50-4-1004. Prohibitions. (1) (a) Except as provided in subsection (1)(c), a person may not knowingly provide the following medical treatments to a female minor to address the minor’s perception that her gender or sex is not female:

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(i)surgical procedures, including a vaginectomy, hysterectomy, oophorectomy, ovariectomy, reconstruction of the urethra, metoidioplasty, phalloplasty, scrotoplasty, implantation of erection or testicular protheses, subcutaneous mastectomy, voice surgery, or pectoral implants;

(ii)supraphysiologic doses of testosterone or other androgens; or

(iii)puberty blockers such as GnRH agonists or other synthetic drugs that suppress the production of estrogen and progesterone to delay or suppress pubertal development in female minors.

(b)Except as provided in subsection (1)(c), a person may not knowingly provide the following medical treatments to a male minor to address the minor’s perception that his gender or sex is not male:

(i)surgical procedures, including a penectomy, orchiectomy, vaginoplasty, clitoroplasty, vulvoplasty, augmentation mammoplasty, facial feminization surgery, voice surgery, thyroid cartilage reduction, or gluteal augmentation;

(ii)supraphysiologic doses of estrogen; or

(iii)puberty blockers such as GnRH agonists or other synthetic drugs that suppress the production of testosterone or delay or suppress pubertal development in male minors.

(c)The medical treatments listed in subsections (1)(a) and (1)(b) are prohibited only when knowingly provided to address a female minor’s perception that her gender or sex is not female or a male minor’s perception that his gender or sex is not male. Subsections (1)(a) and (1)(b) do not apply for other purposes, including:

(i)treatment for a person born with a medically verifiable disorder of sex development, including:

(A)a person born with external biological sex characteristics that are irresolvably ambiguous, including an individual born with 46 XX chromosomes with virilization, 46 XY chromosomes with undervirilization, or having both ovarian and testicular tissue; and

(B)a person whom a physician has otherwise diagnosed with a disorder of sexual development in which the physician has determined through genetic or biochemical testing that the person does not have normal sex chromosome structure, sex steroid hormone production, or sex steroid hormone action for a male or female; and

(ii)treatment of any infection, injury, disease, or disorder that has been caused or exacerbated by a medical treatment listed in subsection (1)(a) or (1)(b), whether or not the medical treatment was performed in accordance with state and federal law and whether or not funding for the medical treatment is permissible under state and federal law.

(2)If a health care professional or physician violates subsection (1)(a) or (1)(b):

(a)the health care professional or physician has engaged in unprofessional conduct and is subject to discipline by the appropriate licensing entity or disciplinary review board with competent jurisdiction in this state. That discipline must include suspension of the ability to administer health care or practice medicine for at least 1 year.

(b)parents or guardians of the minor subject to the violation have a private cause of action for damages and equitable relief as the court may determine is justified. The court may also award reasonable attorney fees and court costs to a prevailing party.

(3)Public funds may not be directly or indirectly used, granted, paid, or distributed to any individual, entity, or organization for the purposes of providing the medical treatments prohibited in subsection (1)(a) or (1)(b).

(4)Any individual or entity that receives state funds to pay for or subsidize the treatment of minors for psychological conditions, including gender dysphoria, may not use state funds to promote or advocate the medical treatments prohibited in subsection (1)(a) or (1)(b).

(5)Any amount paid by an individual or entity during a tax year for the provision of the procedures described in subsection (1)(a) or (1)(b) is not tax deductible under state law.

(6)The Montana medicaid and children’s health insurance programs may not reimburse or provide coverage for the medical treatments prohibited in subsection (1)(a) or (1)(b).

(7)Except to the extent required by the first amendment to the United States constitution, state property, facilities, or buildings may not be knowingly used to promote or advocate the use of social transitioning or the medical treatments prohibited in subsection (1)(a) or (1)(b).

(8)A health care professional or physician employed by the state or a county or local government may not, while engaged in the official duties of employment, knowingly provide the medical treatments prohibited in subsection (1)(a) or (1)(b).

(9)State property, facilities, or buildings may not knowingly be used to provide the medical treatments prohibited in subsection (1)(a) or (1)(b).

(10)A state employee whose official duties include the care of minors may not, while engaged in those official duties, knowingly provide or promote the medical treatments prohibited in subsection (1)(a) or (1)(b).

(11)The attorney general may bring an action to enforce compliance with this section.