Amends Article 1N of GS Chapter 90 by changing its title to “Gender Transition Procedures on Minors and Detransitioner Bill of Rights” (was, Gender Transition Procedures on Minors).

Amends GS 90-21.150 by adding definitions for the terms department, detransitioner, detransition procedure, female, gender clinic, and male. Defines detransition procedure as any treatment, including mental health treatment, medical interventions, and surgeries that (i) stop or reverse the effects of a prior surgical gender transition procedure or regimen of cross-sex hormones or puberty-blocking drugs due to the resolution of any inconsistency between the individual's sex and the individual's perceived sex or perceived gender or (ii) help an individual cope with the effects of a prior surgical gender transition procedure or regimen of cross-sex hormones or puberty-blocking drugs after the resolution of any inconsistency between the individual's sex and the individual's perceived sex or perceived gender.

Amends GS 90-21.151 making it unlawful for a medical professional to perform a detransition procedure. Amends GS 90-21.152(a) to add detransition procedure to the list of procedures a medical professional may provide if the minor's parents or guardians give informed consent.

Amends GS 90-21.153(a) stating that a violation of any of the provisions of Article 1N by a medical professional shall result in the revocation of the medical professional's license to practice for a minimum of one year. Adds a new subsection (b) stating that an entity that employs or contracts with a medical professional who violates Article 1N shall be liable for a civil penalty of up to $250,000.

Amends 90-21.154 clarifying that the liability to a minor for any medical professional who performs a surgical gender transition procedure on a minor or who prescribes, provides, or dispenses puberty-blocking drugs or cross-sex hormones to a minor or any entity who contracts with such medical professional shall be strict liability. Adds a new subsection (a1), allowing any individual who undergoes a detransition procedure to bring a civil action against a medical professional, either within 10 years from the day the person reaches 18 years of age or within four years from the time the cost of a detransition procedure is incurred, whichever date is later. Makes conforming changes to subsection (b) by adding injury caused by a detransition procedure under (a1) as grounds for a civil action. Changes the time limit for civil actions under subsection (b) to within the latter of 10 years (was, 25) from the day the minor reaches 18 years of age or four years from the time of discovery by the injured party of both the injury and the causal relationship between the treatment and the injury against the offending medical professional or entity. Adds “Costs associated with a subsequent detransition procedure” to the types of relief an individual may seek in a civil action under 90-21.154.

Enacts GS 90-21.155, which requires any gender clinic operating in the State to provide a report of statistics regarding all surgical gender transition procedures and prescribed regimens of cross-sex hormones or puberty-blocking drugs to patients to the Department of Health and Human Services (DHHS). Requires DHHS to develop a form for this report and determine the statistics that must be reported. Lists seven different types of information regarding patients, procedures, and medical providers that must be included in the report to DHHS. Requires each gender clinic to (i) complete a form to be signed by the medical professional who prescribes the surgical gender transition procedure or regimen of cross-sex hormones or puberty-blocking drugs or makes a referral for either, and (ii) transmit such form to DHHS within a prescribed amount of time.

Enacts GS 90-21.156, which prohibits cities and counties from (i) prohibiting the provision of mental health services or therapy to help a minor address an inconsistency between the minor's biological sex and the minor's perceived gender or perceived biological sex, or (ii) prohibiting a parent or legal guardian from consenting to, or withholding consent from, the provision of mental health services or therapy to help a minor address an inconsistency between the minor's biological sex and the minor's perceived gender or perceived biological sex.

Enacts GS 90-21.157, authorizing the Attorney General to investigate any complaints received alleging violation of Article 1N, to impose civil penalties for violations, and seek other appropriate relief under the Article. Enacts GS 90-21.158, requiring DHHS to submit an annual report on November 1st of each year to the Joint Legislative Oversight Committee on Health and Human Services that compiles the data required to be collected under this Article 1N. Specifies that the information in the report shall not disclose the identity of any person or entity that is the subject of any report. Requires DHHS to also publish the annual report on a publicly available website.

Enacts GS 58-3-257, requiring all health benefit plans that provide coverage for one or more gender transition procedures for insureds who are minors to also provide coverage for (i) all possible adverse consequences related to the gender transition procedure, (ii) testing and screening necessary to monitor the mental health and physical health of any insured on no less than an annual basis and without regard to the sex designation on the insured's medical record, and (iii) any procedure or treatment, including therapy, necessary to manage, reverse, or recover from the insured's previous gender transition procedure. Requires such coverage to be provided to all insureds that underwent a gender transition procedure as a minor regardless of whether that gender transition procedure occurred when the individual was not insured under the current health benefit plan. Clarifies that this statute does not require an insurer to provide any coverage for gender transition procedures. Requires an insurer offering a health benefit plan that provides coverage for gender transition or detransition procedures to report certain information regarding insurance claims and claimants to the Commissioner of Insurance of North Carolina and the Secretary of DHHS. Provides definitions that apply in the section. Becomes effective October 1, 2025, and applies to insurance contracts issued, renewed, or amended on or after that date.

Amends GS 130A-118, regarding amendment of birth and death certificates, clarifying that a new certificate of birth must be made by the State Registrar if any of the conditions specified in the statutes is met. Adds a new condition requiring the State Registrar to issue a new birth certificate upon written request from an individual to change the sex on that individual's birth record because the person is a destransitioner, if the request is accompanied by a notarized statement from a licensed physician certifying that the person has undergone a detransition procedure.

Enacts GS 90-21.5A, prohibiting any medical professional from denying a parent or legal guardian access to the medical records or medical information of the parent's or legal guardian's minor, except in the following circumstances: (1) the medical records or medical information relate to harm resulting from abuse, neglect, or domestic violence; (2) the person denying access reasonably believes (i) the parent or legal guardian is responsible for the abuse, neglect, or other injury resulting from domestic violence or (ii) that informing the parent or legal guardian would not be in the best interest of the minor. Clarifies that for purposes of this statute, the term “abuse, neglect, or domestic violence” does not include a parent's or legal guardian's refusal to permit the minor to seek a surgical gender transition procedure or regimen of cross-sex hormones or puberty-blocking drugs or a parent's or legal guardian's refusal to address the minor using pronouns that are inconsistent with the minor's sex. Creates a private right of action for any parent or legal guardian who is denied access to medical records or medical information in violation of this new statute, including availability of damages, equitable relief, and reasonable attorneys’ fees and court costs. Authorizes the Attorney General to investigate a potential violation of this new statute, seek production of documentation or testimony through a civil investigative demand, and bring an action to enforce compliance. Effective when it becomes law.

Effective October 1, 2025, except enactment of GS 90-21.5A (regarding access to medical records) is effective when bill becomes law. 

Includes a severability clause.