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  • Summary date: Apr 20 2023 - View Summary

    Includes whereas clauses.

    Section One

    Enacts Article 1M, Youth Health Protection Act, of GS Chapter 90. Makes it unlawful for any individual to engage in any of the following practices upon a minor, or cause them to be performed for the purpose of attempting to alter the appearance of or affirm the minor's perception of his or her gender or sex, if that is inconsistent with the minor's sex: (1) performing surgeries that sterilize, including castration, vasectomy, hysterectomy, oophorectomy, orchiectomy, or penectomy; (2) performing surgeries that artificially construct tissue with the appearance of genitalia that differs from the individual's sex, including metoidioplasty, phalloplasty, and vaginoplasty; (3) performing a mastectomy; (4) prescribing, administering, or supplying gonadotropin releasing hormone analogues or other synthetic drugs used to stop luteinizing hormone and follicle stimulating hormone secretion, synthetic antiandrogen drugs used to block the androgen receptor, or any drug to suppress or delay normal puberty; (5) prescribing, administering, or supplying testosterone, estrogen, or  progesterone to a minor in an amount greater than would normally be produced endogenously in a healthy individual of that individual's age and sex; (6) removing any otherwise healthy or nondiseased body part or tissue. Defines sex to mean the biological state of begin female or male, based on sex organs, chromosomes, and endogenous hormone profiles, without regard to an individual’s psychological, chosen, or subjective experience of gender. Defines minor to mean individuals younger than 18 years of age.

    Makes it unlawful for any medical professional or mental health care professional, or counselor to knowingly engage in conduct that aids or abets any of the above described medical treatments described above to a minor. Specifies that the act may not be construed to impose liability on any speech protected by federal or State law.

    Deems medical professionals, mental health care professionals, or counselors who engage in any of the specified unlawful practices to have engaged in unprofessional conduct and subject to licensure revocation for at least one year, or other appropriate discipline by the respective licensing board. Establishes a $1,000 civil penalty per occurrence, with remittance to the Civil and Penalty Forfeiture Fund. Excludes from the scope good-faith medical decisions of parents or guardians of a minor born with a medically verifiable genetic disorder of sexual development, and specifies such examples. Further excludes from the scope of the statute, the treatment of any infection, disease, or disorder that has been caused or  exacerbated by the performance of  one of the medical treatments described above, whether or not the procedures were performed in accordance with State or federal law. Also excludes any procedure undertaken because an individual suffers from a physical disorder, physical injury, or physical illness that is certified by a physician and  that would place the individual in imminent danger of death or impairment of major bodily function unless surgery is performed.

    Makes it unlawful for a health care provider that receives State funds to furnish, provide, or perform any health care service that constitutes the performance of or preparation for gender transition procedure to a minor.

    Bars State entities, local governments, and any organization with authority to license or discipline members of a profession from prohibiting, imposing any penalty, or taking any adverse action against any individual who gives or receives counsel, advice, guidance, or any other speech or communication, whether described as therapy or provided for a fee, consistent with conscience or religious belief.

    Explicitly allows parents, guardians, or custodians to withhold consent for any treatment, activity, or mental health care services that are designed and intended to form their child's conceptions of sex and gender or to treat gender dysphoria or gender nonconformity, without government infringement. Prohibits government agents, and State or local employees, or any other governmental entity, other than law enforcement, from encouraging or coercing a minor to withhold information from the minor's parent, or withholding from a minor's parent information relevant to the physical or mental health of their child as specified. Provides that such conduct is grounds for employee discipline in addition to other remedies under the Article. Establishes a duty for a government agent with knowledge that a minor under its care or supervision has exhibited symptoms of gender dysphoria, gender nonconformity, or otherwise demonstrates a desire to be treated in a manner incongruent with the minor's sex to immediately notify each of the minor's parents, guardians, or custodians in writing, with descriptions of relevant circumstances.

    Prohibits discrimination against persons providing or causing to be provided information or an act or omission regarding Article violations to his or her employer or specified public entities, testified or prepared to testify in a proceeding under the Article, or assisted or participated in a proceeding under the Article. Prohibits discrimination against persons who make disclosures under the Article believed to be a violation of law, rule, or regulation; any violation of any standard of care or other ethical guidelines for the provision of health care service; or gross mismanagement, a gross waste of funds, an abuse of authority, or a substantial and specific danger to public health or safety.

