LRB-2358/1
KRP&JPC:skw
2023 - 2024 LEGISLATURE
September 29, 2023 - Introduced by Senators Hutton, Tomczyk, Nass, Kapenga
and Bradley, cosponsored by Representatives Rozar, Goeben, Maxey,
Gustafson, O'Connor, Gundrum, Dittrich, Schraa, Behnke, Brandtjen,
Duchow, Nedweski, Rettinger, Green and Wichgers. Referred to Committee
on Health.
SB479,1,2 1An Act to create 895.039 of the statutes; relating to: a civil cause of action for
2a minor injured by a gender transition procedure.
Analysis by the Legislative Reference Bureau
This bill establishes a civil cause of action against a health care provider who
performs a gender transition procedure, as defined in the bill, on an individual who
is under 18 years of age and who is injured, including any physical, psychological,
emotional, or physiological injury, by the gender transition procedure or related
treatment or the aftereffects of the gender transition procedure or related treatment.
Under the bill, such an action must be commenced before the individual attains the
age of 33 years.
The bill provides that it is a defense to an action under the bill if all of the
following occur before a health care provider performs a gender transition procedure
on an individual who is under 18 years of age:
1. The health care provider documents the individual's perceived gender or
perceived sex for at least two continuous years, and the individual's perceived gender
or perceived sex is invariably inconsistent with the individual's biological sex
throughout the two-year period.
2. To the extent that the individual suffers from a mental health concern, at
least one mental health professional and one other health care provider certifies in
writing that the gender transition procedure is the only way to treat the mental
health concern.
3. At least one mental health professional and one other health care provider
certifies in writing that the individual suffers from no other mental health concerns.

4. The health care provider receives the voluntary and informed consent of the
individual and the individual's parent or legal guardian by providing them, both
orally and in writing, with a notice, the contents are which are prescribed in the bill,
at least 30 days before the first treatment of the gender transition procedure and
during every subsequent medical visit for treatment during the following six months.
The people of the state of Wisconsin, represented in senate and assembly, do
enact as follows:
SB479,1 1Section 1. 895.039 of the statutes is created to read:
SB479,2,3 2895.039 Performing gender transition procedures on minors; liability.
3(1) Definitions. In this section:
SB479,2,64 (a) 1. “Gender transition procedure” means a medical or surgical service,
5including a physician's service, inpatient or outpatient hospital service, or prescribed
6drug, related to gender transition that seeks to do any of the following:
SB479,2,87 a. Alter or remove an individual's physical or anatomical characteristics or
8features that are typical for the individual's biological sex.
SB479,2,159 b. Instill or create for an individual physiological or anatomical characteristics
10that resemble a sex different from the individual's biological sex, including a medical
11service that provides puberty-blocking drugs, cross-sex hormones, or another
12mechanism to promote the development of feminizing or masculinizing features in
13a sex different from the individual's biological sex, or genital or nongenital gender
14reassignment surgery performed for the purpose of assisting an individual with a
15gender transition.
SB479,2,1716 2. Notwithstanding subd. 1., “gender transition procedure” does not include
17any of the following:
SB479,3,318 a. A service provided to an individual born with a medically verifiable disorder
19of sexual development, including an individual with external biological sex

1characteristics that are irresolvably ambiguous, such as an individual born with
246,XX chromosomes with virilization, with 46,XY chromosomes with
3undervirilization, or having both ovarian and testicular tissue.
SB479,3,84 b. A service provided to an individual when a physician has diagnosed a sexual
5development disorder and the physician has determined through genetic or
6biochemical testing that the individual does not have the normal sex chromosome
7structure, sex steroid hormone production, or sex steroid hormone action for a
8biological male or biological female.
SB479,3,129 c. The treatment of an infection, injury, disease, or disorder that is caused or
10exacerbated by the performance of a gender transition procedure, regardless of
11whether the gender transition procedure was performed in accordance with state or
12federal law.
SB479,3,1613 d. A procedure undertaken because an individual suffers from a physical
14disorder, physical injury, or physical illness that would, as certified by a physician,
15place the individual in imminent danger of death or impairment of major bodily
16function unless surgery is performed.
SB479,3,1717 (b) “Health care provider” has the meaning given in s. 146.81 (1) (a) to (hp).
SB479,3,1818 (c) “Mental health professional” means any of the following:
SB479,3,1919 1. A physician licensed under subch. II of ch. 448 who specializes in psychiatry.
SB479,3,2020 2. A psychologist licensed under ch. 455.
SB479,3,2121 3. A professional counselor licensed under ch. 457.
SB479,3,2222 4. A marriage and family therapist licensed under ch. 457.
SB479,3,2323 5. A social worker certified or licensed under ch. 457.
SB479,3,2424 (d) “Minor” means an individual who is under 18 years of age.
SB479,4,7
1(2) Civil causes of action. A health care provider who performs a gender
2transition procedure on a minor is liable to the minor if the minor is injured,
3including any physical, psychological, emotional, or physiological injury, by the
4gender transition procedure or related treatment or the aftereffects of the gender
5transition procedure or related treatment. The minor, or the minor's parent, legal
6guardian, or legal representative, may bring a civil action against the health care
7provider for any of the following damages:
SB479,4,88 (a) Declaratory or injunctive relief.
SB479,4,99 (b) Compensatory damages.
SB479,4,1010 (c) Punitive damages.
SB479,4,1111 (d) If the prevailing party, reasonable attorney fees and costs.
SB479,4,15 12(3) Limitation of actions. An action under this section shall be commenced
13before the minor has attained the age of 33 years or, if the minor dies before attaining
14the age of 33 years, the date on which the minor would have attained the age of 33
15years.
SB479,4,18 16(4) Safe harbor. (a) It is a defense to an action brought under this section if,
17before a health care provider performs a gender transition procedure on a minor, all
18of the following occur:
SB479,4,2219 1. The health care provider documents the minor's perceived gender or
20perceived sex for at least 2 continuous years, and the minor's perceived gender or
21perceived sex is invariably inconsistent with the minor's biological sex throughout
22the 2-year period.
SB479,5,223 2. To the extent that the minor suffers from a mental health concern, at least
242 health care providers, including at least one mental health professional, certifies

