LRB-4459/1
SWB&JPC:cdc
2023 - 2024 LEGISLATURE
September 29, 2023 - Introduced by Senators Stroebel, Tomczyk, Knodl, Nass,
Felzkowski, Kapenga, Wimberger and Ballweg, cosponsored by
Representatives Allen, Vos, Armstrong, Behnke, Binsfeld, Bodden,
Brandtjen, Dittrich, Goeben, Green, Gundrum, Gustafson, Hurd, Macco,
Magnafici, Maxey, Michalski, Murphy, Nedweski, O'Connor, Plumer,
Pronschinske, Rettinger, Rozar, Sapik, Schraa, Sortwell, Tittl, Tusler
and Wichgers. Referred to Committee on Health.
SB480,1,4
1An Act to amend 441.07 (2), 448.02 (6), 448.02 (9) (intro.) and 448.978 (2)
2(intro.); and
to create 146.36, 441.07 (1j), 448.02 (3m) and 448.978 (1m) of the
3statutes;
relating to: prohibiting gender transition medical intervention for
4individuals under 18 years of age.
Analysis by the Legislative Reference Bureau
This bill prohibits health care providers from engaging in, causing the
engagement in, or making referrals for, certain medical intervention practices upon
an individual under 18 years of age if done for the purpose of changing the minor's
body to correspond to a sex that is discordant with the minor's biological sex. The
prohibitions under the bill do not apply to any of the following: 1) a health care
provider providing a service in accordance with a good faith medical decision of a
parent or guardian of a minor born with a medically verifiable genetic disorder of sex
development; 2) the treatment of any infection, injury, disease, or disorder that has
been caused by or exacerbated by the performance of a gender transition medical
procedure, whether or not that procedure was performed in accordance with state
and federal law; or 3) any procedure undertaken because the minor suffers from a
physical disorder, physical injury, or physical illness that would, as certified by a
physician, place the minor in imminent danger of death or impairment of a major
bodily function unless surgery is performed.
Under the bill, the Board of Nursing, the Medical Examining Board, and the
Physician Assistant Affiliated Credentialing Board are required to investigate any
allegation that any person licensed or certified by the respective boards has violated
any of the prohibitions on engaging in, causing the engagement in, or making certain
referrals for the medical intervention practices described in the bill. Upon a finding
by the Board of Nursing, the Medical Examining Board, or the Physician Assistant
Affiliated Credentialing Board that the holder of a license or certificate has violated
any of these prohibitions, the bill requires the Board of Nursing, the Medical
Examining Board, or the Physician Affiliated Credentialing Board to revoke that
person's license or certificate.
The people of the state of Wisconsin, represented in senate and assembly, do
enact as follows:
SB480,1
1Section
1. 146.36 of the statutes is created to read:
SB480,2,3
2146.36 Gender transition medical intervention. (1) Definitions. In this
3section:
SB480,2,54
(a) “Biological sex” means the biological state of being female or male based on
5sex organs, chromosomes, and endogenous hormone profiles.
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(b) “Health care provider” has the meaning given in s. 146.81 (1) (a) to (hp).
SB480,2,77
(c) “Minor" means an individual who is under 18 years of age.
SB480,2,11
8(2) Prohibition. A health care provider may not engage in, cause the
9engagement in, or make a referral for, any of the following practices upon a minor
10for the purpose of changing the minor's body to correspond to a sex that is discordant
11with the minor's biological sex:
SB480,2,1412
(a) Performing a surgery that sterilizes an individual, including castration,
13vasectomy, hysterectomy, oophorectomy, metoidioplasty, orchiectomy, penectomy,
14phalloplasty, and vaginoplasty.
SB480,2,1515
(b) Performing a mastectomy.
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(c) Administering, prescribing, or supplying any of the following medications:
SB480,2,1717
1. Puberty-blocking drugs to stop or delay normal puberty.
SB480,3,2
12. Supraphysiologic doses of testosterone or other androgens to biological
2females.
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3. Supraphysiologic doses of estrogen to biological males.
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(d) Removing any otherwise healthy or nondiseased body part or tissue.
SB480,3,5
5(3) Applicability limitation. This section does not apply to any of the following:
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(a) A health care provider providing a service in accordance with a good faith
7medical decision of a parent or guardian of a minor born with a medically verifiable
8genetic disorder of sex development, including any of the following:
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1. External biological sex characteristics that are irresolvably ambiguous, such
10as those born with 46,XX karyotype with virilization, 46,XY karyotype with
11undervirilization, or having both ovarian and testicular tissue.
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2. A sexual development disorder when a physician has determined through
13genetic testing that the minor does not have the normal sex chromosome structure,
14sex steroid hormone production, or sex steroid hormone action for a biological male
15or biological female.
