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LRB-0396/1
TJD:cjs
2021 - 2022 LEGISLATURE
February 15, 2022 - Introduced by Representatives Allen, Wichgers, Knodl,
Gundrum, Skowronski, Behnke, Brandtjen, Dittrich, Murphy, Penterman,
Schraa and Steffen, cosponsored by Senators Jacque, Bernier and
Stroebel. Referred to Committee on Health.
AB977,1,2 1An Act to amend 448.02 (3) (a); and to create 146.36 and 632.8983 of the
2statutes; relating to: gender transition procedures.
Analysis by the Legislative Reference Bureau
This bill prohibits physician and health care providers from providing any
gender transition procedure to an individual under 18 years of age. The bill also
prohibits a physician or health care provider from referring an individual under 18
years of age to any other health care provider for any gender transition procedure.
“Gender transition procedure” is defined in the bill as a medical or surgical service
provided or performed for the purpose of assisting an individual with a physical
gender transition.
Under the bill, no one may use public moneys for any entity, organization, or
individual that provides any gender transition procedure to an individual under 18
years of age. Facilities owned by and health care providers employed by the state
may not include gender transition procedures for individuals under 18 years of age
in their provided health care services. Under the bill, amounts paid by an entity,
organization, or individual for a gender transition procedure or for premiums for
health care coverage that includes gender transition procedures is not tax
deductible.
The bill prohibits the Department of Health Services from reimbursing or
providing as a benefit under the Medical Assistance program any gender transition
procedure for an individual under 18 years of age. The bill also prohibits a health
insurance policy or self-insured governmental health plan from providing coverage
of any gender transition procedure for an individual under 18 years of age. Health
insurance policies are referred to in the bill as disability insurance policies.

The bill specifies that a violation of the prohibitions on providing to an
individual under 18 years of age, or referring an individual under 18 years of age for,
a gender transition procedure is presumed to be reckless conduct for purposes of civil
liability. The bill explicitly allows an individual injured by such a violation or a
parent, guardian, or legal representative of an injured individual to bring a claim for
any of the damages specified in the bill. The action must be commenced before 30
years after the date the injured individual reached the age of 18. A legal disability
of the injured individual when the individual attains the age of 18 tolls the time to
bring the action until the disability is resolved. Any time during which the injured
individual is subject to threats, intimidation, manipulation, fraudulent
concealment, or fraud by the physician or health care provider involved in the gender
transition procedure or a person acting in that physician's or health care provider's
interest also tolls the time to bring the action. Under the bill, an allegation that a
physician violated either of the prohibitions on providing to an individual under 18
years of age, or referring an individual under 18 years of age for, a gender transition
procedure is considered an allegation of unprofessional conduct, and the Medical
Examining Board is required to investigate allegations of unprofessional conduct.
The attorney general and any district attorney is also authorized to bring an action
to enforce the bill.
The people of the state of Wisconsin, represented in senate and assembly, do
enact as follows:
AB977,1 1Section 1. 146.36 of the statutes is created to read:
AB977,2,2 2146.36 Gender transition procedures. (1) Definitions. In this section:
AB977,2,73 (a) “Biological sex” means the biological indication of male or female in the
4context of reproductive potential or capacity, such as by sex chromosomes, naturally
5occurring sex hormones, gonads, and unambiguous internal and external genitalia
6present at birth, without regard to psychological, chosen, or subjective experience of
7gender.
AB977,2,88 (b) “Cross-sex hormones” means any of the following:
AB977,2,119 1. Testosterone or other androgens given to biological females in amounts that
10are larger or more potent than would normally occur naturally in healthy biological
11females.
AB977,3,2
12. Estrogen given to biological males in amounts that are larger or more potent
2than would normally occur naturally in healthy biological males.
AB977,3,93 (c) “Gender reassignment surgery” means any medical or surgical service that
4seeks to surgically alter or remove healthy physical or anatomical characteristics or
5features that are typical for an individual's biological sex in order to instill or create
6physiological or anatomical characteristics that resemble a sex different from the
7individual's biological sex, including genital gender reassignment surgery or
8nongenital gender reassignment surgery performed for the purpose of assisting an
9individual with a gender transition.
AB977,3,1310 (d) “Gender transition” means a process, which may involve social, legal, or
11physical changes, in which an individual goes from identifying with and living as a
12gender that corresponds with the individual's biological sex to identifying with and
13living as a gender different from the individual's biological sex.
AB977,3,1614 (e) 1. “Gender transition procedure” means any medical or surgical service
15provided or performed for the purpose of assisting an individual with a physical
16gender transition.
AB977,3,1917 2. “Gender transition procedure” includes any physician's service, inpatient
18and outpatient hospital service, puberty-blocking drug, cross-sex hormone, genital
19gender reassignment surgery, or nongenital gender reassignment surgery.