1in writing that the gender transition procedure is the only way to treat the mental
2health concern.
SB479,5,73 3. At least 2 health care providers, including at least one mental health
4professional, certifies in writing that the minor suffers from no mental health
5concerns other than the concern described under subd. 2., including depression, an
6eating disorder, autism, attention deficit hyperactivity disorder, intellectual
7disability, or a psychotic disorder.
SB479,5,98 4. The health care provider receives the voluntary and informed consent of the
9minor and the minor's parent or legal guardian as provided in par. (b).
SB479,5,1510 (b) Consent to a gender transition procedure is voluntary and informed under
11par. (a) 4. only if, at least 30 days before the first treatment of the gender transition
12procedure and during every subsequent medical visit for treatment during the
13following 6 months, the minor and the minor's parent or legal guardian is provided
14with the following notice, both orally and in writing in at least 14-point type in a
15proportional font:
SB479,5,1616 NOTICE
SB479,5,2317 If your child begins one of these treatments, it may actually worsen the
18discordance and thus increase the likelihood that your child will need additional and
19more serious interventions to address the worsening condition. For example, if your
20child begins socially transitioning or taking puberty blockers, that treatment may
21significantly increase the likelihood that your child's discordance will worsen and
22lead to your child eventually seeking cross-sex hormones or even surgery to remove
23some of your child's body parts.
SB479,6,224 Sweden, Finland, and the United Kingdom have conducted systematic reviews
25of evidence and concluded that there is no evidence that the potential benefits of

1puberty blockers and cross-sex hormones for this purpose outweigh the known or
2assumed risks.
SB479,6,73 Medical authorities in Sweden, Finland, and the United Kingdom have since
4recommended psychotherapy as the first line of treatment for youth gender
5dysphoria, with drugs and surgeries reserved as a measure of last resort. Medical
6authorities in France have advised “great caution” when prescribing hormones for
7gender dysphoria.
SB479,6,138 There are people who underwent gender transition treatments as minors and
9later regretted that decision and the physical harm that these treatments caused,
10and the total percentage of people who experience this regret is unknown. Some
11estimate that the rate is below 2 percent, but that estimate is based on studies done
12on adults who transitioned as adults or on minors who transitioned under highly
13restrictive and controlled conditions.
SB479,6,2014 Sometimes gender transition treatments have been proposed as a way to reduce
15the chances of a minor committing suicide due to discordance between the minor's
16sex and his or her perception, but the rates of actual suicide from this discordance
17remain extremely low. Furthermore, as recognized by health authorities in Europe,
18there is no evidence that suicidality is caused by “unaffirmed” gender or that gender
19transition treatments are causally linked to a reduction in serious suicidal attempts
20or ideations.
SB479,6,2121 For puberty blockers:
SB479,7,1122 Puberty blockers are not approved for this purpose by the U.S. food and drug
23administration, which is the federal agency that determines which drugs are safe
24and effective for humans to use. Claims about puberty blockers' safety and efficacy
25are based on their use for precocious puberty, a different condition in which normal

1puberty is allowed to resume once the patient reaches the appropriate age. Studies
2on the benefits of using puberty blockers for gender dysphoria are notoriously weak.
3Puberty blockers are not fully reversible because, among other risks, puberty
4blockers may intensify a minor's discordance and cause it to persist. Puberty
5blockers increase the risk of your child being sterilized, meaning that he or she will
6never be able to have children. Puberty blockers may also cause diminished bone
7density for your child, increasing the risk of fracture and early osteoporosis. Puberty
8blockers may also prevent your child from ever being able to engage in sexual activity
9or achieve orgasm for the rest of your child's life. There is no research on the
10long-term risks to minors of persistent exposure to puberty blockers. The full effects
11of puberty blockers on brain development and cognition are unknown.
SB479,7,1212 For cross-sex hormones:
SB479,7,2513 The use of cross-sex hormones in males is associated with numerous health
14risks, such as thromboembolic disease, including blood clots; cholelithiasis,
15including gallstones; coronary artery disease, including heart attacks;
16macroprolactinoma, which is a tumor of the pituitary gland; cerebrovascular disease,
17including stroke; hypertriglyceridemia, which is an elevated level of triglycerides in
18the blood; breast cancer; and irreversible infertility. The use of cross-sex hormones
19in females is associated with risks of erythrocytosis, which is an increase in red blood
20cells; severe liver dysfunction; coronary artery disease, including heart attack;
21hypertension; and increased risk of breast and uterine cancer. Once a minor begins
22cross-sex hormones, the minor may need to continue taking those hormones for
23many years and possibly for the remainder of the minor's life. The cost of these
24hormones may be tens of thousands of dollars. If the use of cross-sex hormones leads
25to surgery, the total cost of transitioning may exceed $100,000.
SB479,8,1
1For surgical procedures:
SB479,8,42 The dangers, risks, complications, and long-term concerns associated with
3these types of procedures are almost entirely unknown. There are no long-term
4studies on either the effectiveness or safety of these surgical procedures.
SB479,2 5Section 2. Initial applicability.
SB479,8,76 (1) This act first applies to a gender transition procedure performed on the
7effective date of this subsection.
SB479,8,88 (End)
Loading...
Loading...