2025 - 2026 LEGISLATURE
LRB-4270/1
KRP&JPC:skw
August 29, 2025 - Introduced by Representatives Nedweski, Steffen, Allen, Behnke, Brill, Dittrich, Green, Knodl, Kreibich, Maxey, Murphy, Mursau, O'Connor, Penterman, Piwowarczyk and Wichgers, cosponsored by Senators Hutton, Kapenga, Bradley and Nass. Referred to Committee on Judiciary.
AB400,1,2
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:
AB400,1
1Section 1. 895.039 of the statutes is created to read: AB400,2,32895.039 Performing gender transition procedures on minors; 3liability. (1) Definitions. In this section: AB400,2,64(a) 1. “Gender transition procedure” means a medical or surgical service, 5including a physician’s service, inpatient or outpatient hospital service, or 6prescribed drug, related to gender transition that seeks to do any of the following: AB400,2,87a. Alter or remove an individual’s physical or anatomical characteristics or 8features that are typical for the individual’s biological sex. AB400,2,159b. Instill or create for an individual physiological or anatomical characteristics 10that resemble a sex different from the individual’s biological sex, including a 11medical service that provides puberty-blocking drugs, cross-sex hormones, or 12another mechanism to promote the development of feminizing or masculinizing 13features in a sex different from the individual’s biological sex, or genital or 14nongenital gender reassignment surgery performed for the purpose of assisting an 15individual with a gender transition. AB400,3,2
12. Notwithstanding subd. 1., “gender transition procedure” does not include 2any of the following: AB400,3,73a. A service provided to an individual born with a medically verifiable 4disorder of sexual development, including an individual with external biological sex 5characteristics that are irresolvably ambiguous, such as an individual born with 646,XX chromosomes with virilization, with 46,XY chromosomes with 7undervirilization, or having both ovarian and testicular tissue. AB400,3,128b. A service provided to an individual when a physician has diagnosed a 9sexual development disorder and the physician has determined through genetic or 10biochemical testing that the individual does not have the normal sex chromosome 11structure, sex steroid hormone production, or sex steroid hormone action for a 12biological male or biological female. AB400,3,1613c. The treatment of an infection, injury, disease, or disorder that is caused or 14exacerbated by the performance of a gender transition procedure, regardless of 15whether the gender transition procedure was performed in accordance with state or 16federal law. AB400,3,2017d. A procedure undertaken because an individual suffers from a physical 18disorder, physical injury, or physical illness that would, as certified by a physician, 19place the individual in imminent danger of death or impairment of major bodily 20function unless surgery is performed. AB400,3,2121(b) “Health care provider” has the meaning given in s. 146.81 (1) (a) to (hp). AB400,3,2222(c) “Mental health professional” means any of the following: AB400,4,2
11. A physician licensed under subch. II of ch. 448 who specializes in 2psychiatry. AB400,4,332. A psychologist licensed under ch. 455. AB400,4,443. A professional counselor licensed under ch. 457. AB400,4,554. A marriage and family therapist licensed under ch. 457. AB400,4,665. A social worker certified or licensed under ch. 457. AB400,4,77(d) “Minor” means an individual who is under 18 years of age. AB400,4,148(2) Civil causes of action. A health care provider who performs a gender 9transition procedure on a minor is liable to the minor if the minor is injured, 10including any physical, psychological, emotional, or physiological injury, by the 11gender transition procedure or related treatment or the aftereffects of the gender 12transition procedure or related treatment. The minor, or the minor’s parent, legal 13guardian, or legal representative, may bring a civil action against the health care 14provider for any of the following damages: AB400,4,1515(a) Declaratory or injunctive relief. AB400,4,1616(b) Compensatory damages. AB400,4,1717(c) Punitive damages. AB400,4,1818(d) If the prevailing party, reasonable attorney fees and costs. AB400,4,2219(3) Limitation of actions. An action under this section shall be commenced 20before the minor has attained the age of 33 years or, if the minor dies before 21attaining the age of 33 years, the date on which the minor would have attained the 22age of 33 years. AB400,5,223(4) Safe harbor. (a) It is a defense to an action brought under this section if,
