# Florida Senate Bill 254

| ENROLLED 2023 Legislature | CS for SB 254, 2nd Engrossed |
2023254er
​Section 1. Subsection (1) of section 61.517, Florida Statutes, is amended to read:
61.517 Temporary emergency jurisdiction.—
(1) A court of this state has temporary emergency jurisdiction if the child is present in this state and:
(a) The child has been abandoned; or
(b) It is necessary in an emergency to protect the child because the child, or a sibling or parent of the child, is subjected to or threatened with mistreatment or abuse; or
(c) It is necessary in an emergency to protect the child because the child has been subjected to or is threatened with being subjected to sex-reassignment prescriptions or procedures, as defined in s. 456.001.
Section 2. Subsection (1) of section 61.534, Florida Statutes, is amended to read:
61.534 Warrant to take physical custody of child.—
(1) Upon the filing of a petition seeking enforcement of a child custody determination, the petitioner may file a verified application for the issuance of a warrant to take physical custody of the child if the child is likely to imminently suffer serious physical harm or removal from this state. Serious physical harm includes, but is not limited to, being subjected to sex-reassignment prescriptions or procedures as defined in s. 456.001.
Section 3. Section 286.31, Florida Statutes, is created to read:
286.31 Prohibited use of state funds.—
(1) As used in this section, the term “governmental entity” means the state or any political subdivision thereof, including ​the executive, legislative, and judicial branches of government; the independent establishments of the state, counties, municipalities, districts, authorities, boards, or commissions; and any agencies that are subject to chapter 286.
(2) A governmental entity, a public postsecondary educational institution as described in s. 1000.04, the state group health insurance program, a managing entity as defined in s. 394.9082, or a managed care plan providing services under part IV of chapter 409 may not expend state funds as described in s. 215.31 for sex-reassignment prescriptions or procedures as defined in s. 456.001.
Section 4. Subsections (8) and (9) are added to section 456.001, Florida Statutes, to read:
456.001 Definitions.—As used in this chapter, the term:
(8) “Sex” means the classification of a person as either male or female based on the organization of the human body of such person for a specific reproductive role, as indicated by the person’s sex chromosomes, naturally occurring sex hormones, and internal and external genitalia present at birth.
(9)(a) “Sex-reassignment prescriptions or procedures” means:
1. The prescription or administration of puberty blockers for the purpose of attempting to stop or delay normal puberty in order to affirm a person’s perception of his or her sex if that perception is inconsistent with the person’s sex as defined in subsection (8).
2. The prescription or administration of hormones or hormone antagonists to affirm a person’s perception of his or her sex if that perception is inconsistent with the person’s sex ​as defined in subsection (8).
3. Any medical procedure, including a surgical procedure, to affirm a person’s perception of his or her sex if that perception is inconsistent with the person’s sex as defined in subsection (8).
(b) The term does not include:
1. Treatment provided by a physician who, in his or her good faith clinical judgment, performs procedures upon or provides therapies to a minor born with a medically verifiable genetic disorder of sexual development, including any of the following:
a. External biological sex characteristics that are unresolvably ambiguous.
b. A disorder of sexual development in which the physician has determined through genetic or biochemical testing that the patient does not have a normal sex chromosome structure, sex steroid hormone production, or sex steroid hormone action for a male or female, as applicable.
2. Prescriptions or procedures to treat an infection, an injury, a disease, or a disorder that has been caused or exacerbated by the performance of any sex-reassignment prescription or procedure, regardless of whether such prescription or procedure was performed in accordance with state or federal law.
3. Prescriptions or procedures provided to a patient for the treatment of a physical disorder, physical injury, or physical illness that would, as certified by a physician licensed under chapter 458 or chapter 459, place the individual in imminent danger of death or impairment of a major bodily ​function without the prescription or procedure.
Section 5. Section 456.52, Florida Statutes, is created to read:
456.52 Sex-reassignment prescriptions and procedures; prohibitions; informed consent.—
(1) Sex-reassignment prescriptions and procedures are prohibited for patients younger than 18 years of age, except that:
(a) The Board of Medicine and the Board of Osteopathic Medicine shall, within 60 days after the effective date of this act, adopt emergency rules pertaining to standards of practice under which a patient younger than 18 years of age may continue to be treated with a prescription consistent with those referenced under s. 456.001(9)(a)1. or 2. if such treatment for sex reassignment was commenced before, and is still active on, the effective date of this act. In developing rules under this paragraph, the boards shall consider requirements for physicians to obtain informed consent from such patient′s parent or legal guardian, consistent with the parameters of informed consent under subsections (2) and (4), for such prescription treatment, and shall consider the provision of professional counseling services for such patient by a board-certified psychiatrist licensed under chapter 458 or chapter 459 or a psychologist licensed under chapter 490 in conjunction with such prescription treatment.