AB977,3,2020 3. “Gender transition procedure” does not include any of the following:
AB977,3,2521 a. A service provided to individuals who are born with a medically verifiable
22disorder of sex development, including individuals with external biological sex
23characteristics that are irresolvably ambiguous, such as those born with 46,XX
24karyotype with virilization, born with 46,XY karyotype with under virilization, or
25having both ovarian and testicular tissue.
AB977,4,4
1b. A service provided when a physician has diagnosed a disorder of sexual
2development by determining, through genetic or biochemical testing, that the
3individual does not have normal sex chromosome structure, sex steroid hormone
4production, or sex steroid hormone action.
AB977,4,95 c. The acute or chronic treatment of any infection, injury, disease, or disorder
6that has been caused by or exacerbated by the performance of a gender transition
7procedure, whether or not the gender transition procedure was performed in
8accordance with state and federal law and whether or not funding for the gender
9transition procedure is permissible under this section.
AB977,4,1310 d. Any procedure undertaken because the individual suffers from a physical
11disorder, physical injury, or physical illness that would, as certified by a physician,
12place the individual in imminent danger of death or impairment of a major bodily
13function unless surgery is performed.
AB977,4,1614 (f) “Genital gender reassignment surgery” means a medical procedure,
15including any of the following surgical procedures, that is performed for the purpose
16of assisting an individual with a physical gender transition:
AB977,4,1817 1. For individuals of male biological sex, a penectomy, an orchiectomy, a
18vaginoplasty, a clitoroplasty, or a vulvoplasty.
AB977,4,2119 2. For individuals of female biological sex, a hysterectomy, an oophorectomy,
20a reconstruction of the urethra, a metoidioplasty or phalloplasty, a vaginectomy, a
21scrotoplasty, or an implantation of erectile or testicular prostheses.
AB977,4,2222 (g) “Health care provider” has the meaning given in s. 146.81 (1) (a) to (hp).
AB977,4,2523 (h) “Nongenital gender reassignment surgery” means a medical procedure,
24including any of the following surgical procedures, that is performed for the purpose
25of assisting an individual with a physical gender transition:
AB977,5,4
11. For individuals of male biological sex, augmentation mammoplasty, facial
2feminization surgery, liposuction, lipofilling, voice feminization surgery, thyroid
3cartilage reduction, gluteal augmentation, hair reconstruction, or any of various
4aesthetic procedures.
AB977,5,75 2. For individuals of female biological sex, subcutaneous mastectomy, voice
6masculinization surgery, liposuction, lipofilling, pectoral implants, or various
7aesthetic procedures.
AB977,5,108 (i) “Puberty-blocking drug” means any of the following when used to delay or
9suppress pubertal development in children for the purpose of assisting an individual
10with a gender transition:
AB977,5,1311 1. A gonadotropin-releasing hormone analogue or other synthetic drug used
12in biological males to stop luteinizing hormone secretion and, therefore, testosterone
13secretion.
AB977,5,1514 2. A synthetic drug used in biological females to stop the production of estrogen
15and progesterone.
AB977,5,1816 (j) “Public funds” means any moneys of the state, a county or local government,
17or any department, agency, or instrumentality authorized or appropriated under
18state law or derived from any fund in which moneys are deposited.
AB977,5,21 19(2) Prohibiting gender transition on minors. (a) No physician or health care
20provider may provide any gender transition procedure to any individual under 18
21years of age.
AB977,5,2422 (b) No physician or health care provider may refer any individual who is under
2318 years of age to any other physician or health care provider for any gender
24transition procedure.
AB977,6,4
1(3) Prohibiting use of public funds for gender transition of minors. (a) No
2person may use public funds directly or indirectly for or grant, pay, or distribute
3public funds to any entity, organization, or individual that provides any gender
4transition procedure to an individual under 18 years of age.
AB977,6,65 (b) None of the following may include any gender transition procedure provided
6to an individual under 18 years of age in the health care services it provides:
AB977,6,77 1. A facility owned by the state or a county or local government.
AB977,6,98 2. A physician or health care provider who is employed by the state or a county
9or local government.
AB977,6,1210 (c) The department may not reimburse or include as a benefit under the
11Medical Assistance program under subch. IV of ch. 49 any gender transition
12procedure for an individual under 18 years of age.
AB977,6,16 13(4) Tax deduction prohibited. Any amount paid during a taxable year by an
14entity, organization, or individual to provide a gender transition procedure or as
15premiums for health care coverage that includes coverage for a gender transition
16procedure is not tax deductible.
AB977,6,20 17(5) Civil liability. (a) Any violation of sub. (2) is presumed to be reckless
18conduct for purposes of civil liability. The party injured by a violation of sub. (2) or
19a parent, guardian, or legal representative of the injured party may bring a claim for
20any of the following damages:
AB977,6,2321 1. Any compensatory damages, including damages for pain and suffering, loss
22of reputation, loss of income, and loss of consortium, including loss of expectation of
23sharing parenthood.
AB977,6,2424 2. Injunctive relief.
AB977,6,2525 3. Declaratory relief.
AB977,7,1
14. Punitive damages.
AB977,7,22 5. Any other appropriate relief.
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