1before a health care provider performs a gender transition procedure on a minor, all 2of the following occur: AB400,5,631. The health care provider documents the minor’s perceived gender or 4perceived sex for at least 2 continuous years, and the minor’s perceived gender or 5perceived sex is invariably inconsistent with the minor’s biological sex throughout 6the 2-year period. AB400,5,1072. To the extent that the minor suffers from a mental health concern, at least 82 health care providers, including at least one mental health professional, certifies 9in writing that the gender transition procedure is the only way to treat the mental 10health concern. AB400,5,15113. At least 2 health care providers, including at least one mental health 12professional, certifies in writing that the minor suffers from no mental health 13concerns other than the concern described under subd. 2., including depression, an 14eating disorder, autism, attention deficit hyperactivity disorder, intellectual 15disability, or a psychotic disorder. AB400,5,17164. The health care provider receives the voluntary and informed consent of 17the minor and the minor’s parent or legal guardian as provided in par. (b). AB400,5,2318(b) Consent to a gender transition procedure is voluntary and informed under 19par. (a) 4. only if, at least 30 days before the first treatment of the gender transition 20procedure and during every subsequent medical visit for treatment during the 21following 6 months, the minor and the minor’s parent or legal guardian is provided 22with the following notice, both orally and in writing in at least 14-point type in a 23proportional font: AB400,6,82If your child begins one of these treatments, it may actually worsen the 3discordance and thus increase the likelihood that your child will need additional 4and more serious interventions to address the worsening condition. For example, if 5your child begins socially transitioning or taking puberty blockers, that treatment 6may significantly increase the likelihood that your child’s discordance will worsen 7and lead to your child eventually seeking cross-sex hormones or even surgery to 8remove some of your child’s body parts. AB400,6,129Sweden, Finland, and the United Kingdom have conducted systematic reviews 10of evidence and concluded that there is no evidence that the potential benefits of 11puberty blockers and cross-sex hormones for this purpose outweigh the known or 12assumed risks. AB400,6,1713Medical authorities in Sweden, Finland, and the United Kingdom have since 14recommended psychotherapy as the first line of treatment for youth gender 15dysphoria, with drugs and surgeries reserved as a measure of last resort. Medical 16authorities in France have advised “great caution” when prescribing hormones for 17gender dysphoria. AB400,6,2318There are people who underwent gender transition treatments as minors and 19later regretted that decision and the physical harm that these treatments caused, 20and the total percentage of people who experience this regret is unknown. Some 21estimate that the rate is below 2 percent, but that estimate is based on studies done 22on adults who transitioned as adults or on minors who transitioned under highly 23restrictive and controlled conditions. AB400,7,7
1Sometimes gender transition treatments have been proposed as a way to 2reduce the chances of a minor committing suicide due to discordance between the 3minor’s sex and his or her perception, but the rates of actual suicide from this 4discordance remain extremely low. Furthermore, as recognized by health 5authorities in Europe, there is no evidence that suicidality is caused by 6“unaffirmed” gender or that gender transition treatments are causally linked to a 7reduction in serious suicidal attempts or ideations. AB400,7,88For puberty blockers: AB400,8,29Puberty blockers are not approved for this purpose by the U.S. food and drug 10administration, which is the federal agency that determines which drugs are safe 11and effective for humans to use. Claims about puberty blockers’ safety and efficacy 12are based on their use for precocious puberty, a different condition in which normal 13puberty is allowed to resume once the patient reaches the appropriate age. Studies 14on the benefits of using puberty blockers for gender dysphoria are notoriously weak. 15Puberty blockers are not fully reversible because, among other risks, puberty 16blockers may intensify a minor’s discordance and cause it to persist. Puberty 17blockers increase the risk of your child being sterilized, meaning that he or she will 18never be able to have children. Puberty blockers may also cause diminished bone 19density for your child, increasing the risk of fracture and early osteoporosis. 20Puberty blockers may also prevent your child from ever being able to engage in 21sexual activity or achieve orgasm for the rest of your child’s life. There is no 22research on the long-term risks to minors of persistent exposure to puberty
1blockers. The full effects of puberty blockers on brain development and cognition 2are unknown. AB400,8,33For cross-sex hormones: AB400,8,174The use of cross-sex hormones in males is associated with numerous health 5risks, such as thromboembolic disease, including blood clots; cholelithiasis, 6including gallstones; coronary artery disease, including heart attacks; 7macroprolactinoma, which is a tumor of the pituitary gland; cerebrovascular 8disease, including stroke; hypertriglyceridemia, which is an elevated level of 9triglycerides in the blood; breast cancer; and irreversible infertility. The use of 10cross-sex hormones in females is associated with risks of erythrocytosis, which is an 11increase in red blood cells; severe liver dysfunction; coronary artery disease, 12including heart attack; hypertension; and increased risk of breast and uterine 13cancer. Once a minor begins cross-sex hormones, the minor may need to continue 14taking those hormones for many years and possibly for the remainder of the minor’s 15life. The cost of these hormones may be tens of thousands of dollars. If the use of 16cross-sex hormones leads to surgery, the total cost of transitioning may exceed 17$100,000. AB400,8,1818For surgical procedures: