Definitions

In this Act: (1) Sex-trait altering treatment The term sex-trait altering treatment means any medical or surgical service, including physician’s services, practitioner’s services, inpatient and outpatient hospital services, or prescribed drugs related to gender transition, other than an excepted service, that seeks to: (A) Alter or remove physical or anatomical characteristics or features that are typical for the individual’s sex; or (B) Instill or create physiological or anatomical characteristics that resemble a sex different from the individual’s sex, including medical services that provide puberty blocking drugs, gender transition hormone therapy, or genital gender reassignment surgery or nongenital gender reassignment surgery knowingly performed for the purpose of assisting an individual with a gender transition. (2) Sex The term sex means the biological indication of being male or female, including sex chromosomes, and naturally occurring sex hormones, gonads, and nonambiguous internal and external genitalia present at birth. (3) Gender transition hormone therapy The term gender transition hormone therapy means testosterone, estrogen, or progesterone given to an individual in an amount greater than would normally be produced endogenously in a healthy individual of that individual’s age and sex. (4) Gender The term gender means the psychological, behavioral, social, and cultural aspects of being male or female. (5) Gender reassignment surgery The term gender reassignment surgery means any medical or surgical service that seeks to surgically alter or remove healthy physical or anatomical characteristics or features that are typical for the individual’s sex, in order to instill or create physiological or anatomical characteristics that resemble a sex different from the individual’s sex, including genital gender reassignment surgery or nongenital gender reassignment surgery knowingly performed for the purpose of assisting an individual with a gender transition. (6) Gender transition The term gender transition means the process in which an individual shifts from identifying with and living as a gender that corresponds to his or her sex to identifying with and living as a gender different from his or her sex, and may involve social, legal, or physical changes. (7) Genital gender reassignment surgery The term genital gender reassignment surgery means a medical procedure knowingly performed for the purpose of assisting an individual with a gender transition, including the following: (A) Surgical procedures, including a penectomy, orchiectomy, vaginoplasty, clitoroplasty, or vulvoplasty for a male sex patient or hysterectomy or ovariectomy for a female sex patient. (B) Reconstruction of the fixed part of the urethra with or without a metoidioplasty. (C) Phalloplasty, vaginectomy, scrotoplasty, or implantation of erection or testicular prostheses for a female sex patient. (8) Nongenital gender reassignment surgery The term nongenital gender reassignment surgery means medical procedures knowingly performed for the purpose of assisting an individual with a gender transition, including the following: (A) Surgical procedures for a male sex patient, including augmentation mammoplasty, facial feminization surgery, liposuction, lipofilling, voice surgery, thyroid cartilage reduction, gluteal augmentation, hair reconstruction, or associated aesthetic procedures. (B) Surgical procedures for a female sex patient, including subcutaneous mastectomy, voice surgery, liposuction, lipofilling, pectoral implants, or associated aesthetic procedures. (9) Puberty blocking drugs The term puberty blocking drugs means the following when used for the purpose of assisting an individual with a gender transition. (A) Gonadotropin releasing hormone analogues or other synthetic drugs used to stop luteinizing hormone and follicle stimulating hormone secretion; or (B) Synthetic antiandrogen drugs used to block the androgen receptor. (10) Excepted service The term excepted service means any of the following: (A) Medical or surgical services furnished to an individual born with a medically verifiable disorder of sex development, including an individual with: (i) External sex characteristics that are irresolvably ambiguous; (ii) Forty-six XX chromosomes with virilization; (iii) Forty-six XY chromosomes with undervirilization; or (iv) Both ovarian and testicular tissue. (B) Medical or surgical services provided when a physician or practitioner has diagnosed a disorder or condition of sexual development that the physician or practitioner has determined through genetic or biochemical testing that the individual does not have normal sex chromosome structure, sex steroid hormone production, or sex steroid hormone action. (C) The treatment of any infection, injury, disease, or disorder that has been caused by or exacerbated by the performance of sex-trait altering treatments. (D) Any medical or surgical service undertaken because the individual suffers from a physical disorder, physical injury, or physical illness that would, as certified by a physician or practitioner, place the individual in imminent danger of death or impairment of major bodily function unless the medical or surgical service is performed. (E) Mental health or social services, other than sex-trait altering treatments. (F) Services for a disorder or condition of sexual development that is unrelated to a diagnosis of gender dysphoria or gender identity disorder. (11) Minor The term minor means an individual under 18 years of age.