Gender/health providers

AN ACT Relating to prohibiting puberty blocking medications, 1
cross-sex hormones, and gender transition surgeries for minors; and 2
adding a new section to chapter 18.130 RCW. 3
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:4
NEW SECTION. Sec. 1. A new section is added to chapter 18.130 5
RCW to read as follows: 6
(1) Except as provided in subsection (2) of this section, a 7
health care provider licensed under this title may not knowingly 8
engage in or cause any of the following practices to be performed on 9
a minor if the practice is performed for the purpose of attempting to 10
alter the appearance of, or affirm the minor's perception of, the 11
minor's gender or sex, if that appearance or perception is 12
inconsistent with the minor's sex: 13
(a) Prescribing or administering gonadotropin-releasing hormone 14
analogues or other synthetic drugs used to stop luteinizing hormone 15
and follicle-stimulating hormone secretion, synthetic antiandrogen 16
drugs used to block the androgen receptor, or any drug to suppress or 17
delay normal puberty; 18
(b) Prescribing or administering testosterone, estrogen, or 19
progesterone to a minor in an amount greater than would normally be 20
H-0185.1
HOUSE BILL 1038
State of Washington 69th Legislature 2025 Regular Session
By Representatives Jacobsen, Marshall, McEntire, Ley, Walsh, Schmidt,
and Eslick
Prefiled 12/11/24. Read first time 01/13/25. Referred to Committee
on Health Care & Wellness.
p. 1 HB 1038
produced endogenously in a healthy individual of that individual's 1
age and sex; 2
(c) Performing surgeries that sterilize, including castration, 3
vasectomy, hysterectomy, oophorectomy, orchiectomy, and penectomy;4
(d) Performing surgeries that artificially construct tissue with 5
the appearance of genitalia that differs from the individual's sex, 6
including metoidioplasty, phalloplasty, and vaginoplasty; and7
(e) Removing any healthy or nondiseased body part or tissue.8
(2) The following services and treatments are not prohibited by 9
this section: 10
(a) Services provided to a minor born with a medically verifiable 11
disorder of sex development, including a minor with external 12
biological sex characteristics that are irresolvably ambiguous, such 13
as a minor born with 46 XX chromosomes with virilization, 46 XY 14
chromosomes with undervirilization, or having both ovarian and 15
testicular tissue; 16
(b) Services provided to a minor who has otherwise been diagnosed 17
with a disorder of sexual development by a physician, when the 18
physician has determined through genetic or biochemical testing that 19
the minor does not have a normal sex chromosome structure, sex 20
steroid hormone production, or sex steroid hormone action for a 21
biological male or biological female; 22
(c) Services provided to taper a minor off of any puberty 23
blocking medications or other hormones; 24
(d) The treatment of any infection, injury, disease, or disorder 25
that has been caused or exacerbated by the performance of gender 26
transition procedures, whether or not the procedures were performed 27
in accordance with state and federal law; and 28
(e) Any procedure undertaken because a minor suffers from a 29
physical disorder, physical injury, or physical illness that is 30
certified by a physician and that would place the minor in imminent 31
danger of death or impairment of a major bodily function unless 32
surgery is performed. 33
(3) For purposes of this section: 34
(a) "Gender" means the psychological, behavioral, social, and 35
cultural aspects of being male or female. 36
(b) "Minor" means an unemancipated person under 18 years of age.37
(c) "Sex" means the biological indication of male and female, 38
including sex chromosomes, naturally occurring sex hormones, gonads, 39
and nonambiguous internal and external genitalia present at birth 40
p. 2 HB 1038
without regard to an individual's psychological, chosen, or 1
subjective experience of gender. 2
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p. 3 HB 1038