HB 1033 — An Act prohibiting gender transition procedures for minors and coverage for gender transition procedures for minors.

PRINTER'S NO.    1117

                     THE GENERAL ASSEMBLY OF PENNSYLVANIA



                         HOUSE BILL
                         No. 1033
                                              Session of
                                                2025

     INTRODUCED BY ROAE, HAMM, BOROWICZ, JAMES, MENTZER, KAUFFMAN,
        M. BROWN, FEE, ZIMMERMAN, GILLEN, BANTA, GREINER, BARGER,
        FRITZ, SMITH, CUTLER AND FINK, MARCH 24, 2025

     REFERRED TO COMMITTEE ON HEALTH, MARCH 24, 2025


                                    AN ACT
 1   Prohibiting gender transition procedures for minors and coverage
 2      for gender transition procedures for minors.
 3      The General Assembly finds and declares as follows:
 4          (1)   The Commonwealth has a compelling government
 5      interest in protecting the health and safety of vulnerable
 6      minors.
 7          (2)   Gender transition procedures are permanent and often
 8      irreversible treatments that carry serious known risks,
 9      ranging from increased risks of various types of cancer to
10      infertility.
11          (3)   The vast majority of minors who express distress in
12      identifying with their biological sex eventually come to
13      identify with their biological sex in adolescence or
14      adulthood.
15          (4)   Studies have refuted the misconception that
16      providing gender transition procedures to vulnerable minors
17      reduces risk of suicide, psychiatric morbidities and
 1      mortality.
 2          (5)     The risks of performing gender transition procedures
 3      on minors far outweigh any perceived benefits.
 4          (6)     The provisions of this act only apply to minors.
 5          (7)     An individual who has attained 18 years of age may
 6      continue to obtain gender transition procedures.
 7      The General Assembly of the Commonwealth of Pennsylvania
 8   hereby enacts as follows:
 9   Section 1.   Short title.
10      This act shall be known and may be cited as the Save
11   Adolescents from Experimentation Act.
12   Section 2.   Definitions.
13      The following words and phrases when used in this act shall
14   have the meanings given to them in this section unless the
15   context clearly indicates otherwise:
16      "Biological sex."    The biological indication of male and
17   female in the context of reproductive potential or capacity,
18   including sex chromosomes, naturally occurring sex hormones,
19   gonads and nonambiguous internal and external genitalia present
20   at birth, without regard to an individual's psychological,
21   chosen or subjective experience of gender.
22      "Cross-sex hormones."    Any of the following:
23          (1)     Testosterone or other androgens given to a
24      biological female at doses that are profoundly larger or more
25      potent than would normally occur naturally in a healthy
26      biological female.
27          (2)     Estrogen given to a biological male at doses that
28      are profoundly larger or more potent than would normally
29      occur naturally in a healthy biological male.
30      "Gender."    The psychological, behavioral, social and cultural

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 1   aspects of being male or female.
 2      "Gender transition."    The process in which an individual goes
 3   from identifying with and living as a gender that corresponds to
 4   the individual's biological sex to identifying with and living
 5   as a gender different from the individual's biological sex which
 6   may involve social, legal or physical changes.
 7      "Gender transition procedure."      All forms of treatments
 8   related to gender transition, including genital gender
 9   reassignment surgery, nongenital gender reassignment surgery,
10   cross-sex hormones and puberty-blocking drugs.
11      "Genital gender reassignment surgery."      A genital medical
12   procedure performed for the purpose of assisting an individual
13   with a gender transition, including any of the following:
14          (1)   A surgical procedure, including penectomy,
15      orchiectomy, vaginoplasty, clitoroplasty or vulvoplasty, for
16      biologically male patients and hysterectomy or ovariectomy
17      for biologically female patients.
18          (2)   Reconstruction of the fixed part of the urethra with
19      or without a metoidioplasty.
20          (3)   Phalloplasty, vaginectomy, scrotoplasty or
21      implantation of erection or testicular prostheses for
22      biologically female patients.
23      "Government program."    A program of government-sponsored or
24   government-subsidized health care coverage, including any of the
25   following:
26          (1)   The children's health insurance program under
27      Article XXIII-A of the act of May 17, 1921 (P.L.682, No.284),
28      known as The Insurance Company Law of 1921.
29          (2)   The medical assistance program under Subdivision (f)
30      of Article IV of the act of June 13, 1967 (P.L.31, No.21),

