(2) “Parent or guardian” has the same meaning as used in Section 6903 of the Family Code.
(3) “Psychosocial” means an individual’s psychological status in relation to their social and physical environment.
(c) For purposes of this section, a treatment or intervention on the physical sex characteristics of a person includes, but is not limited to, the following procedures:
(1) Clitorectomy, clitoroplasty, clitoral reduction, and clitoral recession, including corporal-sparing procedures.
(2) Gonadectomy, including of testes, ovaries, ovotestes, and streak gonads.
(3) Proximal hypospadias surgery, relocation of the urethral meatus, and chordee release.
(4) Labiaplasty and labial reduction.
(5) Phalloplasty.
(6) Vaginoplasty, introitoplasty, vaginal exteriorization, and partial or total urogenital sinus mobilization.
(7) Any other treatment or intervention on the physical sex characteristics of a person born with variations in their physical sex characteristics intended to assign sex or conform physical sex characteristics to typical binary notions of male or female bodies.
(d) A treatment or intervention on the sex characteristics of a person born with variations in their physical sex characteristics who is under six years of age shall not be performed unless the treatment or intervention is medically necessary.
(e) (1) On or before December 1, 2021, the board shall adopt regulations to determine which treatments and interventions on the sex characteristics of a person born with variations in their physical sex characteristics who is under six years of age are medically necessary, in consultation with the following:
(A) The State Department of Public Health.
(B) The Office of the Surgeon General.
(C) At least two urologists with professional experience treating people born with variations in their physical sex characteristics.
(D) At least one pediatrician or family physician and surgeon with professional experience treating people born with variations in their physical sex characteristics.
(E) At least one mental health professional with professional experience treating people born with variations in their physical sex characteristics.
(F) At least one medical ethicist with published work on variations in physical sex characteristics.
(G) At least one legal expert with published work on variations in physical sex characteristics.
(H) At least one self-identified intersex-led community or advocacy group with a focus on public policy regarding people born with variations in their physical sex characteristics.
(I) At least one representative from a lesbian, gay, bisexual, transgender, queer, and intersex (LGBTQI) medical association.
(2) The regulations adopted pursuant to paragraph (1) shall be subject to the following:
(A) Psychological, psychosocial, and social factors do not constitute a medical necessity for a treatment or intervention on the sex characteristics of a person born with variations in their physical sex characteristics who is under six years of age.
(B) A procedure that carries a meaningful risk of harm and that can be deferred safely until the individual can participate in the decision is not a treatment or intervention that is medically necessary.
(C) The following treatments or interventions are medically necessary:
(i) A procedure to repair the bladder or cloacal exstrophy.
(ii) A gonadectomy to address a risk of cancer that is significantly elevated above the risk to the general population.
(iii) A procedure intended to allow urine to exit the body absent a urethral opening.
(f) A violation of this section constitutes unprofessional conduct. Section 2314 shall not apply to a violation of this section.