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(b) The treatment of any infection, injury, disease, or disorder that has been
17caused by or exacerbated by the performance of a gender transition medical
18procedure, whether or not that procedure was performed in accordance with state
19and federal law.
SB480,3,2320
(c) Any procedure undertaken because the minor suffers from a physical
21disorder, physical injury, or physical illness that would, as certified by a physician,
22place the minor in imminent danger of death or impairment of a major bodily
23function unless surgery is performed.
SB480,2
24Section
2. 441.07 (1j) of the statutes is created to read:
SB480,4,7
1441.07
(1j) Subject to the rules promulgated under s. 440.03 (1), the board shall
2investigate allegations that any person licensed under this chapter has violated s.
3146.36 (2). After an investigation, if the board finds that there is probable cause to
4believe that the person violated s. 146.36 (2), the board shall hold a hearing on such
5conduct. After a hearing, if the board determines that the person has violated s.
6146.36 (2), the board shall revoke the person's license and, if applicable, the person's
7certificate to issue prescription orders under s. 441.16.
SB480,3
8Section
3. 441.07 (2) of the statutes is amended to read:
SB480,4,119
441.07
(2) The board may reinstate a revoked license, no earlier than one year
10following revocation, upon receipt of an application for reinstatement. This
11subsection does not apply to a license that is revoked under
sub. (1j) or s. 440.12.
SB480,4
12Section
4. 448.02 (3m) of the statutes is created to read:
SB480,4,2113
448.02
(3m) Investigations; hearing; action for gender transition medical
14intervention. The board shall investigate allegations that any person holding a
15license or certificate granted by the board has violated s. 146.36 (2). After an
16investigation, if the board finds that there is probable cause to believe that the person
17violated s. 146.36 (2), the board shall hold a hearing on such conduct. After a hearing,
18if the board determines that the person has violated s. 146.36 (2), the board shall
19revoke the person's license or certificate. The board shall comply with the rules of
20procedure for the investigation, hearing and action that are promulgated under ss.
21440.03 (1) and 448.40.
SB480,5
22Section
5. 448.02 (6) of the statutes is amended to read:
SB480,5,223
448.02
(6) Restoration of license or certificate. The board may restore any
24license or certificate that has been voluntarily surrendered or revoked under any of
25the provisions of this subchapter, on such terms and conditions as it may deem
1appropriate
, except for any license or certificate revoked pursuant to sub. (3m),
2which may not be restored by the board.
SB480,6
3Section
6. 448.02 (9) (intro.) of the statutes is amended to read:
SB480,5,94
448.02
(9) Judicial review. (intro.) No injunction, temporary injunction, stay,
5restraining order or other order may be issued by a court in any proceeding for review
6that suspends or stays an order of the board to discipline a physician under sub. (3)
7(c)
, to revoke a physician's license under sub. (3m), or to suspend or limit a physician's
8license under sub. (4), except upon application to the court and a determination by
9the court that all of the following conditions are met:
SB480,7
10Section
7. 448.978 (1m) of the statutes is created to read:
SB480,5,1611
448.978
(1m) Subject to the rules promulgated under s. 440.03 (1), the board
12shall investigate allegations that any person licensed under this subchapter has
13violated s. 146.36 (2). After an investigation, if the board finds that there is probable
14cause to believe that the person violated s. 146.36 (2), the board shall hold a hearing
15on such conduct. After a hearing, if the board determines that the person has
16violated s. 146.36 (2), the board shall revoke the person's license.
SB480,8
17Section
8. 448.978 (2) (intro.) of the statutes is amended to read:
SB480,5,2118
448.978
(2) (intro.) Subject to the rules promulgated under s. 440.03 (1)
and
19except as provided in sub. (1m), if a person who applies for or holds a license issued
20under s. 448.974 does any of the following, the board may reprimand the person or
21deny, limit, suspend, or revoke the person's license:
SB480,9
22Section
9.
Nonstatutory provisions.
SB480,6,523
(1)
Legislative intent statement. By inclusion of a 6-month delayed effective
24date in
Section 10 (1) of this act, the legislature intends to allow time for appropriate
25medication tapering and discontinuation under the care of a physician or other
1healthcare provider for any minor who is using puberty-blocking drugs or cross-sex
2hormones for the purpose of changing the minor's body to correspond to a sex that
3is discordant with the minor's biological sex and who will be a minor when the act
4takes effect. For purposes of this subsection, the terms “biological sex,” “healthcare
5provider,” and “minor” have the meanings given in s. 146.36 (1).
SB480,6,87
(1)
This act takes effect on the first day of the 7th month beginning after
8publication.