    Establishes a civil action for compensatory or special damages, injunctive relief, or other legal remedies for any person for any violation of the Article against the clinic, health care system, medical professional, or other responsible person. Provides a two-year statute of limitations, except allows for minors injured by practices prohibited by the Article to bring an action during their minority through a parent, and bring an action in their own name upon reaching majority at any time from that date until 20 years from the date the minor attained the age of majority. Allows for the award of monetary damages, total costs of the action and reasonable attorneys' fees, and any other appropriate relief.

    Preempts political subdivisions of the State from enacting, adopting, maintaining, or enforcing any order, ordinance, rule, regulation, policy, or similar measure that prohibits, restricts, limits, controls, or directs, or otherwise interferes with the professional conduct and judgement of a mental health care professional or counselor undertaken within the course of treatment and communication with clients, patients, other persons, or the public. Provides for enforcement by the Attorney General or a mental health care professional or counsel through an action for injunctive relief. Allows a mental health care professional to recover reasonable attorneys' fees and reasonable costs incurred in obtaining an injunction. Waives sovereign immunity to suit and immunity from liability under this statute.

    Enacts GS 143C-6-5.6 to prohibit the use of State Funds for the performance of or in furtherance of gender transition procedures or to support the administration of any governmental health plan or government-offered insurance policy offering gender transition procedures.

    Effective October 1, 2023.

    Section Two

    Enacts Article 3, Children’s Default to Safety Act, of GS Chapter 48A. Defines manufacturer as a person that is engaged in the business of manufacturing an electronic device and has an agent registered to conduct business in this State. Also defines activate, electronic device, internet, obscenity filter, smart phone, and tablet. Enacts GS 48A-22, requiring manufacturers to manufacture an electronic device (i.e., a tablet or smart phone) that, when activated in the State, automatically enables an obscenity filter that: (1) prevents the user from accessing or downloading material that is obscene to minors on mobile data networks, applications owned and controlled by the manufacturer, and wired or wireless internet networks; (2) notifies a user of the electronic device when the obscenity filter blocks the  device from downloading an application or accessing a website; (3) gives a user with a passcode the opportunity to unblock a filtered application or website; and (4) reasonably precludes a user other than a user with a passcode the opportunity to deactivate, modify, or uninstall the obscenity filter. Enacts GS 48A-23, which specifies that a manufacturer of an electronic device is liable if, on activation of an electronic device sold and activated in the State, the electronic device or manufacturer does the following: (1) the electronic device does not enable an obscenity filter that prevents the  display of obscene material to minors in such a way that minors will be to view the material, or the manufacturer knowingly or in reckless disregard provides the passcode to a minor to unblock the obscenity filter; or (2) the electronic device displays or disseminates obscene material to a minor, including any performance that is obscene to minors.

    Sets forth rules of construction and good faith exception to liability. Specifies that a person who is not the minor’s parent or legal guardian may not provide a minor with the passcode to remove the obscenity filter. Provides for actual and liquified damages of $10,000 when actual damages are difficult to ascertain. Allows for class actions. Enacts GS 48A-25 (civil action for enforcement) which provides for civil penalties if a manufacturer is found to be in violation of Article 3, of $10,000 per violation plus costs and attorneys’ fees, in addition to any other applicable penalty under state law.  Specifies that a plaintiff must prove, and a court must find, by clear and convincing evidence, that a manufacturer manufactured a device on or after October 1, 2023, and that it was activated in violation of Article 3. Directs that the plaintiff must prove all other elements by a preponderance of the evidence. Sets forth factors the court must consider in imposing any civil penalty. Allows for actions under GS 48A-25 to be brought by the Attorney General. If an action under GS 48A-25 is filed by an individual in the public interest sets notice requirement to Attorney General that must be satisfied before filing suit. 

    Enacts GS 48A-30 prohibiting public display or dissemination of obscene material to minors, as follows. Prohibits a person having custody, control, or supervision of any commercial establishment or newsstand from knowingly or purposefully doing any of the following: display obscene material to minors in certain ways, so that minors as part of the invited public will have to view the material; sell, furnish, present, distribute, or otherwise disseminate to a minor or allow a minor to view, with or without consideration, any obscene material; or present to a minor or participate in presenting to a minor, with or without consideration, any performance that is obscene to minors. Lists five defenses, including reasonable cause to believe the minor was 18 years of age, the person was acting as an employee of an educational institution or retail institution affiliated therewith or a library or a museum and serving the educational purposes of the institution/library/museum in line with policies disseminated by the institution/library/museum.  

    Contains severability clause. 

    Effective January 1, 2024, and applies to electronic devices manufactured in or outside this State or sold and activated in this State on or after that date.