An Act to Safeguard Gender-affirming Health Care
Maine Legislature, Session 131, LD 1735
Committee: Judiciary
Sponsors: OSHER, CARNEY, MILLIKEN, MOONEN, SALISBURY, SHEEHAN, WORTH
Amends: 14 MRSA §403, 15 MRSA §230, 19-A MRSA §1732, 19-A MRSA §1745, 19-A MRSA §1748, 19-A MRSA §1751, 19-A MRSA §1752, 22 MRSA §1711-C

Legislative Document
No. 1735
H.P. 1114
House of Representatives, April 20, 2023
An Act to Safeguard Gender-affirming Health Care
Reference to the Committee on Judiciary suggested and ordered printed.
ROBERT B. HUNT
Clerk
Presented by Representative OSHER of Orono.
Cosponsored by Senator CARNEY of Cumberland and
Representatives: MILLIKEN of Blue Hill, MOONEN of Portland, SALISBURY of 
Westbrook, SHEEHAN of Biddeford, WORTH of Ellsworth.
Be it enacted by the People of the State of Maine as follows:
Sec. 1.  14 MRSA §403, sub-§4 is enacted to read:
4.  Prohibition.  Notwithstanding subsection 2, the clerk of court may not issue a 
subpoena pursuant to this section if the foreign subpoena is based on a violation of another 
state's laws that interfere with a person's right to allow a child to receive gender-affirming 
health care or gender-affirming mental health care.  For the purposes of this subsection, 
"gender-affirming health care" and "gender-affirming mental health care" have the same 
meanings as in Title 19-A, section 1732.
Sec. 2.  15 MRSA §230 is enacted to read:
§230.  Warrants and extradition in connection with provision of gender-affirming 
health care and gender-affirming mental health care
1.  Definitions.  As used in this section, unless the context otherwise indicates, the 
following terms have the following meanings.
A.  "Gender-affirming health care" means medically necessary health care that respects 
the gender identity of the patient, as experienced and defined by the patient, including, 
but not limited to, the following:
(1)  Interventions to suppress the development of endogenous secondary sex 
characteristics;
(2)  Interventions to align the patient's appearance or physical body with the 
patient's gender identity; and
(3)  Interventions to alleviate symptoms of clinically significant distress resulting 
from gender dysphoria, as defined in the Diagnostic and Statistical Manual of 
Mental Disorders, 5th edition or its successor in function.
B.  "Gender-affirming mental health care" means mental health care or behavioral 
health care that respects the gender identity of the patient, as experienced and defined 
by the patient, including, but not limited to, developmentally appropriate exploration 
and integration of identity, reduction of distress, adaptive coping and strategies to 
increase family acceptance.
2.  Public policy.  It is the public policy of this State that an out-of-state arrest warrant 
for an individual based on violating another state's law against providing, receiving or 
allowing a child to receive gender-affirming health care or gender-affirming mental health 
care is the lowest law enforcement priority.
3.  Prohibitions.  A law enforcement agency may not knowingly make or participate 
in the arrest or participate in any extradition of an individual pursuant to an out-of-state 
arrest warrant for violation of another state's law against providing, receiving or allowing 
a child to receive gender-affirming health care or gender-affirming mental health care in 
this State, if that care is lawful under the laws of this State, to the fullest extent permitted 
by federal law. A state or local law enforcement agency may not cooperate with or provide 
information to any individual or out-of-state agency or department regarding the provision 
of lawful gender-affirming health care or gender-affirming mental health care performed 
in this State.
4.  Investigation; sharing of information.  Nothing in this section prohibits the 
investigation of any criminal activity in this State that may involve the performance of 
gender-affirming health care or gender-affirming mental health care, except that no 
information relating to any medical procedure performed on a specific individual may be 
shared with an out-of-state agency or any other individual without the documented consent 
of the patient.
Sec. 3.  19-A MRSA §1732, sub-§6-A is enacted to read:
6-A.  Gender-affirming health care.  "Gender-affirming health care" means 
medically necessary health care that respects the gender identity of the patient, as 
experienced and defined by the patient, including, but not limited to, the following:
(1)  Interventions to suppress the development of endogenous secondary sex 
characteristics;
(2)  Interventions to align the patient's appearance or physical body with the 
patient's gender identity; and
(3)  Interventions to alleviate symptoms of clinically significant distress resulting 
from gender dysphoria, as defined in the Diagnostic and Statistical Manual of 
Mental Disorders, 5th edition or its successor in function.
