87R5743 JG-D
 
  By: Krause, Oliverson, Hefner, Parker, H.B. No. 1399
      et al.
 
 
 
A BILL TO BE ENTITLED
 
AN ACT
  relating to professional liability insurance coverage for and
  prohibitions on the provision to certain children of procedures and
  treatments for gender transitioning, gender reassignment, or
  gender dysphoria.
         BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
         SECTION 1.  Chapter 161, Health and Safety Code, is amended
  by adding Subchapter X to read as follows:
  SUBCHAPTER X. GENDER TRANSITIONING AND GENDER REASSIGNMENT
  PROCEDURES AND TREATMENTS FOR CERTAIN CHILDREN
         Sec. 161.701.  DEFINITIONS. In this subchapter:
               (1)  "Child" means an individual who is younger than 18
  years of age.
               (2)  "Health care provider" means a person other than a
  physician who is licensed, certified, or otherwise authorized by
  the laws of this state to provide or render health care or to
  dispense or prescribe a prescription drug in the ordinary course of
  business or practice of a profession.
               (3)  "Physician" means a person licensed to practice
  medicine in this state.
         Sec. 161.702.  PROHIBITED PROVISION OF GENDER TRANSITIONING
  OR GENDER REASSIGNMENT PROCEDURES AND TREATMENTS TO CERTAIN
  CHILDREN. For the purpose of transitioning a child's biological
  sex as determined by the sex organs, chromosomes, and endogenous
  profiles of the child or affirming the child's perception of the
  child's sex if that perception is inconsistent with the child's
  biological sex, a physician or other health care provider may not:
               (1)  perform a surgery that sterilizes the child,
  including:
                     (A)  castration;
                     (B)  vasectomy;
                     (C)  hysterectomy;
                     (D)  oophorectomy;
                     (E)  metoidioplasty;
                     (F)  orchiectomy;
                     (G)  penectomy;
                     (H)  phalloplasty; and
                     (I)  vaginoplasty;
               (2)  perform a mastectomy;
               (3)  provide, administer, prescribe, or dispense any of
  the following prescription drugs that induce transient or permanent
  infertility:
                     (A)  puberty suppression or blocking prescription
  drugs to stop or delay normal puberty;
                     (B)  supraphysiologic doses of testosterone to
  females; or
                     (C)  supraphysiologic doses of estrogen to males;
  or
               (4)  remove any otherwise healthy or non-diseased body
  part or tissue.
         Sec. 161.703.  EXCEPTIONS. The prohibitions under Section
  161.702 do not apply to the provision by a physician or other health
  care provider, with the consent of the child's parent or legal
  guardian, of appropriate and medically necessary gender
  transitioning or gender reassignment procedures or treatments to a
  child who:
               (1)  is born with a medically verifiable genetic
  disorder of sex development, including:
                     (A)  46, XX chromosomes with virilization;
                     (B)  46, XY chromosomes with undervirilization;
  or
                     (C)  both ovarian and testicular tissue; or
               (2)  does not have the normal sex chromosome structure
  for male or female as determined by a physician through genetic
  testing.
         SECTION 2.  Subchapter F, Chapter 1901, Insurance Code, is
  amended by adding Section 1901.256 to read as follows:
         Sec. 1901.256.  PROHIBITED COVERAGE FOR PROVISION OF CERTAIN
  GENDER-RELATED PROCEDURES AND TREATMENTS TO CERTAIN CHILDREN. A
  professional liability insurance policy issued to a physician or
  health care provider may not include coverage for damages assessed
  against the physician or health care provider who provides to a
  child gender transitioning or gender reassignment procedures or
  treatments that are prohibited by Section 161.702, Health and
  Safety Code.
         SECTION 3.  Section 164.052, Occupations Code, is amended by
  amending Subsection (a) and adding Subsection (d) to read as
  follows:
         (a)  A physician or an applicant for a license to practice
  medicine commits a prohibited practice if that person:
               (1)  submits to the board a false or misleading
  statement, document, or certificate in an application for a
  license;
               (2)  presents to the board a license, certificate, or
  diploma that was illegally or fraudulently obtained;
               (3)  commits fraud or deception in taking or passing an
  examination;
               (4)  uses alcohol or drugs in an intemperate manner
  that, in the board's opinion, could endanger a patient's life;
               (5)  commits unprofessional or dishonorable conduct
  that is likely to deceive or defraud the public, as provided by
  Section 164.053, or injure the public;
               (6)  uses an advertising statement that is false,
  misleading, or deceptive;
               (7)  advertises professional superiority or the
  performance of professional service in a superior manner if that
  advertising is not readily subject to verification;
