Bill Text: HI HB2113 | 2020 | Regular Session | Introduced

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Bill Title: Relating To Health.

Spectrum: Partisan Bill (Democrat 3-0)

Status: (Introduced - Dead) 2020-01-27 - Referred to HLT, JUD, FIN, referral sheet 5 [HB2113 Detail]

Download: Hawaii-2020-HB2113-Introduced.html

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HOUSE OF REPRESENTATIVES	H.B. NO.	2113
THIRTIETH LEGISLATURE, 2020
STATE OF HAWAII

A BILL FOR AN ACT

 

 

relating to health.

 

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:

 

     SECTION 1.  The legislature finds that 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 and should be celebrated, not treated as aberrations in need of "correction".  "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.  In other cases, these variations do not become apparent until puberty.  Further, some chromosomal variations may not be physically apparent at all.

     The legislature further finds that 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.

     Accordingly, the purpose of this Act is 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.

     SECTION 2.  Chapter 453, Hawaii Revised Statutes, is amended by adding a new section to part I to be appropriately designated and to read as follows:

     "§453-     Intersex minors; medically unnecessary surgery; penalty.  (a)  No treatment or intervention on the sex characteristics of a person born with variations in the person's physical sex characteristics shall be performed on a person who is under the age of eighteen unless the treatment or intervention is medically necessary.

     (b)  Any person who knowingly violates subsection (a) shall be fined not more than $2,000 or imprisoned not more than one year, or both.

     (c)  On or before July 1, 2021, the board shall adopt rules, pursuant to chapter 91, to determine the treatments and interventions on the sex characteristics of a person born with variations in the person's physical sex characteristics who is under the age of eighteen that are considered medically necessary, in consultation with the following:

     (1)  The department of health;

     (2)  At least two urologists with professional experience treating people born with variations in their physical sex characteristics;

     (3)  At least one pediatrician or family physician and surgeon with professional experience treating people born with variations in their physical sex characteristics;

     (4)  At least one mental health professional with professional experience treating people born with variations in their physical sex characteristics;

     (5)  At least one medical ethicist with published work on variations in physical sex characteristics;

     (6)  At least one legal expert with published work on variations in physical sex characteristics;

     (7)  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; and

     (8)  At least one representative from a lesbian, gay, bisexual, transgender, queer, and intersex medical association.

     (d)  The rules adopted pursuant to subsection (c) shall be subject to the following:

     (1)  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 the person's physical sex characteristics who is under the age of eighteen;

     (2)  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; and

     (3)  The following treatments or interventions are medically necessary:

          (A)  A procedure to repair the bladder or cloacal exstrophy;

          (B)  A gonadectomy to address a risk of cancer that is significantly elevated above the risk to the general population; and

          (C)  A procedure intended to allow urine to exit the body absent a urethral opening.

     (e)  As used in this section:

     (1)  "Person born with variations in the person's 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 in sex development resulting from androgen insensitivity syndrome, congenital adrenal hyperplasia, and proximal hypospadias.

     (2)  "Psychosocial" means an individual's psychological status in relation to their social and physical environment.

     (3)  "Treatment or intervention on the sex characteristics of a person born with variations in the person's physical sex characteristics" includes the following procedures:

          (A)  Clitorectomy, clitoroplasty, clitoral reduction, and clitoral recession, including corporal-sparing procedures;

          (B)  Gonadectomy, including of testes, ovaries, ovotestes, and streak gonads;

          (C)  Proximal hypospadias surgery, relocation of the urethral meatus, and chordee release;

          (D)  Labiaplasty and labial reduction;

          (E)  Phalloplasty;

          (F)  Vaginoplasty, introitoplasty, vaginal exteriorization, and partial or total urogenital sinus mobilization; and

          (G)  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."

     SECTION 3.  This Act does not affect rights and duties that matured, penalties that were incurred, and proceedings that were begun before its effective date.

     SECTION 4.  New statutory material is underscored.

     SECTION 5.  This Act shall take effect upon its approval.

 

INTRODUCED BY:	_____________________________

 

 

Report Title:

Hawaii Medical Board; Intersex Minors; Unnecessary Surgery; Administrative Rules

 

Description:

Prohibits medically unnecessary treatment or intervention on the sex characteristics of persons born with variations in their physical sex characteristics who are under the age of 18.  Requires the Hawaii Medical Board to adopt rules to determine which treatments and interventions are medically necessary.

 

 

 

The summary description of legislation appearing on this page is for informational purposes only and is not legislation or evidence of legislative intent.