Sec. 4.  19-A MRSA §1732, sub-§6-B is enacted to read:
6-B.  Gender-affirming mental health care.  "Gender-affirming mental health care" 
means mental health care or behavioral health care that respects the gender identity of the 
patient, as experienced and defined by the patient, including, but not limited to, 
developmentally appropriate exploration and integration of identity, reduction of distress, 
adaptive coping and strategies to increase family acceptance.
Sec. 5.  19-A MRSA §1745, sub-§1, ¶B-1 is enacted to read:
B-1.  A court of another state does not have jurisdiction under paragraph A, or a court 
of the home state of the child has declined to exercise jurisdiction on the grounds that 
this State is the more appropriate forum under section 1751 or 1752, and the child is 
present in this State for the purpose of obtaining gender-affirming health care or 
gender-affirming mental health care;
Sec. 6.  19-A MRSA §1748, sub-§1, as enacted by PL 1999, c. 486, §3 and affected 
by §6, is amended to read:
1.  Abandoned child; emergency.  A court of this State has temporary emergency 
jurisdiction if the child is present in this State and the child has been abandoned or 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 because the child has 
been unable to obtain gender-affirming health care or gender-affirming mental health care.
Sec. 7.  19-A MRSA §1751, sub-§2-A is enacted to read:
2-A.  Prohibition.  In a case in which the provision of gender-affirming health care or 
gender-affirming mental health care to the child is at issue, a court of this State may not 
determine that it is an inconvenient forum if the law or policy of the other state that may 
take jurisdiction limits the ability of a parent to obtain gender-affirming health care or 
gender-affirming mental health care for the parent's child.
Sec. 8.  19-A MRSA §1752, sub-§4 is enacted to read:
4.  Prohibition.  In making a determination under this section, a court may not consider 
as a factor weighing against the petitioner any taking of the child, or retention of the child 
after a visit or other temporary relinquishment of physical custody, from the person who 
has legal custody, if there is evidence that the taking or retention of the child was for the 
purposes of obtaining gender-affirming health care or gender-affirming mental health care 
for the child and the law or policy of the other state limits the ability of a parent to obtain 
gender-affirming health care or gender-affirming mental health care for the parent's child.
Sec. 9.  22 MRSA §1711-C, sub-§8, as amended by PL 2011, c. 373, §2, is repealed 
and the following enacted in its place:
8.  Prohibited disclosure.  A health care practitioner, facility or state-designated 
statewide health information exchange may not disclose health care information:
A.  For the purpose of marketing or sales without written or oral authorization for the 
disclosure; or
B.  Related to a person or entity allowing a child to receive gender-affirming health 
care or gender-affirming mental health care in response to any civil action, including a 
foreign subpoena, based on another state's law that authorizes a person to bring a civil 
action against a person or entity that allows a child to receive gender-affirming health 
care or gender-affirming mental health care.
For the purposes of this paragraph, "gender-affirming health care" and 
"gender-affirming mental health care" have the same meanings as in Title 19-A, section 
1732.
SUMMARY
This bill prohibits the enforcement of an order based on another state's law authorizing 
a child to be removed from the child's parent or guardian based on that parent or guardian 
allowing the child to receive gender-affirming health care or gender-affirming mental 
health care. The bill prohibits a court from finding that it is an inconvenient forum if the 
law or policy of another state that may take jurisdiction limits the ability of a parent to 
obtain gender-affirming health care or gender-affirming mental health care for a child and 
the provision of that care is at issue in the case before the court. The bill authorizes a court 
to take temporary jurisdiction because a child has been unable to obtain gender-affirming 
health care or gender-affirming mental health care. The bill prohibits a court from 
considering the taking or retention of a child from a person who has legal custody of the 
child if the taking or retention was for obtaining gender-affirming health care or 
gender-affirming mental health care for the child. The bill prohibits a health care 
practitioner, health care facility or state-designated statewide health information exchange 
from releasing medical information related to a person or entity allowing a child to receive 
gender-affirming health care or gender-affirming mental health care in response to a 
criminal or civil action, including a foreign subpoena, based on another state's law that 
authorizes a person to bring a civil or criminal action against a person or entity that allows 
a child to receive gender-affirming health care or gender-affirming mental health care. The 
bill prohibits law enforcement agencies from knowingly making or participating in the 
arrest or extradition of an individual pursuant to an out-of-state arrest warrant based on 
another state's law against providing, receiving or allowing a child to receive gender-
affirming health care or gender-affirming mental health care in this State.