Amend CSHB 1 (house committee printing) in ARTICLE I of the bill, following the appropriations to the Employees Retirement System (page I-39), by adding the following appropriately numbered rider:

____.  Prohibition on Use of General Revenue for Gender Transitioning or Reassignment Procedures or Treatments for Minors. (a)  General revenue appropriated by this Act to the Employees Retirement System may not be used to provide gender transitioning or gender reassignment procedures or treatments to minors for the purpose of transitioning a minor's biological sex organs or endogenous profiles or affirming the minor's perception of the minor's sex if that perception is inconsistent with the minor's biological sex as determined by the sex organs, chromosomes, and endogenous profiles. Specifically, the money may not be used to:

(1)  perform a surgery that sterilizes the minor, including:

(A)  castration;

(B)  vasectomy;

(C)  hysterectomy;

(D)  oophorectomy;

(E)  metoidioplasty;

(F)  orchiectomy;

(G)  penectomy;

(H)  phalloplasty; and

(I)  vaginoplasty;

(2)  perform:

(A)  a mastectomy on a female; or

(B)  a breast augmentation on a male;

(3)  prescribe, administer, or supply any of the following medications that induce transient or permanent infertility:

(A)  puberty-blocking medication 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.

(b)  Subsection (a) does not apply to the provision by a physician or health care provider, with the consent of the minor's parent or legal guardian, of appropriate and medically necessary gender transitioning or gender reassignment procedures or treatments to a minor 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.