Senate committee substitute to the 4th edition makes the following changes. 

Amends GS 90-21.152 by amending the conditions that must be met in order for a medical professional to be allowed to continue or complete a course of treatment for a minor that includes a surgical gender transition procedure, or the administration of puberty-blocking drugs or cross-sex hormones, to require that the course of treatment have commenced before August 1 (was, October 1), 2023. 

Changes the effective date for new Article 1N (Gender Transition Procedures on Minors) and new GS 143C-6-5.6 (limitation on use of State funds for gender transition procedures) from October 1 to August 1, 2023.