(b) A patient meeting the criteria of paragraph (a) may continue to be treated by a physician with such prescriptions according to rules adopted under paragraph (a) or nonemergency rules adopted under paragraph (6)(b). ​(2) If sex-reassignment prescriptions or procedures are prescribed for or administered or performed on patients 18 years of age or older, consent must be voluntary, informed, and in writing on forms adopted in rule by the Board of Medicine and the Board of Osteopathic Medicine. Consent to sex-reassignment prescriptions or procedures is voluntary and informed only if the physician who is to prescribe or administer the pharmaceutical product or perform the procedure has, at a minimum, while physically present in the same room:
(a) Informed the patient of the nature and risks of the prescription or procedure in order for the patient to make a prudent decision;
(b) Provided the informed consent form, as adopted in rule by the Board of Medicine and the Board of Osteopathic Medicine, to the patient; and
(c) Received the patient’s written acknowledgment, before the prescription or procedure is prescribed, administered, or performed, that the information required to be provided under this subsection has been provided.
(3) Sex-reassignment prescriptions or procedures may not be prescribed, administered, or performed except by a physician. For the purposes of this section, the term “physician” is defined as a physician licensed under chapter 458 or chapter 459 or a physician practicing medicine or osteopathic medicine in the employment of the Federal Government.
(4) Consent required under subsection (2) does not apply to renewals of prescriptions consistent with those referenced under s. 456.001(9)(a)1. and 2. if a physician and his or her patient have met the requirements for consent for the initial ​prescription or renewal. However, separate consent is required for any new prescription for a pharmaceutical product not previously prescribed to the patient.
(5)(a) Violation of this section constitutes grounds for disciplinary action under this chapter and chapter 458 or chapter 459, as applicable.
(b) Any health care practitioner who willfully or actively participates in a violation of subsection (1) commits a felony of the third degree, punishable as provided in s. 775.082, s. 775.083, or s. 775.084.
(c) Any health care practitioner who violates subsection (2), subsection (3), or subsection (4) commits a misdemeanor of the first degree, punishable as provided in s. 775.082 or s. 775.083.
(6)(a) The Board of Medicine and the Board of Osteopathic Medicine shall adopt emergency rules to implement this section.
(b) Any emergency rules adopted under this section are exempt from s. 120.54(4)(c) and shall remain in effect until replaced by rules adopted under the nonemergency rulemaking procedures of the Administrative Procedure Act.
Section 6. Present paragraphs (c) through (gg) of subsection (5) of section 456.074, Florida Statutes, are redesignated as paragraphs (d) through (hh), respectively, and a new paragraph (c) is added to that subsection, to read:
456.074 Certain health care practitioners; immediate suspension of license.—
(5) The department shall issue an emergency order suspending the license of any health care practitioner who is arrested for committing or attempting, soliciting, or conspiring ​to commit any act that would constitute a violation of any of the following criminal offenses in this state or similar offenses in another jurisdiction:
(c) Section 456.52(5)(b), relating to prescribing, administering, or performing sex-reassignment prescriptions or procedures for a patient younger than 18 years of age.
Section 7. Section 766.318, Florida Statutes, is created to read:
766.318 Civil liability for provision of sex-reassignment prescriptions or procedures to minors.—
(1) A cause of action exists to recover damages for personal injury or death resulting from the provision of sex-reassignment prescriptions or procedures, as defined in s. 456.001, to a person younger than 18 years of age which are prohibited by s. 456.52(1).
(2) The limitations on punitive damages in s. 768.73(1) do not apply to actions brought under this section.
(3) An action brought under this section:
(a) May be commenced within 20 years after the cessation or completion of the sex-reassignment prescription or procedure.
(b) Is in addition to any other remedy authorized by law.
(4) The cause of action created by this section does not apply to:
(a) Treatment with sex-reassignment prescriptions if such treatment is consistent with s. 456.001(9)(a)1. or 2. and was commenced on or before, and is still active on, the effective date of this act.
​Section 8. If any provision of this act or its application to any person or circumstance is held invalid, the invalidity does not affect other provisions or applications of this act which can be given effect without the invalid provision or application, and to this end the provisions of this act are severable.
Section 9. The Division of Law Revision is directed to replace the phrase “the effective date of this act” wherever it occurs in this act with the date this act becomes a law.
Section 10. This act shall take effect upon becoming a law.
CODING: Words stricken are deletions; words underlined are additions.
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