Bill Text: CA SB225 | 2021-2022 | Regular Session | Introduced


Bill Title: Medical procedures: individuals born with variations in their physical sex characteristics.

Spectrum: Partisan Bill (Democrat 4-0)

Status: (Introduced) 2021-01-28 - Referred to Coms. on B., P. & E.D. and JUD. [SB225 Detail]

Download: California-2021-SB225-Introduced.html


CALIFORNIA LEGISLATURE— 2021–2022 REGULAR SESSION

Senate Bill
No. 225


Introduced by Senator Wiener
(Principal coauthor: Assembly Member Chiu)
(Coauthors: Assembly Members Lee and Ting)

January 14, 2021


An act to add Section 2295 to the Business and Professions Code, relating to medical procedures.


LEGISLATIVE COUNSEL'S DIGEST


SB 225, as introduced, Wiener. Medical procedures: individuals born with variations in their physical sex characteristics.
Under existing law, the Medical Practice Act, certain procedures or treatments constitute unprofessional conduct, including, among others, the prescribing, dispensing, administering, or furnishing of liquid silicone for the purpose of injecting it into a human breast or mammary. Any violation of the law relating to enforcement of the Medical Practice Act is a misdemeanor, as specified.
This bill would prohibit a physician and surgeon from performing certain sex organ modification procedures on an individual born with variations in their physical sex characteristics who is under 6 years of age unless the procedure is a surgery required to address an immediate risk of physical harm, as specified. The bill would make any violation of these provisions subject to disciplinary action by the board, but not criminal prosecution.
Vote: MAJORITY   Appropriation: NO   Fiscal Committee: YES   Local Program: NO  

The people of the State of California do enact as follows:


SECTION 1.

 Section 2295 is added to the Business and Professions Code, to read:

2295.
 (a) Consistent with Senate Concurrent Resolution 110 of the 2017–18 Regular Session (Resolution Chapter 225 of the Statutes of 2018), the Legislature hereby finds and declares all of the following:
(1) The Legislature opposes all forms of prejudice, bias, or discrimination and affirms its commitment to the dignity and autonomy of all people, including those born with variations in their physical sex characteristics.
(2) “Variations in physical sex characteristics” is an umbrella term used to describe a wide range of natural bodily variations in traits including genitals, gonads, hormone function, and chromosomal patterns.
(3) 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 are equally entitled to dignity and bodily autonomy.
(4) People born with variations in their physical sex characteristics are regularly subjected in infancy to nonemergency surgeries to change the appearance or function of those variations, even though such surgeries may result in lasting harm.
(5) The Legislature recognizes that nonemergency surgeries on infants with variations in their physical sex characteristics are often justified by generalized assumptions about people’s preferences about their bodies’ appearance and function. These assumptions perpetuate gender stereotypes and may not reflect an individual’s actual preferences when they are capable of articulating their wishes.
(6) The Legislature recognizes the parallels between these nonemergency surgeries on infants with variations in their sex characteristics and the long histories of practicing conversion therapy on LGBTQ youth and performing surgeries on disabled populations based on society’s discomfort rather than the individual’s health and well-being.
(7) Not all persons with variations in their physical sex characteristics will need or desire the surgeries that may be recommended or performed on them in infancy. People born with variations in their physical sex characteristics should be free to choose whether to undergo surgeries that impact not only their bodily autonomy but also their reproductive and sexual futures.
(8) The Legislature recognizes that leading pediatric hospitals have begun to institute partial bans on these surgeries on patients who are too young to participate in a meaningful discussion of the implications of these surgeries.
(9) California has a compelling interest in protecting the physical and psychological well-being of children, including those born with variations in their physical sex characteristics. The enactment of legislation is necessary to safeguard the bodily autonomy of people born with variations in their physical sex characteristics and to ensure patient-centered care that conforms with best practices in the medical profession.
(b) The following definitions apply for purposes of this section:
(1) “Individual born with variations in their physical sex characteristics” means an individual born with physical traits, including genitals, gonads, hormone function, or chromosomal patterns, that vary from stereotypical notions regarding the development, appearance, or function of sex characteristics, including those variations resulting from androgen insensitivity syndrome and congenital adrenal hyperplasia.
(2) “Surgery required to address an immediate risk of physical harm” means any of the following:
(A) Surgery to remove tissue that poses a heightened clinical risk of malignancy relative to that of the general population.
(B) Surgery to allow urine to exit the body, to treat urinary incontinence, or to make a minimally invasive adjustment to urinary function in order to decrease a risk of infection or renal complication in a patient whose current urinary function puts them at a demonstrated clinical risk of infection or renal complication.
(C) Surgery that is required to treat complications of a previous surgery and cannot be delayed without increasing physical health risks to the patient.
(D) Any other surgery necessary to preserve life in the event of a medical emergency.
(c) A physician and surgeon shall not perform the following procedures on an individual born with variations in their physical sex characteristics who is under six years of age unless the procedure is a surgery required to address an immediate risk of physical harm:
(1) Clitoroplasty, clitoral reduction, and clitoral recession, including corporal-sparing procedures.
(2) Gonadectomy.
(3) Any procedure that lengthens or reroutes a urethra from its native orifice.
(4) Vaginoplasty, urogenital sinus mobilization, and vaginal exteriorization.
(d) A violation of this section constitutes unprofessional conduct. Section 2314 shall not apply to a violation of this section.

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