               (8)  purchases, sells, barters, or uses, or offers to
  purchase, sell, barter, or use, a medical degree, license,
  certificate, or diploma, or a transcript of a license, certificate,
  or diploma in or incident to an application to the board for a
  license to practice medicine;
               (9)  alters, with fraudulent intent, a medical license,
  certificate, or diploma, or a transcript of a medical license,
  certificate, or diploma;
               (10)  uses a medical license, certificate, or diploma,
  or a transcript of a medical license, certificate, or diploma that
  has been:
                     (A)  fraudulently purchased or issued;
                     (B)  counterfeited; or
                     (C)  materially altered;
               (11)  impersonates or acts as proxy for another person
  in an examination required by this subtitle for a medical license;
               (12)  engages in conduct that subverts or attempts to
  subvert an examination process required by this subtitle for a
  medical license;
               (13)  impersonates a physician or permits another to
  use the person's license or certificate to practice medicine in
  this state;
               (14)  directly or indirectly employs a person whose
  license to practice medicine has been suspended, canceled, or
  revoked;
               (15)  associates in the practice of medicine with a
  person:
                     (A)  whose license to practice medicine has been
  suspended, canceled, or revoked; or
                     (B)  who has been convicted of the unlawful
  practice of medicine in this state or elsewhere;
               (16)  performs or procures a criminal abortion, aids or
  abets in the procuring of a criminal abortion, attempts to perform
  or procure a criminal abortion, or attempts to aid or abet the
  performance or procurement of a criminal abortion;
               (17)  directly or indirectly aids or abets the practice
  of medicine by a person, partnership, association, or corporation
  that is not licensed to practice medicine by the board;
               (18)  performs an abortion on a woman who is pregnant
  with a viable unborn child during the third trimester of the
  pregnancy unless:
                     (A)  the abortion is necessary to prevent the
  death of the woman;
                     (B)  the viable unborn child has a severe,
  irreversible brain impairment; or
                     (C)  the woman is diagnosed with a significant
  likelihood of suffering imminent severe, irreversible brain damage
  or imminent severe, irreversible paralysis;
               (19)  performs an abortion on an unemancipated minor
  without the written consent of the child's parent, managing
  conservator, or legal guardian or without a court order, as
  provided by Section 33.003 or 33.004, Family Code, unless the
  abortion is necessary due to a medical emergency, as defined by
  Section 171.002, Health and Safety Code;
               (20)  otherwise performs an abortion on an
  unemancipated minor in violation of Chapter 33, Family Code;
               (21)  performs or induces or attempts to perform or
  induce an abortion in violation of Subchapter C, F, or G, Chapter
  171, Health and Safety Code; [or]
               (22)  in complying with the procedures outlined in
  Sections 166.045 and 166.046, Health and Safety Code, wilfully
  fails to make a reasonable effort to transfer a patient to a
  physician who is willing to comply with a directive; or
               (23)  for the purpose of facilitating the gender
  transition or treating the gender dysphoria of an unemancipated
  minor:
                     (A)  provides, administers, prescribes, or
  dispenses a puberty suppression or blocking prescription drug or
  cross-sex hormone to the minor, including by writing a false or
  fictitious prescription; or
                     (B)  performs or attempts to perform a surgical
  intervention on the minor.
         (d)  Notwithstanding Subsection (a)(23), a physician or
  applicant for a license to practice medicine does not commit a
  prohibited practice if the physician or applicant provides a
  puberty suppression or blocking prescription drug to an
  unemancipated minor for the purpose of normalizing puberty for a
  minor experiencing precocious puberty.
         SECTION 4.  Section 1901.256, Insurance Code, as added by
  this Act, applies only to a medical professional liability
  insurance policy that is delivered, issued for delivery, or renewed
  on or after January 1, 2022. An insurance policy that is delivered,
  issued for delivery, or renewed before January 1, 2022, is governed
  by the law in effect immediately before the effective date of this
  Act, and that law is continued in effect for that purpose.
         SECTION 5.  Section 164.052, Occupations Code, as amended by
  this Act, applies only to conduct that occurs on or after the
  effective date of this Act. Conduct that occurs before the
  effective date of this Act is governed by the law in effect on the
  date the conduct occurred, and the former law is continued in effect
  for that purpose.
         SECTION 6.  This Act takes effect September 1, 2021.