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 1      known as the Human Services Code.
 2      "Health care practitioner."     As defined in section 103 of the
 3   act of July 19, 1979 (P.L.130, No.48), known as the Health Care
 4   Facilities Act.
 5      "Health insurance policy."     A policy, subscriber contract,
 6   certificate or plan issued by an insurer that provides medical
 7   or health care coverage. The term includes a dental only and a
 8   vision only policy. The term does not include:
 9          (1)     An accident only policy.
10          (2)     A credit only policy.
11          (3)     A long-term care or disability income policy.
12          (4)     A specified disease policy.
13          (5)     A Medicare supplement policy.
14          (6)     A TRICARE policy, including a Civilian Health and
15      Medical Program of the Uniformed Services supplement policy.
16          (7)     A fixed indemnity policy.
17          (8)     A hospital indemnity policy.
18          (9)     A worker's compensation policy.
19          (10)     An automobile medical payment policy under 75
20      Pa.C.S. (relating to vehicles).
21          (11)     A homeowner's insurance policy.
22          (12)     Any other similar policies providing for limited
23      benefits.
24      "Insurer."     An entity licensed by the Insurance Department
25   that offers, issues or renews a health insurance policy and is
26   governed under any of the following:
27          (1)     The act of December 29, 1972 (P.L.1701, No.364),
28      known as the Health Maintenance Organization Act.
29          (2)     40 Pa.C.S. Ch. 61 (relating to hospital plan
30      corporations).

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 1          (3)    40 Pa.C.S. Ch. 63 (relating to professional health
 2      services plan corporations).
 3      "Licensing board."   Each licensing board within the Bureau of
 4   Professional and Occupational Affairs of the Department of State
 5   with jurisdiction over a health care practitioner.
 6      "Minor."   An individual who is younger than 18 years of age.
 7      "Nongenital gender reassignment surgery."    A nongenital
 8   medical procedure performed for the purpose of assisting an
 9   individual with a gender transition, including any of the
10   following:
11          (1)    A surgical procedure for a biologically male
12      patient, including augmentation mammoplasty, facial
13      feminization surgery, liposuction, lipofilling, voice
14      surgery, thyroid cartilage reduction, gluteal augmentation,
15      hair reconstruction or various aesthetic procedures.
16          (2)    A surgical procedure for a biologically female
17      patient, including subcutaneous mastectomy, voice surgery,
18      liposuction, lipofilling, pectoral implants or various
19      aesthetic procedures.
20      "Pharmacist."   An individual duly licensed by the State Board
21   of Pharmacy to engage in the practice of pharmacy.
22      "Physician."    A medical doctor or doctor of osteopathy.
23      "Puberty-blocking drugs."    Any of the following:
24          (1)    Gonadotropin-releasing hormone analogs or other
25      synthetic drugs used in a biological male patient to stop
26      luteinizing hormone secretion and, therefore, testosterone
27      secretion.
28          (2)    Synthetic drugs used in biological females that stop
29      the production of estrogens and progesterone when used to
30      delay or suppress pubertal development in children for the

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 1      purpose of assisting an individual with a gender transition.
 2   Section 3.     Prohibition on gender transition procedures for
 3                  minors.
 4      (a)   Prohibition on health care practitioners.--
 5            (1)   A health care practitioner may not perform gender
 6      transition procedures on a minor or refer a minor to receive
 7      gender transition procedures.
 8            (2)   A health care practitioner with prescriptive
 9      authority may not prescribe cross-sex hormones or puberty-
10      blocking drugs to a minor or refer a minor to be prescribed
11      cross-sex hormones or puberty-blocking drugs.
12      (b)   Prohibition on pharmacists.--A pharmacist may not
13   dispense cross-sex hormones or puberty-blocking drugs to a
14   minor.
15      (c)   Construction.--Nothing in this section shall be
16   construed to restrict any of the following:
17            (1)   Services provided to an individual born with a
18      medically verifiable disorder of sex development, sex
19      chromosome structure, sex steroid hormone production or sex
20      steroid hormone action.
21            (2)   The treatment of an infection, injury, disease or
22      disorder that has been caused or exacerbated by the
23      performance of gender transition procedures.
24            (3)   Medically necessary procedures, as determined by a
25      physician, undertaken to prevent death or impairment of a
26      major bodily function.
27            (4)   Mental health treatment that is not prohibited under
28      subsection (a).
29      (d)   Penalties.--A health care practitioner who violates
30   subsection (a) shall be subject to discipline by the applicable

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 1   licensing board with jurisdiction over the health care
 2   practitioner. A licensing board with jurisdiction over a health
 3   care practitioner who violates subsection (a) shall consider the
 4   violation to be a violation of the health care practitioner's
 5   scope of practice as specified under State law and grounds for
 6   sanctions as specified under State law.
 7   Section 4.   Prohibition on coverage for gender transition
 8                procedures for minors.
 9      (a)   Prohibition on insurers.--Except as authorized under
10   section 3(c), an insurer may not provide a health insurance
11   policy to provide coverage for gender transition procedures.
12      (b)   Prohibition on government programs.--Except as
13   authorized under section 3(c), a government program may not
14   provide coverage for gender transition procedures.
15   Section 5.   Severability.
16      The provisions of this act are severable. If any provision of
17   this act or its application to any person or circumstance is
18   held invalid, the invalidity shall not affect other provisions
19   or applications of this act which can be given effect without
20   the invalid provision or application.
21   Section 6.   Effective date.
22      This act shall take effect in 60 days.




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